Detrimental Effects of XXXX in Acute Coronary Syndromes: from Pathophysiological Mechanisms to Therapeutic Strategies.

@entity1 @entity1187 @entity6 @entity2690 @entity4053 @entity1188 @entity2661 @entity4854 @entity413
@entity4854 recognized during hospitalization for @entity1187 ( @entity1187 ) is common. It is a powerful predictor of worse prognosis in @entity1 both with and without previously known @entity6 . @entity4854 during @entity1187 is caused by an inflammatory and adrenergic response to ischemic stress, when @entity2661 are released and glycogenolysis induced. The link between @entity4854 and prognosis in @entity1187 @entity1 is multi-factorial. @entity4854 exerts detrimental effects on left ventricular and platelet function and it also activates other systemic pathological processes that contribute to cellular and tissue injury such as increasing oxidative stress and worsening endothelial function. @entity413 management strategies in @entity1187 may improve outcome in @entity1 with @entity4854 , by reducing inflammatory and clotting mediators, by improving endothelial function and fibrinolysis and by reducing @entity1188 size. Most of available oral anti- @entity6 drugs are contraindicated for the increased risk of @entity4053 . Thus, @entity2690 is the preferred agent for glycemic control in @entity1187 and conversion from intravenous to subcutaneous therapy commonly occurs when the critical acute phase of @entity1187 resolves. Pharmacodynamics of @entity2690 allows it to be adaptable to the changing physiology of the @entity1187 @entity1 , is easily titrated and has no dosage threshold. Nevertheless, findings concerning the effect on @entity1187 -related mortality of the control of @entity413 levels by intravenous infusion of @entity2690 have been conflicting and intervention trials are needed to optimize the definition of @entity4854 and to establish appropriate modalities and goals of @entity413 lowering treatment. In particular, the clinical benefit of an aggressive treatment with @entity2690 is yet unproved.
