Coronary Heart Diseases

Health Evidence Bulletins - Wales

Subject Index

A B C D E F G H I K L M N O P Q R S T U V W X Z
A

abcimimab

  Stenting with abciximab glycoprotein IIb/IIIa blockade
  For coronary revascularisation, abciximab and stent implantation
  abciximab was more effective than tirofiban
  Improvements of early clinical outcome with abciximab treatment and stenting
  If PCI is indicated….
  treatments are contraindicated:
  tirofiban
  The NICE 4 study
  The NICE 3 study
  SYNERGY
  acute myocardial infarction
ablation and pacing therapy
ACE inhibitors
  and aspirin
    weak evidence of any reduction in the benefit of ACE-inhibitor therapy when added to aspirin
    both aspirin and ACE inhibitors (ACEi) are beneficial in acute myocardial infarction (MI)
    ACE inhibitor/ aspirin interactions?
    associated with lower mortality
    no evidence from long-term randomised controlled trials
  and heart failure
    The effect of beta-blockade
    severe heart failure mortality is significantly reduced by enalapril
    carvedilol treatment
    β-blocker therapy
  for hypertension
  for stable angina
  to prevent heart failure after MI
  versus angiotensin receptor blockers for HF

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active chest compression-decompression
ACTIVE for LIFE
acute coronary syndromes
  assessment in the emergency department
  cardiac rehabilitation
  guidelines and audit
    for pre-hospital management
  heart failure post ACS
  information and advice to patients
  non-invasive investigations
  percutaneous coronary intervention
    Heart failure was associated with less frequent use of percutaneous procedures
  post ACS therapies
  prehospital care
    prehospital management
  risk stratification at discharge
  secondary prevention
  thrombolysis
advanced heart failure, see severe heart failure
advanced life support for cardiac arrest
advice & relaxation tape after MI
AFASAK
AFCAPS/TexCAPS
AF-CHF
AFFIRM
African American women, hypertension therapy
Afro-caribbeans, atrial fibrillation
aggressive lipid-lowering
  an aggressive lowering of LDL cholesterol

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AIRE
ALLHAT
  Statins in older moderately hypercholesterolemic, hypertensive patients
  Thiazide-type diuretics
alcohol consumption
  More than one in four men in Wales drink above sensible limits compared with one in nine women
  The association between alcohol consumption and risk of chronic hypertension in young women
  and hypertension
  ethanol
algorithm
  for heart failure
  for hypertension
amiodarone
  amiodarone is of unknown effectiveness for the treatment of heart failure
  for survivors of ventricular fibrillation or sustained ventricular tachycardia
  pharmacological cardioversion
amlodipine
  with valsartan
  patients with heart failure
  severe heart failure
angiography
angioplasty
  primary angioplasty
  Effect of centre size on angioplasty outcomes
  developing in some district hospitals
angiotension converting converting enzyme inhibitors, see ACE inhibitors

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angiotensin receptor blockers for heart failure
  with valsartan
  long-term treatment
  angiotensin receptor blockers
antiarrythmics
  for cardioversion
  for heart failure
    Antiarrythmic therapies
    Class I antiarrhythmic agents
  for secondary prevention after ACS
anticoagulants
  with subcutaneous low molecular weight heparin or intravenous unfractionated heparin
  Anticoagulants for secondary prevention
  Patients with atrial fibrillation
  oral anticoagulants
antioxidant vitamins
  in primary prevention
  in secondary prevention
antiplatelet therapy
  aspirin 
  vasodilators for hypertension treatment
  Antiplatelets & anticoagulants for stable angina/coronary heart disease
  Aspirin, clopidogrel and heparin for acute coronary syndromes 
  ACE inhibitors to prevent heart failure
  Aspirin/clopidogrel for secondary prevention
  see also, aspirin, dopidogrel
    ACE inhibitor/ aspirin interactions?
    possible interaction with ACE inhibitors may reduce the efficacy of aspirin
    compared with oral anticoagulant
    atrial fibrillation patients
antithrombotic therapy
  men at high risk
  Anticoagulants for secondary prevention
  oral anticoagulants

