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Sample records for angina pectoris variant

  1. Angina Pectoris (Stable Angina)

    Science.gov (United States)

    ... Peripheral Artery Disease Venous Thromboembolism Aortic Aneurysm More Angina Pectoris (Stable Angina) Updated:Sep 19,2016 You may have heard the term “angina pectoris” or “stable angina” in your doctor’s office, but ...

  2. Double hazards of ischemia and reperfusion arrhythmias in a patient with variant angina pectoris.

    Science.gov (United States)

    Xu, Mingzhu; Yang, Xiangjun

    2015-01-01

    Variant angina pectoris, also called Prinzmetal's angina, is a syndrome caused by vasospasms of the coronary arteries. It can lead to myocardial infarction, ventricular arrhythmias, atrioventricular block and even sudden cardiac death. We report the case of a 53 year-old male patient with recurrent episodes of chest pain and arrhythmias in the course of related variant angina pectoris. It is likely that the reperfusion following myocardial ischemia was responsible for the ventricular fibrillation while the ST-segment returned to the baseline. This case showed that potential lethal arrhythmias could arise due to variant angina pectoris. It also indicated that ventricular fibrillation could be self-terminated.

  3. Statine bei instabiler Angina pectoris

    Directory of Open Access Journals (Sweden)

    Marschang G

    1999-01-01

    Full Text Available Die Statine stellen die derzeit wirksamsten cholesterinsenkenden Medikamente dar, deren Effektivität und Verträglichkeit bereits durch große Primär- und Sekundärpräventionsstudien an zahlreichen Patienten gesichert ist. Subanalysen einiger dieser Interventionsstudien (AFCAPS/TexCAPS, 4S, CARE, LIPID haben eine signifikante Reduktion von Episoden instabiler Angina pectoris und damit verbundener Krankenhausaufenthalte ergeben. In der LIPID-Studie wurde weiters gezeigt, daß Patienten mit einer Anamnese von instabiler Angina pectoris mindestens ebenso wie Postinfarktpatienten von einer Therapie mit einem Statin profitieren. Von zwei derzeit noch nicht publizierten Studien (AVERT, MIRACL wird die Klärung weiterer Fragestellungen (hochdosierte Statintherapie im Vergeich zu Angioplastie, aggressive Cholesterinsenkung als Akuttherapie der instabilen Angina pectoris erwartet.

  4. Klinik der instabilen Angina pectoris

    Directory of Open Access Journals (Sweden)

    Auer J

    1999-01-01

    Full Text Available Die instabile Angina pectoris wird zu den akuten Koronarsyndromen gerechnet und weist als pathophysiologisches Substrat ein thrombotisches Ereignis auf dem Boden einer koronaren Endothelläsion auf. Aufgrund der Anamnese und unter Zuhilfenahme von EKG und serologischen Markern kann eine Risikostratifizierung von Patienten mit instabiler Angina pectoris vorgenommen werden. Je nach Risikoeinstufung und der damit möglichen prognostischen Abschätzung der klinischen Situation kann das weitere therapeutische Management stratifiziert werden. Im Rahmen der folgenden Übersicht werden anamnestische Kriterien für Definition und Klassifikation der instabilen Angina pectoris abgehandelt und darüber hinaus versucht, den Stellenwert der klinischen Untersuchung, der Echokardiographie und serologischer Tests für Risikoabschätzung und Therapieplanung dieser Patienten anzugeben.

  5. Angina pectoris efter sumatriptan (Imigran)

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Christiansen, B D

    1992-01-01

    Developed for the treatment of migraine, sumatriptan is an agonist of 5-hydroxytryptamine-1-receptors. Though a pressure sensation is a common complaint, significant ECG changes have not been reported after subcutaneous administration of sumatriptan. A case history is given where angina pectoris...... after sumatriptan self-administration was experienced on two occasions by a 61-year old man with a history of minor myocardial infarction--without post-infarction angina--two years previously. The angina after sumatriptan was accompanied on both occasions by significant ST-segment depression on ECG...

  6. Instabile Angina pectoris: nichtinvasive und invasive Diagnostik

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    Benzer W

    1999-01-01

    Full Text Available Patienten mit instabiler Angina pectoris befinden sich grundsätzlich in einer lebensbedrohlichen Situation, die eine notfallmäßige sofortige Klinikeinweisung und Einleitung einer maximalen medikamentösen Therapie unter intensivmedizinischer Überwachung nötig macht. Trotz moderner diagnostischer Möglichkeiten ist der Nachweis einer tatsächlich instabilen Angina pectoris nicht immer einfach. In der Beurteilung des klinischen Schweregrades der Symptomatik und der daraus abzuleitenden Prognose einer instabilen Angina pectoris hat sich zuletzt hauptsächlich die Braunwald-Klassifikation durchgesetzt. Die leichteste Form der instabilen Angina pectoris ist die Klasse IA1, die schwerste Form die Klasse IIIC3. Wenn eine EKG-Registrierung während einer Episode von Angina pectoris eine akute ST- Streckenveränderung zeigt, muß mit einem höheren Schweregrad der Erkrankung gerechnet werden. Das EKG ist darüber hinaus ein wichtiger prognostischer Marker für den Langzeitverlauf der Patienten über 6 Monate bis 1 Jahr. Die Bestimmung der kardialen Troponine ist heute ein unerläßlicher Eckpfeiler der Diagnostik und Risikostratifizierung von Patienten mit instabiler Angina pectoris. Wie in großen Studien gezeigt wurde, haben Patienten mit instabiler Angina pectoris und positivem Troponin T eine schlechtere Prognose als jene ohne Anstieg. Ist das Troponin I bzw. das Troponin T 6 Stunden nach Schmerzbeginn negativ, haben die Patienten ein sehr geringes Risiko ( 1% für ein folgendes kardiales Ereignis in den nächsten 30 Tagen. Bei den Troponin-positiven Patienten liegt die ereignisfreie Überlebensrate hingegen bei lediglich etwa 80%. Das C-reaktive Protein ist kein Prädiktor für die Prognose, gerade wenn die kardialen Troponine normal sind. Deshalb sollte dieser Parameter nicht als alleinstehender prognostischer Marker zur Abklärung der instabilen Angina pectoris verwendet werden. Das prognostische Gesamtbild der instabilen Angina pectoris

  7. [Panic disorder and angina pectoris].

