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Background: Current European Guidelines suggest the use of cardiovascular risk categories and also recommend using high-intensity statins for patients with acute coronary syndromes (ACS). Objective: We examined the risk of ACS patients prior to the event, as well as the overall use and intensity of statins. Methods: We enrolled 687 ACS patients (mean age 63 years, 78% males). Low-density lipoprotein cholesterol (LDL-C) levels upon admission were used to assess attainment of LDL-C targets. Patients were categorized as very high, high, moderate and low risk based on their prior to admission cardiovascular (CV) risk. We examined statin use and dosage intensity among patients discharged from the hospital. Patients were followed for a median period of 189 days. Results: The majority of the patients (n=371, 54%) were at very high CV risk prior to admission, while 101 patients were at high risk (15%), 147 (21%) moderate risk and 68 (10%) low risk. Interestingly, LDL-C target attainment decreased as the risk increased (p<0.001). The majority (96%) of patients received statins at discharge; however, most of them (60.4%) received low/moderate intensity statins and just 35.9% received the suggested by the Guidelines high-intensity dose of statins. At follow-up, the rate of patients at high-intensity dose of statins remained similar (34.8%); 6% received no statins at all at follow-up. Conclusion: According to our study, the majority of ACS patients are already at high risk prior to their admission. Further, LDL-C targets are underachieved prior to the event and high-intensity statins are underutilized in ACS patients at, and post-discharge.

In view of recent therapeutic breakthroughs in acute coronary syndromes (ACS) and essential demographic and socioeconomic changes in Greece, we conducted the prospective, multi-center, nationwide PHAETHON study (An Epidemiological Cohort Study of Acute Coronary Syndromes in the Greek Population) that aimed to recruit a representative cohort of ACS patients and examine current management practices and patient prognosis.

Phosphodiesterase type-5 (PDE5) inhibitors are widely used as first-line therapy for erectile dysfunction (ED). Their efficacy and safety combined with an increasing understanding of cyclic guanosine monophosphate (cGMP)- regulated mechanisms, have triggered a number of attempts to determine their effects and potential benefits in nonurological conditions. In recent years, extensive and diverse preclinical and clinical evidence has been made available. PDE5 inhibition has shown collateral benefits for a multitude of risk factors or diseases associated with, or accompanying ED. To date, PDE5 inhibition has been shown to be effective for the treatment of idiopathic pulmonary arterial hypertension and both sildenafil and tadalafil are approved for this indication. However, PDE5 inhibitors appear to have the potential of further expanding their indications. Importantly, accumulating data show that the therapeutic potential extends to the cardiovascular, gastrointestinal, cutaneous and nervous system and that these agents may be beneficial in a multitude of conditions such as Raynauds phenomenon, heart failure, essential hypertension and stroke. PDE5 inhibitors are a conceptually attractive therapeutic class of agents with pleiotropic effects. The present review discusses recent findings regarding the effects of PDE5 inhibitors on non-urological conditions and highlights current and future clinical applications beyond ED.

Ikaria, the Greek island of the East Aegean, is among the five places in the world with the highest rates of octagenarians. Aortic stiffness, assessed by aortic pulse wave velocity (PWV), is an independent prognostic factor of cardiovascular and all-cause mortality. However, data on the assessment of aortic stiffness in long-living populations are lacking. The aim of the present study was to evaluate aortic stiffness in the inhabitants of Ikaria island, across a broad spectrum of age.

Vascular aging, as assessed by structural and functional properties of the arteries, is an independent indicator of cardiovascular risk. We hypothesized that the number presence of hypertension and dyslipidemia determine the progression of arterial stiffening.

Metabolic syndrome (MS) is associated with increased prothrombotic state. Arterial stiffness and microalbuminuria, markers of target organ damage, predict cardiovascular events and are closely related to MS. However, whether prothrombotic status is associated with arterial stiffness and microalbuminuria in hypertensive patients with MS is not clarified.

There is evidence for an inverse association between plasma testosterone and blood pressure. Recently, low plasma testosterone was associated with increased risk of major cardiovascular events in middle-aged hypertensive men. Central (aortic) blood pressures predict cardiovascular mortality with equal ability compared to peripheral (brachial) blood pressures. The aim of the present study was to assess the relationship of plasma total testosterone (TT) with peripheral and central haemodynamics in hypertensive men.

Vascular aging, as assessed by structural and functional properties of the arteries, is an independent indicator of cardiovascular risk. We investigated the effect of cardiovascular risk factors (RFs) on the progression of vascular aging.