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158
CHAPTER 10 Therapy for Type 2 Diabetes
40. Hall TC, Pellen MG, Sedman PC, Jain PK . Preoperative factors predicting remis-
sion of type 2 diabetes mellitus after Roux-en-Y gastric bypass surgery for obe-
sity. Obes Surg 2010; 20 (9): 1245–1250 .
41. Terranova L, Busetto L, Vestri A, Zappa MA . Bariatric surgery: cost-effectiveness
and budget impact. Obes Surg 2012; 22 (4): 646–653 .
42. Schauer PR, Kashyap SR, Wolski K, et al . Bariatric surgery versus intensive medical
therapy in obese patients with diabetes. N Engl J Med 2012; 366 (17): 1567–1576 .
43. Mingrone G, Panunzi S, De Gaetano A, et al . Bariatric surgery versus conventional
medical therapy for type 2 diabetes. N Engl J Med 2012; 366 (17): 1577–1585 .
44. Carlsson LM, Peltonen M, Ahlin S, et al . Bariatric surgery and prevention of type
2 diabetes in Swedish obese subjects. N Engl J Med 2012; 367 (8): 695–704 .
45. Adams TD, Gress RE, Smith SC, et al . Long-term mortality after gastric bypass
surgery. N Engl J Med 2007; 357 (8): 753–761 .
46. Reoch J, Mottillo S, Shimony A, et al . Safety of laparoscopic vs open bariatric sur-
gery: a systematic review and meta-analysis. Arch Surg 2011; 146 (11): 1314–1322 .
47. Gerstein HC, Miller ME, Genuth S, et al . Long-term effects of intensive glucose
lowering on cardiovascular outcomes. N Engl J Med 2011; 364 (9): 818–828 .
48. Patel A, MacMahon S, Chalmers J, et al . Intensive blood glucose con-
trol and vascular outcomes in patients with type 2 diabetes. N Engl J Med
2008; 358 (24): 2560–2572 .
49. Ohkubo Y, Kishikawa H, Araki E, et al . Intensive insulin therapy prevents the
progression of diabetic microvascular complications in Japanese patients with
non-insulin-dependent diabetes mellitus: a randomized prospective 6-year
study. Diabetes Res Clin Pract 1995; 28 (2): 103–117 .
50. Intensive blood-glucose control with sulphonylureas or insulin compared with
conventional treatment and risk of complications in patients with type 2 dia-
betes (UKPDS 33). UK Prospective Diabetes Study (UKPDS) Group. Lancet
1998; 352 (9131): 837–853 .
51. Effect of intensive blood-glucose control with metformin on complications in
overweight patients with type 2 diabetes (UKPDS 34). UK Prospective Diabetes
Study (UKPDS) Group. Lancet 1998; 352 (9131): 854–865 .
52. Duckworth W, Abraira C, Moritz T, et al . Glucose control and vascular compli-
cations in veterans with type 2 diabetes. N Engl J Med 2009; 360 (2): 129–139 .