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anxiety
  as a risk factor
  in heart failure
anxiolytics for smoking cessation
APRICOT-2
Asian patients and statin therapy
ASPECT-2
aspirin
  and ACE inhibitors
    strong evidence of benefits
    to prevent heart failure
    ACE inhibitor/ aspirin interactions?
    possible interaction with ACE inhibitors may reduce the efficacy of aspirin
  for acute coronary syndromes
  for atrial fibrillation
    compared with oral anticoagulant
    in a cohort of a trial
  for heart failure
  for hypertension
  for secondary prevention after ACS
  for stable angina/CHD
  longterm
  low dose in primary prevention
ATACS
atenolol, see also betablockers

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ATLAS
  high-dose lisinopril
  cost effective therapy
atorvastatin, see also statins
  in a short-term study
  simvastatin versus atorvastatin
ATRIA
atrial fibrillation
  cardioversion
  guidelines
  management of embolicrisk
  mortality, morbidity & stroke risk
  prevalence
  screening & assessment
  surgical interventions
Atrial Fibrillation and Congestive Heart
  Failure (AF-CHF) trial
atrioventricular plane displacement
automated defibrillator (AED), see defibrillation AUZ study
aversive stimulation for smoking cessation
AWESOME

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B
balloon angioplasty
balloon dilation
  stenting
  direct stenting
basic life support for cardiac arrest
benzafibrate to reduce cholesterol
beta-blockers
  after myocardial infarction
  for heart failure
    beta-blocker therapy
  for hypertension
    Beta-blockers for hypertension treatment
    in elderly patients
  for secondary prevention after ACS
  for stable angina
betacarotene for primary prevention
bilateral internal mammary grafts
BIP study
bisprolol, see beta blockers
black patients, heart failure treatments
  Enalapril therapy
body mass index and CHD risk
brain natriuretic peptide
  symptoms suspected to be due to heart failure
brief behavioural counselling in health promotion
British Regional Heart Study (BRHS)
buddies for smoking cessation
buproprion for smoking cessation
bypass surgery, see coronary artery bypass bystander cardiopulmonary resuscitation

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C  
c-reactive protein and CHD risk
CABRI
calcium antogonists
  and fish oils
  for hypertension
  for stable angina
calcium channel blockers
  for heart failure
    inotropic agents
    amlodipine
  for secondary prevention
    versus beta-blocker
CAMIAT
candesartan
  for heart failure
  for hypertension in older people
CAPRICORN
CAPRIE
capropril, see also ACE inhibitors
  long-term treatment
  high dose
  Losartan
cardiac imaging
cardiac rehabilitation
cardiac resynchronisation
cardiac sonographer
cardiac transplantation
cardiomyoplasty
cardiopulmonary resuscitation
cadioversion
CARE study
CARS study

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carvedilol, see also beta blockers
  compared to metoprolol
  long-term
  in patients with severe heart failure
CATCH
CHALLENGE study
CHAMP
CHARM
chelation therapy for secondary prevention
CHIPS study
cholesterol
  at risk factor
  control for primary prevention
  control for secondary prevention
  control for stable angina
  familial hypercholesterolaemia
CIBIS
  beta-blocker therapy
  CIBIS-2
  the effect of beta-blockade
  beta-blockade in heart failure
cigarette smoking, see smoking
Clinical Decision Support  System (SDSS)

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dopidogrel
  after revascularisation in stable angina/CHD
  for acute coronary syndromes
  for secondary prevention after ACS
coaching for smoking cessation
coffee and CHD risk
cognitive behaiour therapy for secondary prevention
cognitive impairment in heart failure
combination treatment for hypertension
COMET
community interventions for health promotion
  uptake of smoking in young people
  Multiple risk factor interventions
complementary medicine for hypertension
COPERNICUS
copper for primary prevention
coronary angioplasty, see angioplasty 

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coronary artery bypass
  coronary artery bypass grafting (CABG)
  the use of coronary stents
  bypass surgery
  percutaneous transluminal coronary revascularisation (PCTR)
  Surgical revascularisation
coronary artery stents, see stents 
coronary revascularisation, see revascularisation
cost-effectiveness
  ACE inhibitors in heart failure
  anticoagulation
  atrial fibrillation therapies
  beta blockers in ACS
  cardioversion & sinus rhythm maintenance
  cholesterol lowering therapies
  echocardiography, SPECT & angiography
  enoxaparin in ACS
  exercise
  group behaviour for smoking cessation
  heart failure therapies
  implantable cardioverter defrillators
  revascularisation techniques
  statin therapy
coumadin, see warfarin
Cox-Maze III procedure
Crataegus Special Extract
critical pathway for chest pain
cryothemy/cryoablation for atrial fibrillation
CURE study

