Actualités en cardiologie

Abstract

These last two years, new advances have been observed in the management of cardiovascular diseases. A large therapeutic trial, the LIFE study, has shown the greater efficacy of losartan compared to atenolol in preventing cardiovascular morbidity and mortality in hypertension. The HPS study confirms the benefit of simvastatine in secondary prevention, and, for the first time, whatever the initial level of LDL-cholesterol. The AFFIRM study underlines the necessity of continuing anticoagulation in atrial fibrillation. The recent availability of eplerenone constitutes a real advance in the management of hypertension and heart failure. In stable coronary patients without heart failure, the EUROPA study confirms the preventive role of an ACE inhibitor (perindopril). The results of the CHARM study emphasize the interest of using an angiotensin II inhibitor in cases of intolerance to ACE inhibitors, or in association with such agents. The MADIT II study demonstrated a reduction in the rate of sudden cardiac death following the implementation of a ventricular defibrillator. During the year 2003, active stents began to be routinely used, after the publication of the RAVEL study results in 2002. The high interest of assessing the Brain Natriuretic Peptid for the diagnosis of dyspnoea or diastolic dysfunction was confirmed. The WHI trial confirms the absence of any benefit of hormone replacement therapy in primary cardiovascular prevention. Significant improvement of interventional catheterisation constitutes also a considerable advance in paediatric cardiology.