    Science.gov (United States)

    Prenninger, Markus; Giefing, Georg; Auer, Johann; Windhager, Elmar; Eber, Bernd

    2004-02-01

    Panic attacks are a frequently cited cause of noncardiac chest pain. A strict separation of the internist's job (i. e., ruling out an "organic" cause of the patient's complaints) from the psychiatrist's job (e. g., diagnosing and treating panic disorder if present) may not always be the most efficient way of diagnostic work-up. We present the case of a 56-year-old female referred to our institution for elective coronary arteriography. Significant cardiovascular risk factors and symptoms compatible with unstable angina illustrate the common problem of a high probability of cardiac pathology in a patient with possible psychiatric symptoms. A modified SCID-interview complementing the coronary angiography results finally led to the definite diagnosis in this patient after symptoms had been present for over 20 years.

  8. Selection of medical treatment in stable angina pectoris

    DEFF Research Database (Denmark)

    Ardissino, D; Savonitto, S; Egstrup, K

    1995-01-01

    pectoris. BACKGROUND: The characteristics of anginal symptoms and the results of exercise testing are considered of great importance for selecting medical treatment in patients with chronic stable angina pectoris. However, little information is available on how this first evaluation may be used to select...... the best pharmacologic approach in individual patients. METHODS: In this prospective multicenter study, 280 patients with stable angina pectoris were enrolled in 25 European centers. After baseline evaluation, consisting of an exercise test and a questionnaire investigating patients' anginal symptoms....... CONCLUSIONS: The results of a baseline exercise test, but not the characteristics of anginal symptoms, may offer useful information for selecting medical treatment in stable angina pectoris....

  9. Treating angina pectoris by acupuncture therapy.

    Science.gov (United States)

    Xu, Lixian; Xu, Hao; Gao, Wei; Wang, Wei; Zhang, Hui; Lu, Dominic P

    2013-01-01

    Acupuncture therapy on PC 6 (Neiguan) has a therapeutic effect on cardiac and chest ailments including angina pectoris. Additional beneficial acupuncture points are PC 4 (Ximen), HT 7 (Shenmen point), PC 7 (Daling point), PC 5 (Jianshi point), PC 3 (Quze point), CV 17 (Danzhong point), CV 6 (Qihai point), BL 15 (Xinshu point), L 20 (Pishu point), BL 17 (Geshu point), BL23 (Shenshu point), BL18 (Ganshu point), HT 5 (Tongli point), and ST36 (Zusanli point). Acupuncture not only quickly relieve the symptoms of acute angina pectoris, but also improve nitroglycerine's therapeutic effects. Therefore, it is an efficient simple therapeutic method used for emergency and for regular angina treatment. Review of studies on acupuncture therapy has shown effectiveness were between 80% to 96.2% that are almost as effective as conventional drug regimen. When compared with conventional medical treatment, the acupuncture therapy shows the obvious advantage of lacking, adverse side effects commonly associated with the Western anti-anginal drugs such as 1) Nitroglycerine (headache--63% with nitroglycerine patch and 50% with spray; syncope--4%; and dizziness--8% with patch; hypotension--4% with patch; and increased angina 2% with patch). 2) Isosorbide mononitrate (dizziness--3 to 5%; nausea/vomiting--2 to 4% and other reactions including hypotension, and syncope even with small doses). 3) Propranolol (bradycardia, chest pain, hypotension, worsening of AV conduction disturbance, Raynaud's syndrome, mental depression, hyperglycemia, etc.). Many conventional anti-anginal medications cause inter-drug reactions with other medications the patients taking for other diseases. Whereas, acupuncture therapy does not pose such an interference with patient's medications. Nevertheless, surgery is still the treatment of choice when acupuncture or conventional drug therapy fails. Combination of conventional drug therapy and acupuncture would considerably decrease the frequency and the required dosage

  10. Anipamil prevents ST depression in patients with stable angina pectoris

    DEFF Research Database (Denmark)

    Larsen, C T; Sørum, C; Rasmussen, V

    1993-01-01

    . The patients received anipamil 80 mg once daily, anipamil 160 mg once daily, and placebo in a randomized order. At the end of each treatment period the patients underwent 24-hour ambulatory ECG recording. Nineteen patients were included, all with typical stable angina pectoris for at least 2 months, exercise...... test with > or = 0.10 mV horizontal or down-sloping ST-segment depression and limited by angina pectoris, and at least 10 attacks of angina pectoris in the initial single-blind placebo period. During the placebo period, a total duration of transient myocardial ischemia > or = 0.10 mV during the 24-hour...

  11. Use of ranolazine in patients with stable angina pectoris.

    Science.gov (United States)

    Khera, Sahil; Kolte, Dhaval; Aronow, Wilbert S

    2014-01-01

    The current American Heart Association/American College of Cardiology guidelines for patients with stable angina pectoris recommend β-blockers as the initial drug therapy for prevention of angina pectoris (class I B indication). Long-acting nitrates or calcium channel blockers should be prescribed for prevention of angina when β-blockers are contraindicated or not tolerated secondary to side effects (class I B indication). Long-acting nitrates or calcium channel blockers in combination with β-blockers should be prescribed for angina prevention when initial treatment with β-blockers is unsuccessful (class I B indication). Only sublingual nitroglycerin or nitroglycerin spray should be used for immediate relief of angina pectoris (class I B indication). Ranolazine with β-blockers can be used for prevention of angina when initial treatment with β-blockers is not successful (class IIa A indication). If angina persists despite treatment with β-blockers, long-acting nitrates and calcium channel blockers, we recommend the addition of ranolazine for prevention of stable angina pectoris. This editorial discusses the contemporary role of ranolazine in the management of patients with stable angina pectoris.

  12. Association of interleukin-6 gene polymorphism with angina pectoris.

    Science.gov (United States)

    Amorim, Fernanda Gobbi; Campagnaro, Bianca Prandi; Tonini, Clarissa Loureiro; Norbim, Ana Paula Capua; Louro, Iuri Drummond; Vasquez, Elisardo Corral; Arruda, Jose Airton; Meyrelles, Silvana Santos

    2011-10-01

    In this study, we investigated the role of the -174G>C polymorphism of interleukin-6 (IL-6) as a predisposing factor to angina pectoris. Patients were separated into 2 groups: angina (N = 72) and nonangina (N = 71). There were no statistical differences between groups for all cardiovascular risk factors evaluated. The GG genotype frequency was 18% lower in the angina than in the non-angina group, whereas GC + CC was 18% higher in the angina group (P = .036). The frequency of G allele was 11% lower in the angina than in the nonangina group and C allele was 11% higher in the angina group (P = .043). Patients carrying the C allele showed a 2-fold increased risk for angina pectoris (P = .036). Our study demonstrates a high incidence of the -174G>C polymorphism of the IL-6 gene in patients with angina pectoris compared with those carrying the G allele, reinforcing the contribution of genetic factors to the symptoms of angina pectoris.