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D
DASH diet
  sodium levels
decision analysis for atrial fibrillation risk
  decision analysis based computer software package
  warfarin
defibrillation
  prehospital resuscitation
  out-of-hospital decisions
  automated external defrillation
depression in heart failure
diabetes
  lipid-lowering therapy
  diabetes melitus
  type 2 diabetes
  CABG versus PTCA
  ACE inhibition after myocardial infarction
distolic heart failure
diet, see also obesity and overweight
  advice for secondary prevention
  antioxidants in primary prevention
  folate in primary prevention
  fruit and vegetable consumption in Wales
  fruit and vegetables in primary prevention
  guidelines
  interventions for hypertension management
  interventions to promote health eating
    among women
    Heartbeat Wales programme
    community strategy

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dietitians
DIG study
digitalis/digoxin
diltiazem for secondary prevention
  see also calcium channel blockers
dipyridamole before PTCA
dipyridamole stress echocardiography
direct thombin inhibitors
  Oral direct thrombin inhibition with ximelagatran
directional coronary artherectomy
disease management programmes
  for ACS
  for heart failure
dispatcher assisted bystander CPR
diuretics
  beta-blockers
dobutamine echocardiography
  see also echocardiography
dobutamine SPECT
dofetilide for cardioversion
drug eluting stents, see also stents
  A review of coronary artery stents including drug eluting stents
  guidance from NICE
dual versus single chamber pacing

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E
EAFT
early invasive strategy for ACS
  general agreement from ACC/AHA
  glycoprotein IIb/IIIa inhibitor tirofiban
echocardiography
  Exercise and dipyridamole stress echocardiography
  comparison of stress echocardiography and perfusion scintigraphy
  assessment of myocardial perfusion
  Evidence-based guidelines
  stress echocardiographic imaging
  left-ventricular systolic dysfunction
  Echocardiography Techniques
  transesophageal echocardiography
electro-stimulation for smoking cessation
electrocardiography (ECG)
  guidelines
  B-type natriuretic peptide (Brain natriuretic peptide)
electron beam computed tomography
ELITE II
EMIAT
enalapril, see also ACE inhibitors
  enalapril therapy
  clinical output
  telmisartan
  severe heart failure

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endoscopic thoracic sympathicotomy
enoxaparin, see also heparin
ENRICHD
environmental tobacco smoke
EPHESUS
EPISTENT
eplerenone for MI complicated by heart failure
eptifibatide after revascularisation
ERACI II
ESCAPE
ESPRIT
ESSENCE
  low molecular weight heparin (LMWH)
  low molecular weight heparin, enoxaparin
ESTEEM study
EUROASPIRE
Euro-HF
  echocardiography
  primary care practice in Europe
EUROPA
evidence-based guidelines, see guidelines
exercise
  and risk reduction
    physical activity
    increased physical activity
  before revascularisation
  current levels of, in Wales & the UK
  for heart failure
  for hypertension
  in cardiac rehabilitation
  interventions to promote
    interventions to reduce overweight and obesity and promote healthy eating at the individual level
    Interventions to promote physical activity among the adult population
exercise testing
  stress/exercise testing
  non-invasive investigation
ezetimibe for hypercholesterolaemia

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F
family history of CHD
fat-restricted diets
FAXIS
feedback of prescribed practice
fibric acid derivatives
fibrinogen as risk factor
'Fighting Fat, Fighting Fit'
fish consumption, see also diet
  Lifestyle
  associated with markedly reduced coronary heart disease
flavinoids for primary prevention
flecainide
FLUVACS
fluvastatin, see also statins
  LDL-C goals
  patients with average cholesterol levels
folate
Food Dudes
Framingham risk model
FRISC
  unfractionated heparin
  enoxaparin
fruit and vegetable intake, see also diet
  cohort studies
  Food Dudes
  cochrane review
furosemide

