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The deadly quartet revisited

  • Prakash C. Deedwania
    Correspondence
    Requests for reprints should be addressed to Prakash C. Deedwania, MD, University of California, San Francisco School of Medicine, 2615 East Clinton Avenue, Fresno, California 93703
    Affiliations
    Cardiology Division, Department of Medicine, University of California/San Francisco School of Medicine, San Francisco, California, USA

    Stanford University Medical Center, Palo Alto, California, USA
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      Coronary artery disease (CAD) is the leading cause of death and disability in the United States. Each year, >1 million US citizens suffer from myocardial infarction.

      1998 Heart and Stroke Statistical Update. Dallas, TX: American Heart Association; 1998.

      In addition, nearly 14 million people have stable CAD. It is accepted that the risk of CAD is increased in individuals with major coronary risk factors. Hypertension is a well-established risk factor for CAD. Hyperlipidemia, particularly the presence of high levels of low-density lipoprotein (LDL) cholesterol, has also gained attention as a major risk factor for CAD. Most recently, it has been found that hyperglycemia and hyperinsulinemia in people suffering from diabetes are both major risk factors for CAD.
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