  13. Invaliderende angina pectoris behandlet med elektrisk rygmarvsstimulation (ERS)

    DEFF Research Database (Denmark)

    Andersen, C; Clemensen, S E; Henneberg, S W

    1992-01-01

    Thirty patients who had severe incapacitating angina pectoris which had not reacted to the conventional therapeutic measures and which required massive daily opioid consumption were treated with electrical spinal cord stimulation (SCS) by means of a completely implantable stimulation system...

  14. Neurostimulation bei refraktärer Angina pectoris

    Directory of Open Access Journals (Sweden)

    Theres H

    2005-01-01

    Full Text Available Trotz großer Fortschritte der katheterinterventionellen und operativen Versorgung der koronaren Herzkrankheit (KHK verbleiben Patienten, bei denen eine Revaskularisierung nicht möglich ist. Besteht eine ausgeprägte Angina pectoris (CCS III–IV, so sprechen wir von einer "refraktären Angina pectoris". Eine Arbeitsgruppe der Europäischen Gesellschaft für Kardiologie führt die Neurostimulation an erster Stelle der alternativen Therapiemöglichkeiten für diese Patienten an. Zahlreiche Studien belegen, daß es sich dabei um eine effiziente und sichere adjuvante Therapie handelt. Sie führt zu einer Abnahme der Angina pectoris-Symptomatik mit konsekutiver Zunahme der körperlichen Leistungsfähigkeit. Ingesamt wird eine entscheidende Verbesserung der Lebensqualität erzielt, die Angina pectoris als Warnsymptom bei Myokardinfarkt wird jedoch nicht maskiert.

  15. Severe angina pectoris in asthma attack: a case report.

    Science.gov (United States)

    Nabavizadeh, Seyed Hesamedin; Farahbakhsh, Nazanin; Fazel, Ali; Mosavat, Fereshteh; Anushiravani, Amir

    2016-06-01

    Asthma is a chronic inflammatory disorder of the airways related to the obstruction of reversible airflow. Asthma presents as recurrent attacks of cough and dyspnea. Poor control causes recurrent admissions to the ICU, and mortality is related to poor drug compliance and follow-up. Angina pectoris is a syndrome of recurrent chest discomfort related to myocardial ischemia. The presence of these two disorders rarely has been reported. We reported a 12-year-old boy who was referred with exacerbation of asthma and developed angina pectoris during hospitalization. He had labored breathing and diffuse wheezing. During treatment of the asthma, the patient developed severe chest pain due to shunt formation and coronary hypoxia, caused by the sole administration of ventolin, since oxygen had been disconnected. After receiving appropriate therapy, both his asthma and angina recovered, and, to date, he has not experienced angina pectoris again.

  16. Effectiveness of Ivabradine in Treating Stable Angina Pectoris.

    Science.gov (United States)

    Ye, Liwen; Ke, Dazhi; Chen, Qingwei; Li, Guiqiong; Deng, Wei; Wu, Zhiqin

    2016-04-01

    Many studies show that ivabradine is effective for stable angina.This meta-analysis was performed to determine the effect of treatment duration and control group type on ivabradine efficacy in stable angina pectoris.Relevant articles in the English language in the PUBMED and EMBASE databases and related websites were identified by using the search terms "ivabradine," "angina," "randomized controlled trials," and "Iva." The final search date was November 2, 2015.Articles were included if they were published randomized controlled trials that related to ivabradine treatment of stable angina pectoris.Patients with stable angina pectoris were included.The patients were classified according to treatment duration (ivabradine and control groups, respectively. The ivabradine group had significantly longer exercise duration when they had been treated for at least 3 months, but not when treatment time was less than 3 months. Ivabradine significantly improved time to angina onset regardless of treatment duration. Control group type did not influence the effect of exercise duration (significant) or time to angina onset (significant).Compared with beta-blocker and placebo, ivabradine improved exercise duration and time to onset of angina in patients with stable angina. However, its ability to improve exercise duration only became significant after at least 3 months of treatment.

  17. Angina pectoris: current therapy and future treatment options.

    Science.gov (United States)

    Parikh, Raj; Kadowitz, Philip J

    2014-02-01

    Angina pectoris is the consequence of an inequality between the demand and supply of blood to the heart. Angina manifests itself as chest pain or discomfort and is a common complaint of patients in the hospital and in the clinic. There are, in fact, roughly half a million new cases of angina per year. Chest pain, while having many etiologies, is generally considered to be most lethal when related to a cardiac cause. In this review, the authors outline the current medical and surgical therapies that are used in the management of angina. Highlights of the various clinical trials that have assisted in the investigation of these therapies are summarized also. Then, the authors provide a focused review of the novel therapy options for angina that are currently being explored. From new medical treatments to revised surgical techniques to the discovery of stem cell therapy, many innovative options are being investigated for the treatment of angina.

  18. The Role of Ivabradine in the Management of Angina Pectoris.

    Science.gov (United States)

    Giavarini, Alessandra; de Silva, Ranil

    2016-08-01

    Stable angina pectoris affects 2-4 % of the population in Western countries and entails an annual risk of death and nonfatal myocardial infarction of 1-2 % and 3 %, respectively. Heart rate (HR) is linearly related to myocardial oxygen consumption and coronary blood flow, both at rest and during stress. HR reduction is a key target for the prevention of ischemia/angina and is an important mechanism of action of drugs which are recommended as first line therapy for the treatment of angina in clinical guidelines. However, many patients are often unable to tolerate the doses of beta blocker or non-dihydropyridine calcium antagonists required to achieve the desired symptom control. The selective pacemaker current inhibitor ivabradine was developed as a drug for the management of patients with angina pectoris, through its ability to reduce HR specifically. The available data suggest that ivabradine is a well-tolerated and effective anti-anginal agent and it is recommended as a second-line agent for relief of angina in guidelines. However, recent clinical trials of ivabradine have failed to show prognostic benefit and have raised potential concerns about safety. This article will review the available evidence base for the current role of ivabradine in the management of patients with symptomatic angina pectoris in the context of stable coronary artery disease.