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Index
A
AASK TRIAL, 133
ABCIXIMAB, 27, 32t, 120
Acarbose, 149
ACCOMPLISH study,
136–38
ACCORD trial, 104–5, 132,
147t
ACE inhibitors
acute coronary
syndromes, 24
angina pectoris, 21
atrial fi brillation, 73
blood pressure control, 132
combination therapy,
137–38
hypertension, 133, 135
peripheral artery disease
(PAD), 87–88t, 90
RAAS blockade, 135–36
valvular heart disease, 39
ACT34-CMI trial, 31
ACTION Registry-GWTG
scores, 26t
ACTIVE-A trial, 67
ACTIVE-I trial, 73
ACTIVE-W trial, 66–67
ACUITY trial, 120–21, 121f
Acute coronary syndromes
antithrombotics dosing,
31–33t, 118, 119
cardiac biomarkers, 23
clinical manifestations, 1, 2f
clinical presentation, 23
electrocardiogram, 23
endothelial disruption, 38
epidemiology, 4, 22
fi brinolytic drugs, 29–30t
management, 23–24, 26
non-ST-elevation acute
coronary syndrome
(NSTE-ACS), 8, 114,
120, 123
non-ST elevation MI
(NSTEMI) (see non-ST
elevation MI (NSTEMI))
overview, 22
PAR-1 antagonists, 119–20
pathophysiology, 22
prasugrel (see prasugrel)
prognosis, 22
reperfusion therapy,
27–28, 29–30t
rivaroxaban, 70, 123–24
ST-elevation MI (STEMI)
(see ST-elevation MI
(STEMI))
ticagrelor (see ticagrelor)
Adult Treatment Panel IV
guidelines, 105–6
ADVANCE trial, 147t
Aerobic exercise, 146–48
African-Americans, 7, 49, 50,
129, 134
Age as risk factor, 5–6
AIM-HIGH trial, 104
Alcohol, 57–58, 58t, 101
Aldosterone antagonists,
73, 136
Aliskiren, 136
ALLHAT trial, 134, 138, 139
Alpha-1 blockers, 139
Alpha-glucosidase inhibitors,
149
Alteplase, 32t
Amaurosis fugax, 53
Amlodipine, 134, 136–38
Angina pectoris
ABI as risk predictor, 82
anatomical, functional
investigation, 20
classifi cation, 19, 20t
epidemiology, 19
hypertension (see
hypertension)
management, 20–21, 24
pathophysiology, 19
percutaneous coronary
intervention (PCI),
21–22, 24
revascularization strategy,
21–22
Angiotensin receptor
blockers (ARBs)
atrial fi brillation, 73
hypertension, 133
peripheral artery disease
(PAD), 87–88t, 90
RAAS blockade, 135–36
valvular heart disease, 39
Ankle–brachial index (ABI),
79, 81–84, 82f
Anticoagulation. see also
specifi c agents
acute coronary syndromes
dosing, 32t
NSTEMI/UA, 26
in secondary prevention of
stroke, 58–59
valvular heart disease, 40
Antihypertensives, 133–35.
see also specifi c agents
Antiplatelet agents. see also
specifi c agents
atrial fi brillation, 66–67
dual therapy, 58, 59t, 87t,
89–90, 116
in secondary prevention of
stroke, 58–59, 58t, 59t
Antithrombotic therapy
aspirin (see aspirin)
atrial fi brillation, 66–67
benefi ts of, 111
dosing, ACS, 31–33t
P2Y12 antagonists, 113,
114f (see also specifi c
agents)
Antithrombotic Trialists’
Collaboration (ATC), 112
Aortic stenosis
biomarkers, 39–40
pathophysiology, 37–38
pharmacologic
management, 38–39
prognosis, 38
transcatheter aortic valve
replacement (TAVR),
41–45, 42–43f
“valve in valve”
implantation, 45
Apixaban, 67t, 70, 72, 124
Apoplipoprotein E4, 39
ARBITER 6-HALTS study,
102–3
ARCTIC trial, 116–17
ARIC study, 7, 50, 80t, 131
ARISTOTLE Trial, 70, 70t
ASCOT trial, 134
Asians, 49
Aspirin
acute coronary
syndromes, 23–24, 26
acute coronary syndromes
dosing, 31t
angina pectoris, 21
atrial fi brillation, 66–67
clopidogrel vs., 115
dosing, 111, 113
fi brinolytics vs., 113
hypertension, 112
mechanism of action, 111
Page numbers followed by t indicate a table and f indicate a fi gure.