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G
GAP initiative
gemfibrozil for secondary prevention
Global Registry of Acute Coronary Events
glucose-insulin-potassium for ACS
glycoprotein llb/llla inhibitors
  before revascularisation, stable angina/CHD
  for acute coronary syndromes
    National Institute for Clinical Excellence (NICE)
  in percutaneous coronary intervention
gout as risk factor
guidelines
  activity promotion in schools
  acute coronary syndromes
    American College of Cardiologists/American Heart Association (ACC/AHA)
    operative procedures
    Guidelines and audit standards for the management of acute coronary syndromes
  alcohol, sensible drinking limit
  aspirin in primary prevention
  atrial fibrillation
  cardiac radionudeide imaging
  cardiac rehabilitation
  cardiac sonography
  coronary angiography
  coronary artery stents
    guidance from NICE
    guidance from NICE on the use of coronary artery stents including eluting stents
  coronary revascularisation
diet & nutrition
  echocardiography
    Exercise and dipyridamole stress echocardiography
    stress echocardiography and perfusion scintigraphy
    echocardiography techniques

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  electrocardiography
  exercise testing
  familial hypercholesterolaemia
  heart failure
    algorithm for pharmacological treatment
    evidence-based guidelines
  hyperlipidaemia
  hypertension
  implantable cardioverter defibrillators
  information for the public/patients
  intravenous thrombolysis
  myocardial perfusion imaging
  physical activity
    young people
    minimum level of exercise
    among women
    activity promotion in schools
  prehospital management of ACS
  primary prevention of CHD
  reduction of overwieght/obesity
  reduction of smoking
  salt intake
  secondary prevention in ACS
  stable angina

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  stents
    Guidance from NICE on the use of coronary artery stents
    review of coronary artery stents including drug eluting stents
    Stent thrombosis
    guidance from NICE on the use of coronary artery stents including eluting stents
  termination of resuscitation
  thrombolysis
GUSTO IV
H
Healthwise Survey
heart attack, see acute coronary syndromes
heart failure
  clinics
  diagnosis and assessment
  diastolic heart failure
  guidelines
    NICE guidelines
  multidisciplinary care
  non-pharmacological & surgical therapies
  pharmacological therapies
  prevalence and incidence
  severe heart fialure & palliative care
Heartbeat Wales
HeartStart Wales
HEART UK
helical computed tomography
heparin for ACS
high intensity behavioural interventions for smoking

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high risk and CHD-diagnosed
  cholesterol lowering interventions
  familial hypercholesterolaemia
  guidelines
    for coronary revascularisation
    for the management of stable angina
  hypertension
  patient information
  pharm therapies for stable angina/CHD
  refractory angina
  revascularisation techniques
  revascularisation vs medical intervention
  risk assessment
    in primary care
    risk assessment and treatment in minority population groups
  therapies after revascularisation
Hispanic patients, and warfarin
home monitoring for heart failure
home recovery following coronary artery bypass
home intervention after heart failure hospitalisation
homocysteine as risk factor
hormone replacement therapy (HRT)
  a Cochrane review
  evidence suggests
HOT study
hydrazaline plus isosorbide dinitrate (H-I)
hypercholesterolaemia in childhood

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hypertension
  and left ventricular hypertrophy
  as risk factor
  guidelines
  management
I  
ibutilide for cardioversion
implantable cardioverter defibrillator (ICD)
incidence, see prevalence/incidence HAZEL
INDANA
Indo-Asians, & information about atrial fibrillation
influenza vaccination post ACS
inotropes for heart failure
integrated management programme for heart failure
INTERCEPT
INTER-HEART
Intersalt
INVEST
intravascular ultrasound (IVUS) guided angioplaty
IONA
ISIS
  magnesium sulphate
  myocardial infarction
  oral mononitrate therapy

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K  
kidney function, & antihypertensive treatment
Kuopio IHD risk factor study
L  
laser angioplasty
laser technology for atrial fibrillation
left stellate ganglion blockade for refractory angina
left ventricular assist devices for heart failure
left ventricular reconstruction for heart failure
LIFE study
  High Risk and CHD diagnosed
  Heart Failure
lifestyle
  guidelines for primary prevention
  interventions to prevent or reduce smoking
  interventions to promote exercise
  interventions to reduce overweight & promote health eating
  measures of lifestyle in Wales & the UK
  mortality rates for CHD
  multiple risk-factor interventions
LIPID study
  psychological well-bring
  risk stratification strategy
lipids, see cholesterol
LIPS study
lisinopril for heart failure, see also ACE inhibitors
losartan, see also angiotensin receptor blockers
  LIFE study
lycopene as risk factor