  19. High probability of disease in angina pectoris patients

    DEFF Research Database (Denmark)

    Høilund-Carlsen, Poul F.; Johansen, Allan; Vach, Werner

    2007-01-01

    BACKGROUND: According to most current guidelines, stable angina pectoris patients with a high probability of having coronary artery disease can be reliably identified clinically. OBJECTIVES: To examine the reliability of clinical evaluation with or without an at-rest electrocardiogram (ECG......) in patients with a high probability of coronary artery disease. PATIENTS AND METHODS: A prospective series of 357 patients referred for coronary angiography (CA) for suspected stable angina pectoris were examined by a trained physician who judged their type of pain and Canadian Cardiovascular Society grade...... of pain. Pretest likelihood of disease was estimated, and all patients underwent myocardial perfusion scintigraphy (MPS) followed by CA an average of 78 days later. For analysis, the investigators focused on the approximate groups of patients with more severe disease, ie, typical angina (n=187), Canadian...

  20. The sensitivity of the symptom angina pectoris as a marker of transient myocardial ischaemia in chronic stable angina pectoris

    DEFF Research Database (Denmark)

    Egstrup, K

    1987-01-01

    Therapeutic decisions in patients with angina pectoris are traditionally based on the history reported by the patient, since objective evidence of myocardial ischaemia during daily life is often not available. In this study, ambulatory ST segment monitoring was performed in 60 patients...... with a history of chronic stable angina pectoris, positive exercise test and/or positive coronary angiography, and a correlation was made between the episodes of chest pain and ST segment change. The patients were grouped according to the results of exercise testing and coronary arteriography, and one group...... was studied with and without antianginal medication. Overall, 195 episodes of angina were noted, only 94 of which (48%) were accompanied by ST segment depression. Pain and ST segment changes were best correlated in patients with a positive exercise test, positive angiography and who were not receiving...

  1. NEBIVOLOL IN TREATMENT OF STABLE EXERTIONAL ANGINA PECTORIS

    Directory of Open Access Journals (Sweden)

    Y. V. Gavrilov

    2015-12-01

    Full Text Available Aim. To evaluate antianginal and antiischemic efficiency of nebivolol in patients with stable angina pectoris.Material and methods. 100 patients with ischemic heart disease showing stable exertional angina pectoris and having no contraindications to beta-blockers were studied. After 5-7 days of control period 50 randomly selected patients began to take nebivolol in initial dose of 5mg once daily and 50 patients started to take metoprolol in initial dose of 50 mg twice daily. Duration of treatment was 8 weeks. Efficiency of treatment was assessed according to the results of control treadmill assessment and control daily ECG monitoring.Results. 56-day therapy with nebivolol at a dose of 7,5 mg per day results in increase in duration of treadmill test before angina or ST depression (p<0.05. Antianginal and antiischemic effect of nebivolol 7.5 mg once daily is rather similar with that of metoprolol in average daily dose of 175 mg. Nebivolol compared to metoprolol significantly (p<0.05 more effectively reduces the number of silent myocardial ischemia.Conclusion. Nebivolol is an efficient antianginal and antiischemic drug for patients with stable exertional angina pectoris.

  2. Non-Linear Dynamics In Patients With Stable Angina Pectoris

    CERN Document Server

    Krstacic, G; Vargovic, E; Knezevic, A; Krstacic, A

    2001-01-01

    We investigate the clinical and prognostic significance of fractal dimension and detrended fluctuation analysis by comparing the group of patients with stable angina pectoris without previous myocardial infarction with the group of age-matched healthy controls. The fractal dimension of the R-R series was determined using the rescaled range (R/S) analysis technique. To quantify fractal longe-range-correlation properties of heart rate variability, the detrended fluctuation analysis (DFA) technique was used. The heart rate variability was characterized by a scaling exponent $\\alpha$, separately for short-term ($$ 11 beats) time scales. The results of data sets show the existence of crossover phenomena between short-time scales. The short-term fractal scaling exponent was significantly lower in patients with stable angina pectoris.

  3. Sexual function in patients with chronic angina pectoris.

    Science.gov (United States)

    Kloner, Robert A; Henderson, Luana

    2013-06-01

    Drugs for erectile dysfunction (ED) may be contraindicated with nitrates commonly used to treat patients with angina pectoris, and certain antianginal therapies may worsen ED. The American Heart Association and the Princeton Consensus Conference panel of experts recommend that patients with coronary artery disease and ED who experience angina pectoris undergo full medical evaluations to assess the cardiovascular risks associated with resuming sexual activity before being prescribed therapy for ED. Current antianginal therapies include β blockers, calcium channel blockers, short- and long-acting nitrates, and ranolazine, a late sodium current inhibitor. Short- and long-acting nitrates remain a contraindication with phosphodiesterase-5 inhibitors commonly used to treat patients with ED, and the benefits of the other antianginal therapies must be weighed against their effects on cardiovascular health and erectile function. In conclusion, patients with coronary artery disease and ED who wish to initiate phosphodiesterase-5 inhibitor therapy and need to discontinue nitrate therapy need treatment options that manage their angina pectoris effectively, maintain their cardiovascular health, and provide the freedom to maintain their sexual function.

  4. [Pain perception and peripheral pain localization in angina pectoris].

    Science.gov (United States)

    Droste, C

    1988-01-01

    Cardiac nociceptive afferences are mainly transmitted by sympathetic nervous tracts. After passing the ganglion stellatum and neighbouring ganglia, the nerves enter the dorsal horn of the spinal cord at C8-Th9 (especially Th2-Th6). Here the nerve synapses for the first time, mainly to neurons which run up to the thalamus contralaterally by the tractus spinothalamicus. Apart from atypically localised pain (jaw, head, neck), the nervus vagus is rarely involved in transmitting angina pectoris pain. There is no close relation between peripheral pain localisation and localisation of coronary stenosis or myocardial ischemia areas. The localisation of angina pectoris is decided by viscero-somatic summation (convergence-projection-theory). Almost all the ascending tracts of the tractus spinothalamicus with visceral inflow also receive inflow from somatic afferences, from skin areas of the dermatome from the same segment level, and especially from deep somatic structures such as muscle and ligaments (Head's zones). Additional reflex mechanisms, where the efferent part is probably sympathetic, explain transferred effects in the matching dermatome such as hypothermic skin zones, cutaneous hyperalgesia, higher pressure sensitivity of the muscles and occasionally even dystrophic changes. The amount of spinal visceral afferences is relatively small (only 1.5-2.5% of all somatic spinal afferences). The low amount, the pronounced divergence and, compared to converging somatic afferences, the larger receptive fields in the organ explain the diffuse, barely localisable character of angina pectoris pain. Cardiac afferences are tonically and phasically inhibited at spinal and supraspinal levels, especially by descending tracts. This explains why angina pectoris can be missing in spite of pronounced peripheral nociceptive impulse rates. Patients with silent myocardial ischemia have a higher central pain threshold than patients with symptomatic myocardial ischemia. Endogenous opioids

  5. Total occlusion of left main coronary artery without angina pectoris.

    Science.gov (United States)

    DePace, N L; Kimbiris, D; Iskandrian, A S; Bemis, C E; Segal, B L

    1983-05-01

    A patient had total occlusion of the left main coronary artery that was proved by coronary arteriography. The patient was initially seen with clinical signs of congestive heart failure but without symptoms of angina pectoris or ECG evidence of myocardial infarction. The patient's extensive right-to-left coronary artery collaterals may have contributed to the absence of chest pain. Because of the severe left ventricular dysfunction and the absence of chest pain, the patient was treated with medical therapy. Six months after the cardiac catheterization, he was alive and well under New York Heart Association functional classification II.