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INDEX
Aspirin (Cont.)
myocardial infarction,
23–24, 111–13
NSTEMI, 25
percutaneous coronary
intervention (PCI), 113
peripheral artery disease
(PAD), 87t, 89–90, 116
primary prevention role,
11, 111–12
secondary prevention, 113
stroke prevention, 57
ticlopidine vs., 113
valvular heart disease, 40
warfarin vs., 112
ASTRONOMER trial, 39
Atenolol, 134
Atheromatosis, 38
Atherosclerosis
biomarkers, 39–40
defi ned, 1
pathophysiology, 37–38
pharmacologic
management, 38–39
plaques, 52–53, 52t
prognosis, 38
as risk factor, 7
Atherosclerotic
cardiovascular disease
(ASCVD), 95, 97–99,
101–5
Atherothrombosis
clinical manifestations, 1, 2f
defi ned, 1
epidemiology, 4–5
pathophysiology, 1–3,
3f, 65
plaques, 52–53, 52t
polyvascular disease,
7–9, 8f
primary prevention,
9–12, 10t
risk assessment, 9, 10t
risk factors, 5–7, 5t, 65
ATLAS ACS 2-TIMI 51 trial,
70, 123
Atopaxar, 119–20
Atorvastatin, 24, 101
Atrial fi brillation
ACE inhibitors, ARBs, 73
aldosterone antagonists,
73, 136
antithrombotic therapy,
66–67
apixaban, 67t, 70, 72
dabigatran, 67–68t,
67–69, 72
edoxaban, 70–71
epidemiology, 65
genetic markers, 51
nonvalvular, thrombosis
prophylaxis, 41
omega-3 fatty acids, 73–74
post-TAVR, 44–45
practical considerations,
71–72, 72t
risk factors, 65
risk stratifi cation, 66
rivaroxaban, 67t, 69–70, 72
statins, 74
in stroke classifi cation, 49
stroke prevention in
setting of, 59
as thrombotic risk, 40, 65–66
upstream therapies, 72
warfarin, 65–69, 68–70t,
71, 72
B
Bariatric surgery, 151–55,
152f, 154f
BARI 2D trial, 21
Barostim (Rheos Hypertension
System), 139
Basilar artery disease, 54
Benazepril, 137
Beta-blockers
acute coronary
syndromes, 24
angina pectoris, 21, 24
hypertension, 133–34,
137–38
myocardial infarction, 21
peripheral artery disease
(PAD), 88t
Betrixaban, 71
Biguanides, 147t, 148
Bile acid sequestrants,
99–100t, 102, 103
Bisphosphonates, 39
Bivalirudin
acute coronary syndromes
dosing, 32t
benefi ts, effi cacy, 120–21,
121f
NSTEMI, 29t
NSTEMI/UA, 26–27
percutaneous coronary
intervention (PCI), 121–22
STEMI, 30t
Brain natriuretic peptide, 39
Bromocriptine, 150
C
CADASIL, 51
Calcifi c degenerative aortic
valve disease, 37
Calcifi ed nodules, 2–3, 3f
Calcium channel blockers,
21, 24, 134–38
CAMELOT trial, 134
Candesartan, 73
Cangrelor, 124
CAPRIE trial, 115
Captopril Prevention Project
(CAPPP), 134
Cardiovascular Health Study,
80t
Carotid Doppler, 55, 56t
Carotid endarterectomy,
stenting, 57, 60
Carotid intima medial
thickness (CIMT), 102–3
Carvedilol, 137
CAVAATAS study, 60
Cerebrovascular disease
atherothrombotic,
prevention/treatment,
55–60, 58–59t
clopidogrel, 114–16
diagnosis, screening, 55, 56t
extracranial, 51–54, 52t
GP IIb/IIIa inhibitors, 27,
32t, 120, 121
intracranial, 54–55, 54t
lipohyalinosis, 54–55
as risk factor for PAD, 81–82
stroke (see stroke)
transient ischemic attacks
(TIAs), 1, 2f, 50–53,
