Major bleeding in acute coronary syndrome

Acute coronary syndrome forms the vast majority of cases faced in daily cardiology clinical practice. It is usually managed by antiplatelates, antithrombotics and anticoagulants, all of which increase the risk of bleeding with associated increment in morbidity and mortality. Data gained from many studies and registries all over the world try to explore the magnitude of such problem as well as predictors and management. The definition of major bleeding in acute coronary syndrome is a dilemma by itself, as different definitions have led to inconsistency in its reported prevalence and magnitude of sequelae. Predicting the occurrence of major bleeding may help in saving lives, improving outcomes and cost-savings by preventing it. In this review, we try to explore these issues based on data extracted from large numbers of trials, studies and registries

good are we at controlling lipids? A cohort study

Elevated low-density lipoprotein cholesterol [LDL-C] is a major cause of coronary heart disease [CHD]. The relationship between LDL-C and CHD risk is continuous over a broad range of LDL-C levels: the higher the LDL-C level, the greater the risk of CHD1. Although national guidelines for cholesterol management have existed since 1988, many patients with elevated cholesterol do not achieve their target cholesterol with treatment. Our aim was to identify the rate of lipid control in the cardiology outpatient clinics of Hamad General Hospital, and this may lead to improved patient care. This is the first out-patient data study performed in our department. Cohort study of one -hundred and one [101] consecutive documented CHD patients investigated for lipid profile. Blood samples were taken after a strict 12 hours of fasting, the presence of diabetes was also recorded. LDL-C level was less than 2.6 mmol/l in 55 patients [54%], with a mean of 2.66 mmol/l; while HDL-C level was more than 1.15 mmol/l in 76 patients [75%], with a mean level of 1.08 mmol/l. Triglyceride level was less than 1.7 mmol/l in 51 patients [50%], with mean level of 2.22 mmol/l. Conclusions: Acceptable lipid control was achieved in the cardiology outpatient clinics in Hamad General Hospital and the majority of CHD patients were on lipid lowering therapy. Heart Views 2006;7[2]:69-73 2006 Gulf Heart Association