  6. Changes in multifractal properties for stable angina pectoris

    Science.gov (United States)

    Knežević, Andrea; Martinis, Mladen; Krstačić, Goran; Vargović, Emil

    2005-12-01

    The multifractal approach has been applied to temporal fluctuations of heartbeat (RR) intervals, measured in various regimes of physical activity (ergometric data), taken from healthy subjects and those having stable angina pectoris (SAP). The problem we address here is whether SAP changes multifractality observed in healthy subjects. The G-moment method is used to analyse the multifractal spectrum. It is observed that both sets of data characterize multifractality, but a different trend in multifractal behaviour is found for SAP disease, under pronounced physical activity.

  7. Performing stable angina pectoris: an ethnographic study.

    Science.gov (United States)

    Somerville, Claire; Featherstone, Katie; Hemingway, Harry; Timmis, Adam; Feder, Gene Solomon

    2008-04-01

    Symptoms play a crucial part in the formulation of medical diagnoses, yet the construction and interpretation of symptom narratives is not well understood. The diagnosis of angina is largely based on symptoms, but a substantial minority of patients diagnosed with "non-cardiac" chest pain go on to have a heart attack. In this ethnographic study our aims were to understand: (1) how the patients' accounts are performed or enacted in consultations with doctors; (2) the ways in which ambiguity in the symptom narrative is managed by doctors; and (3) how doctors reach or do not reach a diagnostic decision. We observed 59 consultations of patients in a UK teaching hospital with new onset chest pain who had been referred for a specialist opinion in ambulatory care. We found that patients rarely gave a history that, without further interrogation, satisfied the doctors, who actively restructured the complex narrative until it fitted a diagnostic canon, detaching it from the patient's interpretation and explanation. A minority of doctors asked about chest pain symptoms outside the canon. Re-structuring into the canonical classification was sometimes resisted by patients who contested key concepts, like exertion. Symptom narratives were sometimes unstable, with central features changing on interrogation and re-telling. When translation was required for South Asian patients, doctors considered the history less relevant to the diagnosis. Diagnosis and effective treatment could be enhanced by research on the diagnostic and prognostic value of the terms patients use to describe their symptoms.

  8. Treatment of Angina Pectoris Associated with Coronary Microvascular Dysfunction.

    Science.gov (United States)

    Ong, Peter; Athanasiadis, Anastasios; Sechtem, Udo

    2016-08-01

    Treatment of angina pectoris associated with coronary microvascular dysfunction is challenging as the underlying mechanisms are often diverse and overlapping. Patients with type 1 coronary microvascular dysfunction (i.e. absence of epicardial coronary artery disease and myocardial disease) should receive strict control of their cardiovascular risk factors and thus receive statins and ACE-inhibitors in most cases. Antianginal medication consists of ß-blockers and/or calcium channel blockers. Second line drugs are ranolazine and nicorandil with limited evidence. Despite individually titrated combinations of these drugs up to 30 % of patients have refractory angina. Rho-kinase inhibitors and endothelin-receptor antagonists represent potential drugs that may prove useful in these patients in the future.

  9. Angina pectoris in women: focus on microvascular disease.

    Science.gov (United States)

    Zuchi, Cinzia; Tritto, Isabella; Ambrosio, Giuseppe

    2013-02-20

    Ischemic heart disease (IHD) is the leading cause of death among women in Western countries, and it is associated with higher morbidity and mortality than in men. Nevertheless, IHD in women remains underdiagnosed and undertreated, and the misperception that females are "protected" against cardiovascular disease leads to underestimation of their cardiovascular risk; instead, women with chest pain have a high risk of cardiovascular events. Women suffering from angina pectoris tend to have different characteristics compared to men, with a high prevalence of non-significant coronary artery disease. Angina in women is more commonly microvascular in origin than in men, and therefore standard diagnostic algorithms may be suboptimal for women. This different pathophysiology impacts clinical management of IHD in women. While response to medical therapy may differ in women, they are scarcely represented in clinical trials. Therefore, solid data in terms of gender efficacy of antianginal drugs are lacking, and particularly when angina is microvascular in origin women often continue to be symptomatic despite maximal therapy with classical antianginal drugs. Recently, new molecules have shown promising results in women. In conclusion, women with angina are a group of patients in whom it seems appropriate to concentrate efforts aimed at reducing morbidity and improving quality of life.

  10. Salvianolate injection in the treatment of unstable angina pectoris

    Science.gov (United States)

    Zhang, Dan; Wu, Jiarui; Liu, Shi; Zhang, Xiaomeng; Zhang, Bing

    2016-01-01

    Abstract Background: To systematically evaluate the clinical efficacy and safety of Salvianolate injection in the treatment of unstable angina pectoris (UAP). Methods: Using literature databases, we conducted a thorough and systematic retrieval of randomized controlled trials (RCTs) that using Salvianolate injection for treating UAP. The Cochrane Risk of Bias Assessment Tool was used to evaluate the methodological quality of the RCTs, and then the data were extracted and meta-analyzed by RevMan5.2 software. Results: A total of 22 RCTs with 2050 participants were included. The meta-analysis indicated that the combined use of Salvianolate injection and western medicine (WM) in the treatment of UAP can achieve a superior effect in angina pectoris total effective rate (risk ratio [RR] = 1.22, 95% confidence interval [CI] (1.17, 1.27), Z = 10.15, P Adverse drug reactions (ADRs) or adverse drug events (ADEs) were reported in 6 RCTs involving 15 cases; however, there were no serious ADRs/ADEs. Conclusion: Based on the systematic review, the combined use of Salvianolate injection and WM in the treatment of UAP can achieve a better effect; however, there was no definitive conclusion about its safety. More the large-sample and multicenter RCTs are needed to support its clinical usage. PMID:28002341