57–58, 112, 118
Cervical bruits, 55
CHADS
2
risk stratifi cation, 66
CHARISMA trial, 58, 59t, 115
CHA
s
DS
2
VASc score, 66
Chlorothiazide, 133, 135
Chlorthalidone, 133, 134, 139
Cholesterol
HDL-C, 97–98, 100–101
LDL-C, 95–97, 97–98f, 101–4
as risk factor, 6
triglycerides, 98–99, 101–4
Cholesterol absorption
inhibitors, 99t, 102–4
Cholesterol Treatment
Trialists (CTT), 101–2
Chronic kidney disease, 7
Cilostazol, 87t, 90
Clopidogrel
acute coronary
syndromes, 24, 26
acute coronary syndromes
dosing, 31t
angina pectoris, 21
aspirin vs., 115
atrial fi brillation, 66–67
benefi ts, effi cacy, 114–16
cerebrovascular disease,
114–16
dosing, duration of
therapy, 116, 117
fi brinolytics vs., 114–15
GP IIb/IIIa inhibitors vs., 120
mechanism of action, 117
myocardial infarction,
114–16
NSTEMI, 29t
peripheral artery disease
(PAD), 87t, 89–90,
115, 116
prasugrel vs., 117–18, 118f
response variability,
116–17
in secondary prevention of
stroke, 58, 59t
STEMI, 30t, 114–15
stroke, 114–16
ticagrelor vs., 118–19, 119f
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INDEX
COGENT trial, 117
COMMIT trial, 115
Computed tomographic
angiography (CTA),
55, 56t
Coronary artery bypass
grafting (CABG), 21–22
Coronary artery disease
(CAD)
biomarkers, 31, 39–40
epidemiology, 19
future directions, 31
risk factors, 51–52
Coronary Drug Project
(CDP), 103
Coronary heart disease (CHD)
ABI as risk predictor, 82
polyvascular disease, 7–9, 8f
prevalence, 4
risk factors, 6, 7
triglycerides, 98–99
COURAGE trial, 21, 22
C-reactive protein, 39
CREDO trial, 115–16
CREST study, 60
CRUSADE, 8
CURE trial, 114, 115
CURRENT-OASIS 7 trial, 26,
113, 116
D
Dabigatran, 67–68t, 67–69, 72
Dapaglifl ozin, 151
DAPT trial, 116
DASH diet, 133
DECODE group, 51
Diabetes mellitus
aerobic exercise, 146–48
alpha-glucosidase
inhibitors, 149
bariatric surgery, 151–55,
152f, 154f
bromocriptine, 150
clinical trials, 146–48, 147t
complications, 152f
dapaglifl ozin, 151
diagnosis, 145
dopamine-2 agonists, 150
DPP-4 inhibitors, 149–50
epidemiology, 145
fi brate/statin therapy, 105
glinides, 148–49
GLP-1 receptor agonists,
149–50
GP IIb/IIIa inhibitors, 27,
32t, 120, 121
hypertension (see
hypertension)
incretin analogs, 149–50
insulin therapy, 147t, 150–51
lifestyle modifi cation, 146–48
metformin, 147t, 148, 151
pathophysiology, 145–46
pharmacological therapy
considerations, 151
pramlintide, 150
as risk factor, 6, 51, 81
statins (see statins)
stroke prevention, 21, 57, 58
sulfonylureas, 147t,
148–49, 151
thiazolidinediones, 149
Diabetes Prevention
Program (DPP) study,
146, 147t
Dietary guidelines, 10–11
Diltiazem, 136–37
Dipyridamole, 58, 59t
Diuretics, 133, 135
Dopamine-2 agonists, 150
Doxazosin, 139
DPP-4 inhibitors, 149–50
E
EARLY-ACS trial, 120
ECASS III study, 60
Edoxaban, 70–71
Edwards Sapien Valve, 41
EMPHASIS-HF trial, 73
ENGAGE AF TIMI-48 study,
70–71
ENHANCE study, 102
Enoxaparin, 26, 32t, 123
Epidemiologic transition, 4
