Preventive strategies for postinfarction patients
In coronary heart disease, whether after myocardial infarction, in patients with angina pectoris, or in those with silent myocardial ischemia, the major threat for the patient is the progression of the disease. We must consider that there are two underlying mechanisms that lead to such progression. On the one hand there are rapid phenomena, like platelet aggregation, thrombosis, spasm and changes in vasomotor tone, which may lead to a rapid occlusion within preexisting atherosclerotic lesions. For the development of myocardial infarction and unstable angina, as we have seen, the hallmark is the rupture of the plaque with subsequent thrombus formation. In atherosclerosis the formation of new lesions is slow and independent from the forementioned rapid phenomena. Thus, in secondary prevention, one has to deal with both mechanisms; we must address the rapid phenomena as well as prevent the formation of new lesions, while trying to slow the process of atherosclerosis in general.
KeywordsCholesterol Depression Ischemia Smoke Niacin
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