The document discusses cardiovascular risk factors and management. It summarizes that most heart attacks are caused by low-grade coronary artery blockages rupturing and triggering blood clots. Several risk factors can make plaques more vulnerable to rupture, such as inflammation, thin fibrous caps, and lipid-rich cores. Lifestyle changes and statin drugs are effective at reducing cardiovascular risks by lowering cholesterol levels and having additional anti-inflammatory effects. More aggressive lowering of LDL cholesterol is associated with greater reduction in heart attack risk.
Monocytes and macrophages are innate immune cells that reside and accumulate in atherosclerotic lesions but also in the healthy and injured heart and brain. The cells and their subsets pursue distinct functions in steady state and disease, and their tenure may range between hours to months. Some subsets are highly inflammatory, while others support tissue repair.
Dr. Matthias Nahrendorf discusses current concepts of cell supply by the hematopoietic system, lineage relationships and systems’ cross talk, highlights open questions, and describes imaging tools for studying monocytes, macrophages and their progenitors.
Key Topics Include:
- Resident versus bone marrow derived macrophages
- Roles and phenotypes of heart leukocytes
- Hematopoiesis and the bone marrow in cardiovascular disease
Tabaquismo factor de riesgo cardiovascular y disfuncion endotelial Ricardo Mora MD
Tabaquismo como factor de riesgo endotelial y disfuncion endotelial; Dr. Ricardo Mora Moreno R2C; IMSS UMAE T1; León, Guanajuato, Mexico; 09 de Noviembre del 2017
Monocytes and macrophages are innate immune cells that reside and accumulate in atherosclerotic lesions but also in the healthy and injured heart and brain. The cells and their subsets pursue distinct functions in steady state and disease, and their tenure may range between hours to months. Some subsets are highly inflammatory, while others support tissue repair.
Dr. Matthias Nahrendorf discusses current concepts of cell supply by the hematopoietic system, lineage relationships and systems’ cross talk, highlights open questions, and describes imaging tools for studying monocytes, macrophages and their progenitors.
Key Topics Include:
- Resident versus bone marrow derived macrophages
- Roles and phenotypes of heart leukocytes
- Hematopoiesis and the bone marrow in cardiovascular disease
Tabaquismo factor de riesgo cardiovascular y disfuncion endotelial Ricardo Mora MD
Tabaquismo como factor de riesgo endotelial y disfuncion endotelial; Dr. Ricardo Mora Moreno R2C; IMSS UMAE T1; León, Guanajuato, Mexico; 09 de Noviembre del 2017
Management of Anemia in cancer patientsAjeet Gandhi
Anemia in cancer patients are important both in terms of quality of life as well as response to therapy. Cause of anemia is multi-factorial and its management is critical in optimizing best outcomes of cancer patients
A great deal is happening in lupus-related research. This presentation will update participants on recent research developments and their impact on those affected by lupus. Dr. Petri will provide an overview of current lupus research and the prospects for the future of lupus treatments. Learn how to better manage your lupus and make knowledgeable decisions regarding your treatment plan.
Primary Prevention of Cardiovascular Disease: The Role of Aspirin and StatinsCTSI at UCSF
Presented by Michael Pignone, MD, MPH, at UCSF's symposium "The Role of Risk Stratification and Biomarkers in Prevention of Cardiovascular Disease" in Jan 2012.
Management of Anemia in cancer patientsAjeet Gandhi
Anemia in cancer patients are important both in terms of quality of life as well as response to therapy. Cause of anemia is multi-factorial and its management is critical in optimizing best outcomes of cancer patients
A great deal is happening in lupus-related research. This presentation will update participants on recent research developments and their impact on those affected by lupus. Dr. Petri will provide an overview of current lupus research and the prospects for the future of lupus treatments. Learn how to better manage your lupus and make knowledgeable decisions regarding your treatment plan.
Primary Prevention of Cardiovascular Disease: The Role of Aspirin and StatinsCTSI at UCSF
Presented by Michael Pignone, MD, MPH, at UCSF's symposium "The Role of Risk Stratification and Biomarkers in Prevention of Cardiovascular Disease" in Jan 2012.
Dyslipidemia -Assessment and management based on evidence SYEDRAZA56411
This presentation is focused on cardiovascular risk assessment and application of evidence based principles in choosing right intensity statin therapy for patients with dyslipidemia
Putting the SPARK into Virtual Training.pptxCynthia Clay
This 60-minute webinar, sponsored by Adobe, was delivered for the Training Mag Network. It explored the five elements of SPARK: Storytelling, Purpose, Action, Relationships, and Kudos. Knowing how to tell a well-structured story is key to building long-term memory. Stating a clear purpose that doesn't take away from the discovery learning process is critical. Ensuring that people move from theory to practical application is imperative. Creating strong social learning is the key to commitment and engagement. Validating and affirming participants' comments is the way to create a positive learning environment.