Eplerenone, 73
Eptifi batide, 27, 32t, 120
EUROPA study, 21
European EVA-3S study, 60
Exenatide, 149–50
Exercise
aerobic, 146–48
angina pectoris, 21
benefi ts, guidelines, 11
lipid modifying therapies,
100, 101
in secondary prevention of
stroke, 57–58, 58t
supervised treadmill exercise
program (STEP), 89
Ezetimibe, 99t, 102–4
F
Factor Xa agents, stroke
prevention, 59
Family history as risk factor, 6
Felodipine, 131
Fenofi brate, 101
FEVER study, 131
Fibrates, 100t, 104–5
Fibrinolytics
acute myocardial
infarction, 30t
acute myocardial infarction
dosing, 32–33t
aspirin vs., 113
clopidogrel vs., 114–15
prosthetic mechanical
valve thrombosis, 41
Fluvastatin, 101
Fondaparinux
acute coronary syndromes
dosing, 32t
benefi ts, effi cacy, 123
NSTEMI, 29t
NSTEMI/UA, 26
percutaneous coronary
intervention (PCI), 123
STEMI, 30t, 123
Fractional fl ow reserve
(FFR), 22
Framingham Heart Study,
4, 131
Framingham Offspring Study,
80t, 81
Framingham Risk Score
(FRS), 82
Framingham risk score-
revised, 9
FRISC-2 trial, 27
Furosemide, 135
G
Gemfi brozil, 105
GISSI-AF study, 73
Glinides, 148–49
GLP-1 receptor agonists,
149–50
Glucagon, 146
GP IIb/IIIa inhibitors, 27, 32t,
120, 121
GRACE scores, 26t
GRAVITAS trial, 116
H
HAS-BLED score, 66
HDL Atherosclerosis
Treatment (HATS)
study, 103–4
Heart Protection Study, 90
Hematopoietic stem cells, 31
High-density lipoprotein
cholesterol (HDL-C),
97–98, 100–101
HOPE study, 21, 90
HPS2-THRIVE trial, 104
Hydralazine, 139
Hydrochlorothiazide, 133,
135, 137
Hyperlipidemia, 39, 57–58, 58t
Hypertension
ACE inhibitors, 133, 135
antihypertensive therapy
selection, 133–35
aspirin, 112
Barostim (Rheos
Hypertension System),
139
beta-blockers, 133–34,
137–38
blood pressure goals,
131–33
combination therapy,
137–38
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INDEX
Hypertension (Cont.)
epidemiology, 129–30
lifestyle modifi cations, 133
patient selection for
treatment, 130–31
renal sympathetic
denervation treatment
(RDT), 139–40, 140f
resistant, 138–40, 138t, 139f
as risk factor, 6, 51, 65
secondary causes, 138t
in secondary prevention of
stroke, 57–58, 58t
thiazide diuretics, 133, 135
Hypertension Optimal
Treatment (HOT) trial,
112, 132
Hypobetalipoproteinemia, 97
HYVET trial, 132
I
ICTUS trial, 27
IDEAL study, 98
IMPROVE-IT, 103
Incretin analogs, 149–50
Indapamide, 133
Insulin, 146
Insulin therapy, 147t, 150–51
INTERHEART study, 6
Intermittent claudication, 79,
80t, 81, 88–90
INTERSTROKE study, 50
Intravenous recombinant
tissue plasminogen
activator (IV-rtPA), 60
INVEST trial, 130, 132
Irbesartan, 73
ISAR-REACT trial, 120
ISCHEMIA trial, 22, 31
Ivabradine, 21
L
Laropiprant, 100t
Leptin, 39
Life expectancy, 4
Lifestyle Heart Trial, 99
Lifestyle modifi cation
angina pectoris, 21
DASH diet, 133
dietary guidelines, 10–11
hypertension, 133
lipid modifying therapies,
99–100t, 99–101
Mediterranean diet, 100
as primary prevention, 9–10
smoking (see smoking)