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M  
magnesium sulphate for pre-hospital cardiac arrest
management training seminars for health promotion
manganese for primary prevention
mass media interventions
  mass media campaigns
MDC study
mediterranean dietary pattern
MERIT
  beta-blockade
   
metoprolol, see also beta blockers
  therapy with either bisoprolol, carvedilol, or metoprololi
  MERIT
  metoprolol CR/XL
microwaves for atrial fibrillation
MIRACLE study
  statin therapy
  cardiac resynchronisation therapy (crt)
mitral valve repair
moclobemide for smoking cessation
mononitrate, oral post ACS
MRC/BHF Heart Protection study
myocardial infarction, see acute coronary syndromes
Myocardial Infarction Audit Project (MINAP)
myocardial perfusion scintigraphy
  National Institute of Clinical Excellence guidance
  NICE technology appraisal
myopathy, and statin therapy

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N  
nebivolol for heart failure
NETWORK investigators
NICE trials
NICE guidelines, see guidelines
nocorandil for stable angina
Nicotine Replacement Therapy (NRT)
nifedipidine for secondary prevention see also calcium channel blockers
nitroglycerin for stable angina
nurse-led management
  nurse run clinics
  specially trained nurses
  nurse-run management programme
 

nurse-led clinic in a primary-care setting

nurses
  and nutrition of heart failure patients
  and interventions for smoking cessation
    nursing intervention to prevent or reduce tobacco use in hospitals
  and risk assessment
O  
obesity and overweight
  obesity
  improving obesity management
  hypertension - sibutramine
oestrogen replacement, see hormone replacement therapy
omega-3 fatty acids
OPTIME-CHF
oral anticoagulants, see anticoagulants
orlistat
OSCUR
out of hospital, see pre-hospital
overweight, see obesity and overweight

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P  
pacemaker
PAD study
palliative management of heart failure
PATAF
patient decision aids for health treatment/screening
patient information
  information and advice
percutaneous coronary intervention (PCI)
  percutaneous transluminal coronary revascularisation (PTCR)
  intravascular ultrasound (IVUS) guided angioplasty
  percutaneous transluminal coronary angioplasty (PTCA) cost data
  abciximab and stent implantation
  in patients having coronary stenting
  abciximab treatment
  intracoronary dipyridamole before PTCA
  propranolol
percutaneous transluminal coronary angioplasty (PTCA), see PCI
percutaneous transluminal coronary rotational atherectomy (PCTRA), see PCI
percutaneous transluminal laser revascularisation
perfusion scintigraphy
perindopirl
  for heart failure
  for hypertension
  see also ACE inhibitors
pharmacists
phosphodiesterase inhibitors for heart failure
physical activity, see exercise
PIAF
Pol-GIK

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POST study
  Early telephone and postal reminders
  postal prompts
potassium supplements for hypertension
practice guidelines, see guidelines
pravastatin, see also statins HAZEL
 

Statins in older moderately hypercholesterolemic, hypertensive patients

PRECARD(R)
pre-hospital
  cardiac arrest
  ECG
  management of thrombolysis
pre-operative education before revascularisation
prevalence/incidence
  of atrial fibrillation
  overweight children
  of heart failure
procainamide for cardioversion
propafenone for cardioversion
propanolol for PCI, see also beta-blockers
PROTECT study
psychosocial factors in CHD risk
psychoeducational programmes for ACS
Q  
quinidine for cardioversion

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R  
RACE
radiofrequency for atrial fibrillation
radionudeide myocardial perfusion imaging
RALES
rapid access heart failure clinic
rapid smoking for smoking cessation
rate versus rhythm control for atrial fibrillation
reduced
  or modified dietary fat intake
  sodium
    reduced sodium intake
    high risk
Renfrew/Paisley study
REPLACE study
retailers, interventions to reduce tobacco sales
revascularisation
  revascularisation versus medical intervention for stable angina/coronary heart disease
  surgical revascularisation
REVERSAL study
risk stratification
  stopping smoking
  Risk Factor Calculator
  assessment of cardiac damage in the emergency department – Troponin and other markers
  at discharge
  the stratification of embolic risk in patients with atrial fibrillation and appropriate management strategies
  stroke-risk stratification schemes
RITA

