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CVS

CVS

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Published by: Raouf Ra'fat Soliman on May 30, 2012
Copyright:Attribution Non-commercial

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06/29/2013

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C V S
 
Coronary Artery Diseases
Risk Factors
Traditional
-
↑ LDL, HTN, smoking.
-
↓HDL, obesity, DM,
- age >45
, >55
,- FH of premature CHD < 55
, < 65
,- others; hyperuricemia, CRF. Stress, personality.
Non traditional;
Lp(a) , homocysteine , PAI-1, fibrinogen, cytokines, CRP, apo B ,small dense LDL, visceral obesity , fasting hyperinsulinemia,microalbuminuria.
NB; Effect of smoking;
-
↑ Bl viscosity, ↑ carboxyHb, & Hct.
 -
↑ plat adh/agg,
 -
↓HDL.
 Leading to
ischemic stroke, SA Hge, CAD, HTN, AA,thromboembolism. 
 
Protective factors
;1-
↓cholesterol in diet.
 2-
↑HDL by; estrogen, exercise, alcohol.
 
Effect of Estrogen.
1.
↑HDL, ↓LDL, ↓Lpa.
 2.
↓LDL coronary uptake
 3.
↓coagulation factors.
 4.
↑insulin sensitivity.
 
Beneficial effect of small amount of alcohol;
 
↑HDL, ↑ insulin
sensitivity, anti-
thrombotic (↑TPA), anti
-
plat (↑PC/ tx), anti
-oxidant(flavinoids & polyphenolin red wine).

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