LIFE trial, 137
Lipid modifying therapies
Adult Treatment Panel IV
guidelines, 105–6
atherosclerotic
cardiovascular disease
(ASCVD), 95, 97–99,
101–5
bile acid sequestrants,
99–100t, 102, 103
carotid intima medial
thickness (CIMT), 102–3
cholesterol absorption
inhibitors (ezetimibe),
99t, 102–4
exercise, 100, 101
fi brates, 100t, 104–5
high-density lipoprotein
cholesterol (HDL-C),
97–98, 100–101
laropiprant, 100t
lifestyle modifi cation,
99–100t, 99–101
lipid disorder
epidemiology, 95–99,
96–98f
low-density lipoprotein
cholesterol (LDL-C),
95–97, 97–98f, 101–4
niacin (nicotinic acid), 99,
99–100t, 102
omega-3 fatty acids, 99,
100, 100t, 105
PCSK9 inhibitors, 102
pharmacotherapies, 99,
99–100t
smoking cessation, 100
statins, 97, 98f, 99t, 101–2,
104
triglycerides, 98–99, 101–4
Lipohyalinosis, 54–55
Liraglutide, 149–50
Lisinopril, 134
Look AHEAD study, 146, 147t
Loop diuretics, 135
Losartan, 136, 137
Low-density lipoprotein
cholesterol (LDL-C),
95–97, 97–98f, 101–4
Low molecular weight
heparin (LMWH),
29–30t, 120–21
M
Magnetic resonance angiography
(MRA), 55, 56t
MATCH study, 58, 59t
MDRD trial, 133
Mediterranean diet, 100
MELAS, 51
MESA study, 79, 80t
Metformin, 147t, 148, 151
Metolazone, 135
Miglitol, 149
Minoxidil, 139
Myocardial infarction
ABI as risk predictor, 82
aspirin, 23–24, 111–13
beta-blockers, 21
CABG surgery, 21
cardiac biomarkers, 23
clopidogrel, 114–16
high-density lipoprotein
cholesterol (HDL-C),
97–98
polyvascular disease, 7–9, 8f
prevalence, 4
primary prevention, 11
revascularization strategy,
21–22
risk factors, 5–6
warfarin, 69
Myonecrosis detection, 23, 120
Myopathy, 102
N
National Health and
Nutrition Examination
Survey (NHANES), 80t,
81, 129
Niacin (nicotinic acid), 99,
99–100t, 102
Nifedipine, 136–37
NINDS TPA study, 60
Nitrates, 21, 24
Non-ST-elevation acute
coronary syndrome
(NSTE-ACS), 8, 114,
120, 123
Non-ST elevation MI (NSTEMI)
cardiac biomarkers, 23
clinical presentation, 23
electrocardiogram, 23
epidemiology,
prognosis, 22
fi brinolytic drugs, 29t
management, 23–24, 25–27
pathophysiology, 22
revascularization strategy,
timing, 27
risk stratifi cation,
prediction scores,
24–25, 25–26t
O
OASIS-5/6 trials, 123
Obesity, 7, 57–58, 58t
Omega-3 fatty acids
atrial fi brillation, 73–74
lipid modifying therapies,
99, 100, 100t, 105
Omeprazole, 117
ONTARGET trial, 136
Optimal medical treatment
(OMT), 21–22, 31
Osteopontin, 39
P
PAR-1 antagonists, 119–20
PARTNERS study, 41–42, 44,
79, 80t
PCSK9 inhibitors, 102
PEGASUS trial, 119
Percutaneous coronary
intervention (PCI)
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INDEX
antithrombotics dosing,
31–32t
aspirin, stroke prevention,
113
bivalirudin, 121–22
cangrelor, 124
clopidogrel, 115–18, 118f
fondaparinux, 123
GP IIb/IIIa inhibitors, 120
LMWH, 121
prasugrel, 117–18, 118f
stable angina, 21–22, 24
ticagrelor, 30t
UA/STEMI, 26–28, 30t
Peripheral artery disease
(PAD)
