RESUMO
Marijuana consumption is growing up becoming very common especially between young people. 9-THC, the main psychoactive compound in cannabis, acts on the endocannabinoid system having different cardiovascular effects, including arrhythmias, acute coronary syndrome, and sudden cardiac death. We present the case of a young man from Gambia with no cardiovascular risk factors, marijuana consumer, presenting to the emergency department with ST-elevation myocardial infarction. At coronary angiography, thrombotic left anterior descending coronary artery subocclusion was documented. We also describe the association between acute coronary syndrome and cannabis abuse.
Assuntos
Síndrome Coronariana Aguda , Cannabis , Trombose Coronária , Abuso de Maconha , Infarto do Miocárdio com Supradesnível do Segmento ST , Masculino , Humanos , Adolescente , Abuso de Maconha/complicações , Trombose Coronária/diagnóstico por imagem , Trombose Coronária/etiologia , Síndrome Coronariana Aguda/complicações , Cannabis/efeitos adversos , Infarto do Miocárdio com Supradesnível do Segmento ST/complicações , Angiografia Coronária , Vasos CoronáriosRESUMO
The combination of Simvastatin and Ezetimibe allows dual inhibition of both cholesterol production and absorption. This treatment approach allows achieving same low serum cholesterol levels with the administration of much lower doses of statins. This should reduce side effects, compared to statin only therapy, enabling more patients to achieve their LDL cholesterol treatment goals. With ezetimibe/simvastatin therapy, reductions of about 60% from baseline in LDL cholesterol have been shown. Concomitant improvement in other lipid fractions have also been demonstrated. The ezetimibe/simvastatin combination has been well tolerated, with a safety profile similar to that of statin therapy. This article will review clinical experience with ezetimibe/simvastatin combination, commenting upon its place and potential value in the prevention of cardiovascular disease.