B2B payments are rapidly changing. Find out the 5 key questions you need to be asking yourself to be sure you are mastering B2B payments today. Learn more at www.BlueSnap.com.
Discover the innovative and creative projects that highlight my journey throu...dylandmeas
Discover the innovative and creative projects that highlight my journey through Full Sail University. Below, you’ll find a collection of my work showcasing my skills and expertise in digital marketing, event planning, and media production.
LA HUG - Video Testimonials with Chynna Morgan - June 2024Lital Barkan
Have you ever heard that user-generated content or video testimonials can take your brand to the next level? We will explore how you can effectively use video testimonials to leverage and boost your sales, content strategy, and increase your CRM data.🤯
We will dig deeper into:
1. How to capture video testimonials that convert from your audience 🎥
2. How to leverage your testimonials to boost your sales 💲
3. How you can capture more CRM data to understand your audience better through video testimonials. 📊
Improving profitability for small businessBen Wann
In this comprehensive presentation, we will explore strategies and practical tips for enhancing profitability in small businesses. Tailored to meet the unique challenges faced by small enterprises, this session covers various aspects that directly impact the bottom line. Attendees will learn how to optimize operational efficiency, manage expenses, and increase revenue through innovative marketing and customer engagement techniques.
Enterprise Excellence is Inclusive Excellence.pdfKaiNexus
Enterprise excellence and inclusive excellence are closely linked, and real-world challenges have shown that both are essential to the success of any organization. To achieve enterprise excellence, organizations must focus on improving their operations and processes while creating an inclusive environment that engages everyone. In this interactive session, the facilitator will highlight commonly established business practices and how they limit our ability to engage everyone every day. More importantly, though, participants will likely gain increased awareness of what we can do differently to maximize enterprise excellence through deliberate inclusion.
What is Enterprise Excellence?
Enterprise Excellence is a holistic approach that's aimed at achieving world-class performance across all aspects of the organization.
What might I learn?
A way to engage all in creating Inclusive Excellence. Lessons from the US military and their parallels to the story of Harry Potter. How belt systems and CI teams can destroy inclusive practices. How leadership language invites people to the party. There are three things leaders can do to engage everyone every day: maximizing psychological safety to create environments where folks learn, contribute, and challenge the status quo.
Who might benefit? Anyone and everyone leading folks from the shop floor to top floor.
Dr. William Harvey is a seasoned Operations Leader with extensive experience in chemical processing, manufacturing, and operations management. At Michelman, he currently oversees multiple sites, leading teams in strategic planning and coaching/practicing continuous improvement. William is set to start his eighth year of teaching at the University of Cincinnati where he teaches marketing, finance, and management. William holds various certifications in change management, quality, leadership, operational excellence, team building, and DiSC, among others.
3.0 Project 2_ Developing My Brand Identity Kit.pptxtanyjahb
A personal brand exploration presentation summarizes an individual's unique qualities and goals, covering strengths, values, passions, and target audience. It helps individuals understand what makes them stand out, their desired image, and how they aim to achieve it.
Cracking the Workplace Discipline Code Main.pptxWorkforce Group
Cultivating and maintaining discipline within teams is a critical differentiator for successful organisations.
Forward-thinking leaders and business managers understand the impact that discipline has on organisational success. A disciplined workforce operates with clarity, focus, and a shared understanding of expectations, ultimately driving better results, optimising productivity, and facilitating seamless collaboration.
Although discipline is not a one-size-fits-all approach, it can help create a work environment that encourages personal growth and accountability rather than solely relying on punitive measures.
In this deck, you will learn the significance of workplace discipline for organisational success. You’ll also learn
• Four (4) workplace discipline methods you should consider
• The best and most practical approach to implementing workplace discipline.
• Three (3) key tips to maintain a disciplined workplace.
Business Valuation Principles for EntrepreneursBen Wann
This insightful presentation is designed to equip entrepreneurs with the essential knowledge and tools needed to accurately value their businesses. Understanding business valuation is crucial for making informed decisions, whether you're seeking investment, planning to sell, or simply want to gauge your company's worth.