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S  
SAFE study
salt intake, as risk factor
  dietary interventions for the management of hypertension
  dietary interventions for the management of hypertension in older people (≥ 60 years old)
SARIS
SAVE study
  long-term ACE inhibitors
  aspirin
school programmes
  to reduce smoking
  to improve diet
  to increase exercise
Second Heart Protection study
self-management
  for cholesterol reduction
  for smoking cessation
  of oral anticoagulation
severe heart failure
sibutramine for weight loss
simvastatin, see also statins
  Asian patients
  comparative studies of statins
  simvastatin versus atorvastatin
SMAAF
smoking
  as risk factor
  interventions to prevent or reduce
  statistics in Wales & the UK

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socioeconomic differences in diet and smoking
sodium intake, see salt intake
SOLVD
  long-term ACE inhibitors
  aspirin
South Asians
  psychosocial factors
  risk assessment
  coronary artery bypass grafting
  equity of access to revascularisation
SPAF
  risk-stratification schemes
  risk classification scheme
  oral anticoagulant
  low rates of ischaemic stroke
SPECT imaging
SPICE study
spinal cord stimulation for refractory angina
spironolactone
  patients with severe heart failure
SPORTIF
SPRINT study

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stable angina, see high risk and CHD diagnosed
statins
  after revascularisation
  aggressive lipid lowering vs angioplasty
  cost-effectiveness
  for familial hypercholesterolaemia
  for secondary prevention
  guidelines for use
  in cholesterol reduction for high risk groups
    cholesterol-lowering diet
STATT
stents
  cost-effectiveness
  drug eluting
    guidance from NICE on the use of coronary artery stents
    guidance from NICE on the use of coronary artery stents including drug eluting stents
  for acute coronary syndromes
  for stable angina/CHD
    high risk
  long stent placement
STOPAMI 2
stress echocardiography, see echocardiography
stress management
  after ACS
  for hypertension
stress nuclear imaging in ACS

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stroke
  atrial fibrillation
  ischaemic stroke
  people aged 60 and over
stroke risk stratification schemes
Sub-Saharan Africans
SYNERGY
SYMPHONY
T  
TACTICS-TIMI
TARGET
  Comparison of two platelet glycoprotein IIb/IIIa inhibitors, tirofiban and abciximab
  follow-up study
telephone counselling for smoking cessation
telephonic management for heart failure
telmisartan for heart failure
thienopyridine derivatives
thoracic epidural anaesthesia for refractory angina
thorombolysis
acute coronary syndromes - thrombolytic therapy
ticlopidine
TIME study
TIMI
   troponins I and T
  low molecular weight heparin and unfractionated heparin
  low molecular weight heparin, enoxaparin
TIMI risk score

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tirofiban, see also glycoprotein llb/lla inhibitors
  in patients having coronary stenting
  following PCl procedure
  stent implantation
tobacco advertising bans
TONE study
  Effects of reduced sodium intake on hypertension control in older individuals
  overweight people
torasemide in heart failure, see also diuretics
TRACE study
  long-term ACE inhibitors
  trandolapil
  ACE inhibition after myocardial infarction
trandolapril after MI, see also ACE inhibitors
transcutanaous electrical stimulation
transesophageal echcardiography, see echocardiography
transmyocardial laser revascularisation
transplantation
troponins
  Troponin T and troponin I
U  
ultrasound guided interventions
unstable angina, see acute coronary syndromes
upper gastrointestinal complications
  and aspirin
  and warfarin
US Carvedilol

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V  
VALIANT
valsartan
  amlodipine
  long-term treatment
VALUE study
vegetables or salad, consumption in Wales/UK
venous thromboembolism & HRT
ventricular fibrillation & magnesium sulphate
verapamil for secondary prevention 
  see also calcium channel blockers
V-HeFT
vitamin C for primary prevention
vitamin E
  for primary prevention
  for high risk/CHD diagnosed
volunteer, non-medical responders
W  
waist circumference & CHD risk
warfarin, see also anticoagulants
  for atrial fibrillation
  for secondary prevention
  for stable angina/CHD
WATCH study
Whitehall II study
work site intervention to promote exercise
X  
ximelagatran for atrial fibrillation
Z  
zinc for primary prevention
zyban for smoking cessation

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Health Evidence Bulletins: Wales, Duthie Library, UWCM, Cardiff CF14 4XN. e-mail: mannmk@cf.ac.uk