ACE inhibitors/ARBs,
87–88t, 90
ankle–brachial index (ABI),
79, 81–84, 82f
ASA/clopidogrel, 87t,
89–90, 116
beta-blockers, 88t
cardiovascular mortality
risk, 82–83, 82f
cilostazol, 87t, 90
clinical evaluation, 83–86,
85t, 86f
clopidogrel, 87t, 89–90,
115
CVD as risk factor, 81–82
epidemiology, 4,
79–81, 80t
intermittent claudication,
79, 80t, 81, 88–90
limb ischemia, 85–86, 88t
management, 86–91, 87–88t
overview, 79, 91
pathophysiology, 2f
revascularization therapy,
90–91
as risk factor, 7
risk factors, 81
Rutherford Classifi cation,
84, 85t
6-minute walk test, 84–85
smoking cessation, 87t,
88–89
statins, 87–88t, 90
supervised treadmill
exercise program
(STEP), 89
Physicians’ Health Study, 111
Picotamide, 124
Pioglitazone, 149
Plaque erosion, 2, 3f
Plaque rupture, 2, 3f
PLATO trial, 24, 119
Polyvascular disease, 7–9, 8f
Pramlintide, 150
Prasugrel
acute coronary
syndromes, 24, 26, 118
acute coronary syndromes
dosing, 31t, 118
benefi ts, effi cacy, 117–18,
118f
clopidogrel vs., 117–18,
118f
contraindications, 118
mechanism of action, 117
NSTEMI, 29t
percutaneous coronary
intervention (PCI),
117–18, 118f
STEMI, 30t
Primary Prevention Project, 112
PRODIGY trial, 116
PRoFESS study, 58, 59t
Prosthetic mechanical valve
thrombosis, 41
Proton pump inhibitors
(PPIs), 117
PURSUIT scores, 26t
R
RAAS blockade, 135–36
RAAS system, 38, 72, 135
Ranolazine, 21
REACH registry, 8, 50, 57, 83
REDUCE-IT trial, 105
REIN-2 trial, 133
RE-LY trial, 67, 68t
Renal sympathetic
denervation treatment
(RDT), 139–40, 140f
RENEW trial, 31
Reperfusion therapy, 27–28,
29–30t
Reteplase, 33t
Reynolds score, 9
Rhabdomyolysis, 102
Rheos Hypertension System
(Barostim), 139
RITA-3 trial, 27
Rivaroxaban, 67t, 69–70, 72,
123–24
ROCKET-AF trial, 69, 69t
Rose questionnaire, 81
Rosiglitazone, 149
Rosuvastatin, 101
Roux-en-Y gastric bypass,
151–55, 152f, 154f
Rutherford Classifi cation,
84, 85t
S
SALTIRE trial, 39
San Diego Claudication
Questionnaire, 81
SEAS trial, 39
SHARP trial, 103
SHEP trial, 130, 132
Simvastatin, 101, 103
6-minute walk test, 84–85
Smoking
cessation therapy, 87t,
88–89, 100
as risk factor, 6–7, 81
in secondary prevention of
stroke, 57–58, 58t
SPS3 study, 58, 59t
Stable angina. see angina
pectoris
STAMPEDE trial, 153
Statins
acute coronary
syndromes, 24
angina pectoris, 21
atrial fi brillation, 74
fi brate interactions, 105
lipid modifying therapies,
97, 98f, 99t, 101–2, 104
peripheral artery disease
(PAD), 87–88t, 90
side effects, 102
stroke prevention, 57
valvular heart disease,
38–39
ST elevation MI (STEMI)
bivalirudin, 120–21, 121f
cardiac biomarkers, 23
clinical presentation, 23
clopidogrel, 114–15
epidemiology,
prognosis, 22
fi brinolytic drugs, 30t
fondaparinux (see
fondaparinux)
management, 23–24
pathophysiology, 22
reperfusion therapy,
27–28, 29–30t
STOP-Hypertension-2 trial, 134
Streptokinase, 33t
Stroke
acute therapies, 60
AF-related, 65
apixaban, 67t, 70
ASA therapy, 58, 59t