Implicitly or explicitly all competing businesses employ a strategy to select a mix
of marketing resources. Formulating such competitive strategies fundamentally
involves recognizing relationships between elements of the marketing mix (e.g.,
price and product quality), as well as assessing competitive and market conditions
(i.e., industry structure in the language of economics).
16. Coronary Remodeling (Adapted from Glagov et al.) Normal vessel Minimal CAD Progression Compensatory expansion maintains constant lumen Expansion overcome: lumen narrows Severe CAD Moderate CAD Glagov et al, N Engl J Med , 1987.
17. Atherosclerosis: A Progressive Process Disease progression PHASE I: Initiation PHASE II: Progression PHASE III: Complication Normal Fatty Streak Fibrous Plaque Occlusive Atherosclerotic Plaque Plaque Rupture/ Fissure & Thrombosis MI Stroke Critical Leg Ischemia Coronary Death Unstable Angina Libby P. Circulation. 2001;104:365-372.
18. IVUS=intravascular ultrasound Nissen S, Yock P. Circulation 2001 ; 103: 604–616 Angiogram IVUS Little evidence of disease Atheroma No evidence of disease The IVUS technique can detect angiographically ‘silent’ atheroma
19. Correlation of CT angiography of the coronary arteries with intravascular ultrasound illustrates the ability of MDCT to demonstrate calcified and non-calcified coronary plaques (Becker et al., Eur J Radiol 2000) Non-calcified, soft, lipid-rich plaque in left anterior descending artery (arrow) . The plaque was confirmed by intravascular ultrasound (Kopp et al., Radiology 2004)
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21. Estimated 10-Year CHD Risk in 55-Year-Old Adults According to Levels of Various Risk Factors : Framingham Heart Study A B C D Blood Pressure (mm Hg) 120/80 140/90 140/90 140/90 Total Cholesterol (mg/dL) 200 240 240 240 HDL Cholesterol (mg/dL) 50 50 40 40 Diabetes No No Yes Yes Cigarettes No No No Yes Source: Circulation 1998;97:1837-1847.
33. Relationship Between Changes in LDL-C and HDL-C Levels and CHD Risk Third Report of the NCEP Expert Panel. NIH Publication No. 01-3670 2001. http://hin.nhlbi.nih.gov/ncep_slds/menu.htm 1% decrease in LDL-C reduces CHD risk by 1% 1% increase in HDL-C reduces CHD risk by 3%
34. CHD Outcomes in Clinical Trials of LDL Cholesterol-Lowering Therapy Mean CHD CHD No. No. Person- cholesterol Incidence Mortality Intervention trials treated years reduction (%) (% change) (% change) Surgery 1 421 4,084 22 -43 -30 Sequestrants 3 1,992 14,491 9 -21 -32 Diet 6 1,200 6,356 11 -24 -21 Statins 12 17,405 89,123 20 -30 -29 Source: This table is adapted from the meta-analysis of Gordon, 2000.
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36. Vessel Wall And Endothelial Cell Membrane Changes With Atherogenesis Reproduced from Mason et al. Circulation . 2004;109(suppl II):II-34, with permission. Mason et al. Am J Cardiol . 2005;96(suppl):11F.
37. Role Of Statins In ACS: Non-Lipid Effects ( Pleiotropic effects) ADP = adenosine diphosphate; CD40-L = CD40 ligand; IFN = interferon; IL = interleukin; vWF = von Willebrand factor. Reproduced from Ray and Cannon. J Thromb Thrombolysis . 2004;18:89, with permission. Cannon and Ray. Am J Cardiol . 2005;96:54F.