  11. Transcutaneous electrical nerve stimulation (TENS) in angina pectoris.

    Science.gov (United States)

    Mannheimer, C; Carlsson, C A; Vedin, A; Wilhelmsson, C

    1986-09-01

    The aim of this study was to determine the efficacy of transcutaneous electrical nerve stimulation (TENS) in the treatment of chronic stable severe angina pectoris. In a short-term study the effect of TENS was studied in 10 male patients with angina pectoris (functional class III and IV). All patients had previously been stabilized on long-term maximal oral treatment. The effects of the treatment were measured by means of repeated bicycle ergometer tests. All patients had an increased working capacity (16-85%), decreased ST segment depression and reduced recovery time during TENS. No adverse effects were observed. A long-term study of TENS on similarly selected patients showed beneficial effects in terms of pain reduction, reduced frequency of anginal attacks, increased physical activity and increased working capacity during bicycle ergometer tests. An invasive study was carried out with respect to systemic and coronary hemodynamics and myocardial metabolism during pacing provoked myocardial ischemia in 13 patients. The results showed that TENS led to an increased tolerance to pacing, improved lactate metabolism, less pronounced ST segment depression. A drop in systolic blood pressure during TENS treatment at identical pacing rates indicated a decreased afterload. An increased coronary flow to ischemic areas in the myocardium was supported by the fact that the rate pressure product during anginal pain increased during TENS.

  12. Meta-analysis of acupuncture therapy for the treatment of stable angina pectoris.

    Science.gov (United States)

    Zhang, Ze; Chen, Min; Zhang, Li; Zhang, Zhe; Wu, Wensheng; Liu, Jun; Yan, Jun; Yang, Guanlin

    2015-01-01

    Angina pectoris is a common symptom imperiling patients' life quality. The aim of this study is to evaluate the efficacy and safety of acupuncture for stable angina pectoris. Clinical randomized-controlled trials (RCTs) comparing the efficacy of acupuncture to conventional drugs in patients with stable angina pectoris were searched using the following database of PubMed, Medline, Wanfang and CNKI. Overall odds ratio (ORs) and weighted mean difference (MD) with their 95% confidence intervals (CI) were calculated by using fixed- or random-effect models depending on the heterogeneity of the included trials. Total 8 RCTs, including 640 angina pectoris cases with 372 patients received acupuncture therapy and 268 patients received conventional drugs, were included. Overall, our result showed that acupuncture significantly increased the clinical curative effects in the relief of angina symptoms (OR=2.89, 95% CI=1.87-4.47, Pacupuncture therapy was superior to conventional drugs. Although there was no significant difference in overall effective rate relating reduction of nitroglycerin between two groups (OR=2.13, 95% CI=0.90-5.07, P=0.09), a significant reduction on nitroglycerin consumption in acupuncture group was found (MD=-0.44, 95% CI=-0.64, -0.24, Pacupuncture therapy than for traditional medicines (MD=2.44, 95% CI=1.64-3.24, Pacupuncture therapy were found. Acupuncture may be an effective therapy for stable angina pectoris. More clinical trials are needed to systematically assess the role of acupuncture in angina pectoris.

  13. [Myocardial infarct and unstable angina pectoris: diagnostics and therapy].

    Science.gov (United States)

    Weber, M; Hamm, C

    2007-04-01

    Acute coronary syndromes include ST-elevation and non-ST elevation myocardial infarction, and unstable angina pectoris. These are characterised by the acute onset of chest pain. For the diagnostic work up in the acute phase, ECG and the assessment of cardiac markers play a central role. For patients with ST-elevation, primary interventional therapy is the first choice. For patients with an acute coronary syndrome without ST-elevation, a risk adapted therapeutic strategy should be chosen. High risk patients (elevated troponins, clinical, rhythmological and hemodynamic instability, ST-depression and diabetes mellitus) should be treated by an early invasive approach with angiography performed within 48-72 h. Low risk patients should be treated conservatively. For all patients who are treated interventionally, the administration of an aggressive antiaggregatory therapy including aspirin, clopidogrel, glycoprotein IIb/IIIa inhibitors and heparin is indicated in the acute phase. In the chronic phase, the treatment of cardiovascular risk factors is of paramount importance.

  14. Effects of acupuncture in moderate, stable angina pectoris

    DEFF Research Database (Denmark)

    Ballegaard, Søren; Pedersen, F; Pietersen, A

    1990-01-01

    In order to evaluate the effects of acupuncture in moderate, stable angina pectoris, 49 patients were randomized to either genuine or sham acupuncture. In sham acupuncture needles were inserted into points within the same spinal segment as in genuine acupuncture, but outside the Chinese meridian...... system. The effect was evaluated from exercise tests, anginal attack rate and nitroglycerin consumption. There were no significant differences between the effects of genuine and sham acupuncture either on exercise test variables or on subjective variables. In patients receiving genuine acupuncture...... there was a significant increase in exercise tolerance (median 9%) and in delay of onset to pain (median 10%). No significant changes were observed in patients receiving sham acupuncture. Within both groups there was a median reduction of 50% in anginal attack rate and nitroglycerin consumption...

  15. Refractory angina pectoris in end-stage coronary artery disease : Evolving therapeutic concepts

    NARCIS (Netherlands)

    Schoebel, FC; Frazier, OH; Jessurun, GAJ; DeJongste, MJL; Kadipasaoglu, KA; Jax, TW; Heintzen, MP; Cooley, DA; Strauer, BE; Leschke, M

    1997-01-01

    Refractory angina pectoris in coronary artery disease is defined as the persistence of severe anginal symptoms despite maximal conventional antianginal combination therapy. Further, the option to use an invasive revascularization procedure such as percutaneous coronary balloon angioplasty or aortoco

  16. The prognostic significance of post-infarction angina pectoris and the effect of verapamil on the incidence of angina pectoris and prognosis. The Danish Study Group on Verapamil in Myocardial Infarction

    DEFF Research Database (Denmark)

    Jespersen, C M; Hansen, J F; Mortensen, L S

    1994-01-01

    The prognostic significance of angina pectoris and the effect of intervention with verapamil on the incidence of angina pectoris were studied in patients recovering from myocardial infarction and included in the Danish Verapamil Infarction Trial II. During the second week after admission patients...... were doubly-blindly randomized to treatment with verapamil 360 mg.day-1 or placebo. Treatment was continued for up to 18 months. At discharge angina pectoris was reported in 11% of 869 patients randomized to verapamil and in 12% of 888 randomized to placebo (ns). One month after discharge a significant...... increase in the prevalance of angina pectoris was reported in both the verapamil (33%) (P angina pectoris (P = 0.03) and the 18 months overall incidence of angina pectoris (P = 0.002) were both significantly lower...

