Progress in Cardiology 9 [antikvár]

PREFACE Volume 9 of PROGRESS IN CARDIOLOGY is comprised of eight chapters contributed by cardiologists and scientists from five continents. In the first chapter, Dr. Michael F. Oliver reviews critically and thoroughly six clinical trials in which plasma cholesterol was lowered in healthy individuals, in an effort to prevent coronary heart disease. Detailed discussions focus on three trials, and the results of the three other trials are briefly mentioned. The data suggest an appreciable reduction of plasma cholesterol as a result of treatment, a significant reduction in the incidence of nonfatal myocardial infarction, but no change in the incidence of angina pectoris or fatal myocardial infarction. On the other hand, in the populations studied there was a significant increase in the mortality rate due to noncardiovascular diseases, as well as a substantial increase in the incidence of gallstones. Dr. Oliver concludes, based upon available information, that reduction of plasma cholesterol by a diet low in saturated and high in polyunsaturated fats or by use of clofibrate cannot be recommended on a community-wide basis. Management of the late phase of acute myocardial infarction is discussed by Dr. J. Graeme Sloman in the second chapter. An outline is presented of those clinical indices that should be assessed during this recovery period and that may be associated with an unfavorable prognosis. Although the impact of an intermediate coronary care unit (CCU) remains uncertain, Dr. Sloman concludes that it would be advisable to transfer patients out of a CCU to an area where continued monitoring, resuscitative equipment, emergency drugs, and trained nurses are readily available. The rationale for performing a limited exercise stress test prior to discharge from the hospital is discussed. In the posthospital phase, certain unfavorable prognostic factors also can be identified. The chapter concludes with a succinct description of various secondary preventive mea-