Lect 18 CVD Part 2

Trial of individuals with risk factors but free of

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Unformatted text preview: PREDIMED Trial PREDIMED Trial Prevencion con Dieta Mediterranea Large (n=7,447) multicenter European trial of individuals with risk factors but free of CVD. 3 diet arms Med+VOO Med+nuts Low fat diet arms Med+VOO, Med+nuts, Low fat. Followed multiple years • • Decreased cellular & circulating inflammatory biomarkers related to bi cardiovascular risk (Med diet vs Low fat diet) 2012 Pharamcol Res Beneficial changes in apolipoproteins B, A1 and their ratio (Med diet vs Low fat diet) (M di di 2011 Atherosclerosis • Reduced diabetes incidence (up to 52% ). After 4 yr follow-up, incidence of T2DM was 10 was 10.1% vs 17.9% (Med diet vs Low fat). vs 17 (Med diet vs Low fat) 2011 Diabetes Care 33 Acute & Chronic Cardiac Conditions Chronic Cardiac Conditions 34 Myocardial Infarction (MI) Biochemical Biochemical indicator: Creatine phosphokinase (CPK) enzyme released from damaged/necrotic cells; MB CPK is a specific isoform found in cardiac muscle cells. Diet Guidelines: no caffeine no caffeine liquid liquid diet x 24 hr if patient has alertness, or N/V; OR soft to DAT w/ if N/V; soft small frequent meals if patient is fully alert if Low cholesterol AHA/TLC guidelines Low cholesterol, AHA/TLC guidelines Individualize Individualize sodium level; restrict if HTN, pulmonary edema or CHF Provide nutrition counseling as appropriate for TLC and follow-up on follow-up outpatient outpatient basis 35 Surgeries Surgeries for Correcting Occluded Coronary Arteries Coronary Arteries • Coronary Artery Bypass Graft (CABG) Coronar • Angioplasty (Stent placement) Angioplasty Arterial graft Arterial graft area is ver...
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