  17. [Unstable angina pectoris in intermittent left bundle branch block].

    Science.gov (United States)

    Albert, S; Flury, G

    1997-11-19

    We present a case report of a 57 year old woman with recurrent chest pain, initially exclusively at exercise and later also at rest. This led to an emergency hospitalization for suspected myocardial infarction. As there were no enzymatic and electrocardiographic signs of acute infarction she was treated, as unstable angina pectoris. Coronary angiography revealed but a modest coronary atheromatosis without significant coronary stenosis. Therefore her symptoms were interpreted as primary manifestation of an intermittant Left Bundle Branch Block (LBBB) with changing heart-rate dependency. A majority of patients with LBBB and chest pain have a relevant Coronary Artery Disease (CAD). There is a small number of reports in literature about patients with intermittant LBBB without significant CAD but with both typical (exercise-induced) and atypical (at rest) chest pain. Special features of our case are presentation of LBBB as unstable angina, documentation of an intermittant LBBB with changing heart-rate dependency and heart-rate-dependent supranormal conduction in the left bundle branch. We review some important aspects of LBBB with regard to this case.

  18. Phase changes caused by hyperventilation stress in spastic angina pectoris analyzed by first-pass radionuclide ventriculography

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Jin; Takeda, Tohoru; Ajisaka, Ryuichi; Masuoka, Takeshi; Watanabe, Sigeyuki; Sato, Motohiro; Itai, Yuji [Tsukuba Univ., Ibaraki (Japan). Inst. of Clinical Medicine; Toyama, Hinako; Ishikawa, Nobuyoshi

    1999-02-01

    To understand the effect of hyperventilation (HV) stress in patients with spastic angina, left ventricular (LV) contraction was analyzed by quantitative phase analysis. The study was performed on 36 patients with spastic angina pectoris, including vasospastic angina pectoris (VspAP: 16 patients) and variant angina pectoris (VAP: 20 patients). First-pass radionuclide ventriculography (first-pass RNV) was performed at rest and after HV stress, and standard deviation of the LV phase distribution (SD) was analyzed. The SD was lower in patients with VspAP than in VAP(12.8{+-}1.4 degrees vs. 14.6{+-}2.2 degrees, p<0.005) at rest. After HV stress, the SD (HVSD) tended to increase in VspAP patients (62.5%), whereas the SD decreased in VAP patients (70%). Due to HV stress, the percentage change in SD (%SD) in VspAP patients was 8.9{+-}23.7% whereas that in VAP patients was -9.1{+-}17.3% (p<0.01). Moreover, phase histograms were divided into HVSD increase and HVSD decrease groups. The HVSD increase group had a decrease of HVEF, but the HVSD decrease group tended to have more decreased HVEF than the HVSD increase group. These results indicate that spastic angina pectoris patients show various responses to HV stress. The HVSD increase group might have additional myocardial ischemia due to regional coronary spasm. In contrast, in the HVSD decrease group severe LV dysfunction or diffuse wall motion abnormality might have been generated, and this caused a reduction in the SD value. Phase analysis would therefore add new information regarding electrocardiographically silent myocardial ischemia due to coronary spasm, and HV stress might increase sensitivity for the detection of abnormalities in quantitative phase analysis, especially in VspAP patients. (author)

  19. Effect of anxiety and depression on endothelial function and inflammation degree of coronary heart disease patients with angina pectoris

    Institute of Scientific and Technical Information of China (English)

    Lin Ni; Xiang-Yang Xia; Ka Han; Yong-Xin Wu

    2016-01-01

    Objective:To study the effect of anxiety and depression on endothelial function and inflammation degree of coronary heart disease patients with angina pectoris.Methods: 80 cases of patients diagnosed with angina pectoris of coronary heart disease in our hospital from May 2012 to August 2014 were enrolled for study; anxiety and depression were judged by anxiety subscale (HADS-a) and depression subscale (HADS-d). Endothelial progenitor cell and endothelial microparticle contents in peripheral blood as well as serum ET-1, CGRP, IL-6, IL-6R, IL-18, ADAMTS-1 and NO contents were detected.Results:EPC, NO and CGRP contents of angina pectoris patients with anxiety were lower than those of angina pectoris patients without anxiety, and EMP, ET-1, IL-6, IL-6R, IL-18 and ADAMTS-1 contents were higher than those of angina pectoris patients without anxiety; EPC, NO and CGRP contents of angina pectoris patients with depression were lower than those of angina pectoris patients without depression, and EMP, ET-1, IL-6, IL-6R, IL-18 and ADAMTS-1 contents were higher than those of angina pectoris patients without depression.Conclusions:Angina pectoris of coronary heart disease patients complicated with anxiety and depression have endothelial dysfunction and inflammatory reaction activation; endothelial dysfunction and inflammatory reaction activation are possible pathways that anxiety and depression cause the progression of coronary heart disease.

  20. Frequency of Angina Pectoris After Percutaneous Coronary Intervention and the Effect of Metallic Stent Type.

    Science.gov (United States)

    Gaglia, Michael A; Torguson, Rebecca; Lipinski, Michael J; Gai, Jiaxiang; Koifman, Edward; Kiramijyan, Sarkis; Negi, Smita; Rogers, Toby; Steinvil, Arie; Suddath, William O; Satler, Lowell F; Pichard, Augusto D; Waksman, Ron

    2016-02-15

    Although metallic coronary stents significantly reduce angina pectoris compared with optimal medical therapy, angina after percutaneous coronary intervention (PCI) remains frequent. We, therefore, sought to compare the incidence of any angina during the 1 year after PCI among the spectrum of commercially available metallic stents. Metallic stent type was classified as bare metal stent, Cypher, Taxus Express, Xience V, Promus Element, and Resolute. The primary end point was patient-reported angina within 1 year of PCI. Multivariable logistic regression was performed to assess the independent association of stent type with any angina at 1 year. Overall, 8,804 patients were queried in regard to angina symptoms; 32.3% experienced angina at some point in the first year after PCI. Major adverse cardiovascular events, a composite of all-cause mortality, target vessel revascularization, and Q-wave myocardial infarction, increased with angina severity: 6.8% for patients without angina, 10.0% for patients with class 1 or 2 angina, and 19.7% for patients with class 3 or 4 angina (p angina at 1 year after PCI. Baseline Canadian Cardiovascular Society class 3 or 4 angina, history of coronary artery bypass grafting, and history of PCI were associated with a higher likelihood of angina at 1 year; increasing age, male gender, presentation with acute coronary syndrome, and higher stented length were associated with less angina. In conclusion, metallic stent type is not associated with the occurrence of angina at up to 1 year after PCI.

