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Prevention of a First Myocardial Infarction
Author(s) -
Dayspring Thomas D.
Publication year - 2001
Publication title -
the journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.92
H-Index - 116
eISSN - 1552-4604
pISSN - 0091-2700
DOI - 10.1177/00912700122010203
Subject(s) - medicine , myocardial infarction , drug , cardiology , coronary artery disease , secondary prevention , coronary heart disease , lipid metabolism , pharmacology
Coronary heart disease is the leading cause of morbidity and mortality in men and women in the Western world. We now have significant evidence that prevention of the first coronary event using lifestyle and pharmacologic therapies is paramount. Events are caused by inflamed arteries leading to rupture of atherosclerotic plaques that induce potentially occlusive thrombi. Analysis of event reduction trials has revealed that LDL‐C lowering is only one part of the therapy needed to stabilize plaque. HMG‐Co‐A‐reductase inhibitors, fibrates, and statins all have differing mechanisms of action that provide not only lipid but also inflammatory, rheologic, and co‐agulation benefits. Concentration and sizes of lipoprotein subfractions have emerged as important new tools with small dense LDL particles having more atherogenicity, which has led to an increasing use of aggressive combination therapy for prevention of first myocardial infarction. Proper use of lipid‐lowering therapies requires knowledge of drug metabolism drug‐drug interactions.