38. Clinical Events Correlate Directly With On-Treatment LDL-Cholesterol Levels P = placebo; S = statin. Reproduced from O'Keefe et al. J Am Coll Cardiol . 2004;43:2142, with permission. CHD Events (%) 10 9 8 7 6 5 4 3 2 1 0 -1 55 75 95 115 135 155 175 195 LDL Cholesterol (mg/dL) y = 0.0599x - 3.3952 R 2 = 0.9305 P =.0019 AFCAPS-S WOSCOPS-S ASCOT-S ASCOT-P AFCAPS-P WOSCOPS-P Primary prevention: 4-5 yr duration
39. ASCOT-LLA: Nonfatal MI And Fatal CAD Primary End Point Adapted from Sever et al. Lancet . 2003;361:1149, with permission. Sever et al. Am J Cardiol . 2005;96(suppl):39F. 2 0 1 4 3 Years 0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 Cumulative Incidence (%) Placebo Atorvastatin 10 mg Number of Events 36% Reduction HR = 0.64 (0.50-0.83) P =.0005 Number of Events 154 100 N=10,305
40. Effects of Lipid-Lowering Therapy on CHD Events in Statin Trials 25 20 15 10 5 0 Patients with CHD event (%) 90 110 130 150 170 190 210 S = statin-treated P = placebo-treated *Extrapolated to 5 y 4S - P CARE - P LIPID - P 4S - S WOSCOPS - S WOSCOPS - P AFCAPS - P AFCAPS - S LIPID - S CARE - S Primary prevention Simvastatin Pravastatin Lovastatin Modified from Kastelein JJP. Atherosclerosis. 1999;143(suppl 1): S17-S21. HPS - S HPS - P Atorvastatin ASCOT - S * ASCOT - P * Secondary prevention LDL-C (mg/dL)
41. PROVE IT-TIMI 22: A Major Cardiovascular Event Or Death From Any Cause Primary End Point Adapted from Cannon et al. N Engl J Med . 2004;350:1495, with permission. Ray and Cannon. Am J Cardiol . 2005;96(suppl):54F. 15 0 10 30 25 5 20 Months Of Follow-Up 0 3 9 15 21 6 12 18 24 27 30 Death Or Major Cardiovascular Event (%) Pravastatin 40 mg Atorvastatin 80 mg P =.005 Overall P =.03 n= 4,162 with CHD
42.
43. PROVE IT-TIMI 22: A Major Cardiovascular Event Or Death From Any Cause At Different Censoring Times Reproduced from Cannon et al. N Engl J Med . 2004;350:1495, with permission. Ray and Cannon. Am J Cardiol . 2005;96(suppl):54F. Censoring Time Hazard Ratio (95% CI) Risk Reduction (%) Event Rate (%) Atorvastatin Pravastatin 30 days 90 days 180 days End of follow-up 17 1.9 2.2 18 6.3 7.7 14 12.2 14.1 16 22.4 26.3 0.50 0.75 1.0 High-Dose Atorvastatin Better Standard-Dose Pravastatin Better 1.50 1.25
45. Evolution of Lipid Management Guidelines ATP I (1988) ATP II (1993) ATP III (2001) Diet; low-dose, nonstatin monotherapy High-dose statin, combination therapy Low- to moderate-dose statin monotherapy Increasing aggressiveness of cholesterol-lowering therapy The National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP)
46. Update to ATP III: Risk Categories, LDL-C Goals Implications of Recent Clinical Trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines: Circulation . 2004;110:227-239. <160 <130 <130 <100 (optional <70) LDL-C Goal (mg/dL) > 160 > 130 > 130 > 100 Initial TLC (mg/dl) > 130 (optional 100-129) Moderately high risk: 2+ risk factors (10-year risk 10-20%) > 190 (optional 160-189) Lower risk: 0–1 risk factor >160 Moderate risk: 2+ risk factors (10-year risk 10%) > 100 (optional <100) High risk: CHD or CHD risk equivalents (10-year risk >20%) Consider drug (mg/dl) Risk Category
108. Algorithm for ECG identification of the IRA in Anterior MI STE in V 1 , V 2 and V 3 STE in V1 (>2.5 mm) and AVL or RBBB with Q wave or both ST depression (<1 mm) in II, III, and AVF STE in II, III, and AVF Wrap around
109. A 63 yo lady, 3 hrs 7/10 CP Given Metalalyse + Clexane , continuing chest pain, VF x II in cath lab
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115. ED :55 yo man, 3 hrs Lt. CP 5/10, less with sits forward
116. GP: 34 yo athlete, anterior CP 3/10, pt. of tenderness Fish hook
137. Wong, T. Y. et al. N Engl J Med 2004;351:2310-2317 Examples of Mild Hypertensive Retinopathy AV nicking Focal narrowing AV nicking Copper wiring
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140. Cerebral Autoregulation Mean arterial pressure (mmHg) Cerebral blood flow (ml/100 gm per min ) 50 100 150 200 150 100 50 0 Normotensive Hypertensive Strandgaard S,et al; Br Med J 1:507, 1973
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145. Approach to HT crisis BP > 220/120 mmHg Headache No neurosign No target organ damage Urgency Identify the cause and Rx the cause ( panic, anxiety) Otherwise use oral anti HTagent Neurosign( encep., stroke) Retinopathy gr III, IV severe chest pain ( IHD, dissecting aneu) Pulmonary edema Cathecholamine excess ARF Emergency IV therapy Recheck in 6-24 hr