aspirin dosage, 113
atherothrombotic/
atherosclerotic plaques,
52–53, 52t
carotid endarterectomy,
stenting, 57, 60
clopidogrel, 114–16
dissection, 53–54
epidemiology, 4, 49, 55–57
genetic factors, 51
geographic factors, 51
hemorrhagic, 45, 102, 112
lacunar, 54–55, 54t
pathophysiology, 1, 2f
plaque prevention, 57
plaque rupture, 53
polyvascular disease,
7–9, 8f
post-TAVR, 42–45
prasugrel, 118
primary prevention, 112
risk factors, 40, 49–51, 50t
risk reduction, 6
secondary prevention,
57–58, 58t
symptomatology, 53
types, 49
warfarin, 59, 70, 70t
https://t.me/med1917
164
INDEX
Stroke Belt, 51
Strong Heart Study, 80t, 81
Sulfonylureas, 147t, 148–49,
151
Supervised treadmill exercise
program (STEP), 89
Swedish Obese Subjects
study, 154
Symplicity HTN-3 trial, 140,
140f
SYNTAX trial, 21
T
TAVR (transcatheter aortic
valve replacement),
41–45, 42–43f
Telmisartan, 136
Tenecteplase, 33t
Terazosin, 139
Thiazide diuretics, 133, 135
Thiazolidinediones, 149
Thienopyridine, 123–24
Thrombosis Prevention
Trial, 112
Ticagrelor
acute coronary
syndromes, 24, 26
acute coronary syndromes
dosing, 32t, 119
benefi ts, effi cacy, 118–19,
119f
clopidogrel vs., 118–19, 119f
NSTEMI, 29t
STEMI, 30t
Ticlopidine, 113
TIMACS trial, 27
TIMI scores, 26t
Tirofi ban, 27, 32t, 120
TNT study, 98
Torsemide, 135
Transaminitis, asymptomatic,
102
Transcatheter aortic valve
replacement (TAVR),
41–45, 42–43f
Transcranial Doppler (TCD),
55, 56t
Transient ischemic attacks
(TIAs), 1, 2f, 50–53,
57–58, 112, 118
TRA2P-TIMI 50 trial, 120
Triglycerides, 98–99, 101–4
TRILOGY ACS trial, 24,
118
Trimetazidine, 21
TRITON-TIMI 38 trial, 24,
117–18, 118f
TROPHY study, 131
Troponins, cardiac, 23
Type 2 diabetes. see diabetes
mellitus
U
UKPDS trials, 147t, 151
Unfractionated heparin
(UFH)
acute coronary syndromes
dosing, 32t
NSTEMI, 29t
NSTEMI/UA, 26
overview, 121
STEMI, 30t
Unstable angina
cardiac biomarkers, 23
clinical presentation, 23
management, 23–24, 26
pathophysiology, 22
revascularization strategy,
timing, 27
risk stratifi cation,
prediction scores,
24–25, 25–26t
U.S. Preventive Task Force,
11
V
VA Cooperative trial, 130
VADT trial, 147t
VA-HIT trial, 104–5
Valsartan, 73, 134
VALUE trial, 134
Valve Academic Research
Consortium (VARC), 42
“Valve in valve” implantation,
45
Valvular heart disease
anticoagulation, 40
biomarkers, 39–40
overview, 37
pathophysiology, 37–38
pharmacologic
management, 38–39
prognosis, 38
prosthetic mechanical
valve thrombosis, 41
thrombotic risks, 40–41
valve replacement, 40
Vasospastic angina, 21
Verapamil, 136–37
Veteran’s Affairs Normative
Aging Study (VA NAS),
101
Vorapaxar, 58, 59t, 119–20
W
Warfarin
aspirin vs., 112
atrial fi brillation, 65–69,
68–70t, 71, 72
benefi ts, effi cacy, 123
fi brate interactions, 105
myocardial infarction, 69
stroke, 59, 70, 70t
ticlopidine vs., 113
valvular heart disease, 40
Women’s Health Study, 112
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