0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Articles |

Statin and β-Blocker Therapy and the Initial Presentation of Coronary Heart Disease

Alan S. Go, MD; Carlos Iribarren, MD, MPH, PhD; Malini Chandra, MS, MBA; Phenius V. Lathon; Stephen P. Fortmann, MD; Thomas Quertermous, MD; Mark A. Hlatky, MD, Atherosclerotic Disease, Vascular Function and Genetic Epidemiology (ADVANCE) Study
[+] Article and Author Information

From Kaiser Permanente of Northern California, Oakland, California; University of California, San Francisco, San Francisco, California; and Stanford University School of Medicine, Stanford, California.


Grant Support: By the Donald W. Reynolds Foundation, Las Vegas, Nevada.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Alan S. Go, MD, Division of Research, Kaiser Permanente of Northern California, 2000 Broadway Street, 3rd Floor, Oakland, CA 94612-2304; e-mail, Alan.S.Go@kp.org.

Current Author Addresses: Drs. Go and Iribarren, Ms. Chandra, and Mr. Lathon: Division of Research, Kaiser Permanente of Northern California, 2000 Broadway Street, 3rd Floor, Oakland, CA 94612-2304.

Dr. Fortmann: Stanford Medical School, Hoover Pavillion, MD 5705, Stanford, CA 94305-5705.

Dr. Quertermous: Stanford University, Falk Building, 300 Pasteur Drive, Stanford, CA 94305.

Dr. Hlatky: Stanford University, HRP Redwood Building, Room 150, Stanford, CA 94305.

Author Contributions: Conception and design: A.S. Go, C. Iribarren, M. Chandra, S.P. Fortmann, T. Quertermous, M.A. Hlatky.

Analysis and interpretation of the data: A.S. Go, C. Iribarren, M. Chandra, P.V. Lathon, S.P. Fortmann, M.A. Hlatky.

Drafting of the article: A.S. Go, M. Chandra, M.A. Hlatky.

Critical revision of the article for important intellectual content: A.S. Go, C. Iribarren, M. Chandra, P.V. Lathon, S.P. Fortmann, T. Quertermous, M.A. Hlatky.

Final approval of the article: A.S. Go, C. Iribarren, M. Chandra, P.V. Lathon, S.P. Fortmann, T. Quertermous, M.A. Hlatky.

Provision of study materials or patients: A.S. Go.

Statistical expertise: A.S. Go, M. Chandra, M.A. Hlatky.

Obtaining of funding: A.S. Go, C. Iribarren, S.P. Fortmann, T. Quertermous, M.A. Hlatky.

Administrative, technical, or logistic support: A.S. Go, M. Chandra, P.V. Lathon, T. Quertermous, M.A. Hlatky.

Collection and assembly of data: A.S. Go, C. Iribarren, M. Chandra, P.V. Lathon, M.A. Hlatky.


Ann Intern Med. 2006;144(4):229-238. doi:10.7326/0003-4819-144-4-200602210-00004
Text Size: A A A

The natural history of coronary atherosclerosis is characterized by long periods of clinical stability punctuated by episodes of unstable, acute ischemic symptoms that are associated with atherosclerotic plaque rupture and thrombosis. Much of the risk for coronary disease is the consequence of these episodes of clinical instability, particularly at the point when the first symptoms of the disease develop. Systematic differences among patients may affect patients' vulnerability to acute ischemic episodes and may allow identification of higher-risk patients who may benefit from more aggressive primary prevention measures. Treatments that reduce the risk for unstable episodes of acute ischemia in patients with underlying coronary atherosclerosis might prevent the most serious complications of the disease.

First Page Preview

View Large
/>
First page PDF preview

Figures

Grahic Jump Location
Figure.
Multivariable associations between recent medication use and odds of presenting with acute myocardial infarction compared with stable exertional angina among patients with clinical coronary disease.

Variables in the final model included all listed medication classes, age, sex, race or ethnicity, parental history of coronary heart disease, smoking status, previous alcohol use, physical activity, previous stroke, previous peripheral arterial disease, previous hospitalization for heart failure, diabetes mellitus, previous hypertension, systemic malignant condition, diagnosed dementia, diagnosed depression, cirrhosis, chronic lung disease, body mass index, number of outpatient medical visits in the previous 12 months, and number of prescription medications within the 160 days before the index date. Error bars represent 95% CIs. ACE = angiotensin-converting enzyme; ARB = angiotensin-II–receptor blocker.

Grahic Jump Location

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

The Effects of Cholesterol and Blood Pressure Treatments on Severity of Coronary Artery Disease

The summary below is from the full report titled “Statin and β-Blocker Therapy and the Initial Presentation of Coronary Heart Disease.” It is in the 21 February 2006 issue of Annals of Internal Medicine (volume 144, pages 229-238). The authors are A.S. Go, C. Iribarren, M. Chandra, P.V. Lathon, S.P. Fortmann, T. Quertermous, and M.A. Hlatky, for the Atherosclerotic Disease, Vascular Function and Genetic Epidemiology (ADVANCE) Study.

Read More...

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Topic Collections

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)