Effect of chronic statin pretreatment on hospital outcome in patients with acute non-ST-elevation myocardial infarction.

J Cardiovasc Pharmacol. 2009 Feb;53(2):132-6

Authors: Bauer T, Böhm M, Zahn R, Jünger C, Koeth O, Gitt A, Bestehorn K, Senges J, Zeymer U,

PURPOSE: We sought to investigate the impact of prior statin therapy on in-hospital outcome in patients presenting with acute non-ST-elevation myocardial infarction. METHODS AND RESULTS: We analyzed the data of consecutive patients with non-ST-elevation myocardial infarction who were prospectively enrolled in the German Acute Coronary Syndrome Registry between July 2000 and November 2002. Overall, 6358 patients were included, and we compared the patients who received statins before hospital admission (n = 1247, 19.6%) with those who did not (n = 5111, 80.4%). There was no age difference between the two groups; however, pretreated patients had a higher incidence of prior atherothrombotic events diabetes mellitus and renal insufficiency. The percentage of patients undergoing percutaneous coronary intervention and coronary artery bypass grafting was similar. Infarct size measured by peak creatine kinase level was lower in statin users (238 vs. 283 U/L, P < 0.0001). After adjustment for confounding variables, a significant reduction of in-hospital death could be observed in patients on statins (odds ratio 0.65, 95% confidence interval 0.46-0.90). CONCLUSIONS: In clinical practice, pretreatment with statins was associated with smaller myocardial infarction size (peak creatine kinase level) and a significant reduction of hospital mortality. However, the data were obtained from an observational study, and the results need further prospective confirmation.

PMID: 19188836 [PubMed - indexed for MEDLINE]

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The place of hybrid therapies with drugs to supplement nonpharmacological therapies in atrial fibrillation.

J Cardiovasc Pharmacol. 2008 Sep;52(3):210-21

Authors: Govindan M, Catanchin A, Camm AJ

Atrial fibrillation (AF) is one of the most common cardiac arrhythmias, and its prevalence continues to rise as the aged population increases. Comparative studies of rhythm control and rate control have been equivocal; however, the benefits of rhythm control may have been offset by the limitations of antiarrhythmic drugs. More recently, nonpharmacological therapies have emerged that provide hope of more effective rhythm control. Catheter ablation techniques have gained favour with high success rates in specialized centers, although these techniques are not without complications and require considerable expertise. Pacing therapies designed to reduce harmful right ventricular pacing and increase physiological pacing have shown benefit in AF patients with bradycardia. Despite this progress, no single modality confers benefit for all patients. Strategies to combine these treatment modalities in a hybrid approach has shown increasing promise for subgroups of AF patients.

PMID: 18806601 [PubMed - indexed for MEDLINE]

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Biological therapies for atrial fibrillation.

J Cardiovasc Pharmacol. 2008 Sep;52(3):222-7

Authors: Amit G, Qin H, Donahue JK

Atrial fibrillation is a prominent cause of morbidity and mortality in developed countries. Current treatment strategies center on controlling heart rate while allowing fibrillation to persist or targeting fibrillation primarily and attempting to maintain sinus rhythm. Pharmacological therapies are largely successful for rate control, although mild toxicities are common. Rhythm control strategies are often unsuccessful, leaving patients in atrial fibrillation despite attempts to maintain sinus rhythm. This review will discuss novel biological strategies that are currently under development and may eventually have impact on the management of atrial fibrillation.

PMID: 18806602 [PubMed - indexed for MEDLINE]

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