  1. Efficacy of anipamil, a phenylalkylamine calcium antagonist, in treatment of angina pectoris

    DEFF Research Database (Denmark)

    Sørum, C; Larsen, C T; Rasmussen, Verner

    1994-01-01

    with > or = 0.1-mV horizontal or downsloping ST-segment depression limited by angina, and (c) at least 10 attacks of angina pectoris in a single-blind 3-week run-in period. Nineteen patients were randomized to enter the study. In 3-week periods, they received either anipamil 80 mg once daily (o.d.), anipamil...... 160 mg o.d., or placebo. At the end of each period, an exercise test was performed. The number of angina pectoris attacks was significantly reduced during treatment with anipamil 80 mg (p ... reduced during treatment with anipamil 80 mg (p Heart rate (HR) at 0...

  2. The prognostic significance of angina pectoris experienced during the first month following acute myocardial infarction

    DEFF Research Database (Denmark)

    Jespersen, C M

    1997-01-01

    BACKGROUND: Angina pectoris accompanied by transient ST-segment changes during the in-hospital phase of acute myocardial infarction (AMI) is a well established marker of subsequent cardiac death and reinfarction. HYPOTHESIS: This study was undertaken to record the prognostic significance of angina...... on study treatment 1 month after discharge. Of these patients, 311 (39%) reported chest pain during the first month following discharge. RESULTS: Patients with angina pectoris had a significantly increased risk of reinfarction [hazard 1.71; 95%-confidence limit (CL): 1.09, 2.69] and increased mortality...... risk which, however, only reached borderline statistical significance (hazard 1.52; 95%-CL: 0.96, 2.40). When patients were subdivided according to both angina pectoris and heart failure, those with one or both of these risk markers had significantly increased mortality (p 0.03) and reinfarction (p 0...

  3. Atypical presentations among Medicare beneficiaries with unstable angina pectoris.

    Science.gov (United States)

    Canto, John G; Fincher, Contessa; Kiefe, Catarina I; Allison, Jeroan J; Li, Qing; Funkhouser, Ellen; Centor, Robert M; Selker, Harry P; Weissman, Norman W

    2002-08-01

    Chest pain is a hallmark symptom in patients with unstable angina pectoris (UAP). However, little is known regarding the prevalence of an atypical presentation among these patients and its relation to subsequent care. We examined the medical records of 4,167 randomly sampled Medicare patients hospitalized with unstable angina at 22 Alabama hospitals between 1993 and 1999. We defined typical presentation as (1) chest pain located substernally in the left or right chest, or (2) chest pain characterized as squeezing, tightness, aching, crushing, arm discomfort, dullness, fullness, heaviness, pressure, or pain aggravated by exercise or relieved with rest or nitroglycerin. Atypical presentation was defined as confirmed UAP without typical presentation. Among patients with confirmed UAP, 51.7% had atypical presentations. The most frequent symptoms associated with atypical presentation were dyspnea (69.4%), nausea (37.7%), diaphoresis (25.2%), syncope (10.6%), or pain in the arms (11.5%), epigastrium (8.1%), shoulder (7.4%), or neck (5.9%). Independent predictors of atypical presentation for patients with UAP were older age (odds ratio 1.09, 95% confidence interval 1.01 to 1.17/decade), history of dementia (odds ratio 1.49, 95% confidence interval 1.10 to 2.03), and absence of prior myocardial infarction, hypercholesterolemia, or family history of heart disease. Patients with atypical presentation received aspirin, heparin, and beta-blocker therapy less aggressively, but there was no difference in mortality. Thus, over half of Medicare patients with confirmed UAP had "atypical" presentations. National educational initiatives may need to redefine the classic presentation of UAP to include atypical presentations to ensure appropriate quality of care.

  4. Serum cardiac troponin T in unstable angina pectoris patients.

    Science.gov (United States)

    Leowattana, W; Mahanonda, N; Bhuripanyo, K; Pokum, S; Kiartivich, S

    2000-11-01

    Cardiac troponin T (cTnT) is a regulatory contractile protein not normally found in blood. Its detection in the circulation has been shown to be a sensitive and specific marker for myocardial cell damage. In this study, we used a second-generation enzyme immunoassay for cTnT to determine whether its presence in the serum of patients with unstable angina was a prognostic indicator. Thirty patients with unstable angina pectoris (UAP) and 30 patients with Q-wave acute myocardial infarction (AMI) were screened for serum CK-MB activity and cTnT at 6, 12, 24 and 48 hours after the onset of chest pain, All of the mean concentrations of CK-MB activity determined in UAP patients were less than the upper limit of normal (25 U/L). Meanwhile, the mean concentration of cTnT at 6, 12, 24 and 48 hours after onset of chest pain were higher than the cutoff values (0.1 microg/L), We found that one third of UAP patients had serum cTnT at the time of admission more than 0.1 microg/L and that these groups of patients were associated with a high risk for cardiac events. Our results suggested that patients with elevated serum cTnT could be considered as high-risk patients for developing myocardial infarction, Patients with normal cTnT levels and a low or intermediate clinical risk could be stabilized and further stratified noninvasively.

  5. Renal artery stenosis presenting as crescendo angina pectoris.

    Science.gov (United States)

    Tami, L F; McElderry, M W; al-Adli, N M; Rubin, M; Condos, W R

    1995-07-01

    The coexistence of different clinical syndromes due to atherosclerosis in different organs is not rare and emphasizes the diffuse nature of this vascular process. Although renovascular disease may cause hypertension and/or renal insufficiency, it may also occur in the absence of the usual clinical markers that suggest renovascular hypertension. We report a patient with stable coronary anatomy who presented with crescendo angina pectoris. Diagnosis of renovascular hypertension was made by screening renal angiography at the time of the cardiac catheterization. Renal artery stenting resulted in stabilization of the coronary syndrome and obviated the need for further coronary intervention. To our knowledge, this is the first case of renovascular hypertension precipitating an unstable coronary syndrome in a patient with documented stable coronary anatomy. Review of the literature supports that patients undergoing cardiac catheterization are a high risk population for renovascular disease, particularly in the presence of other predictive factors such as documented coronary artery disease, older age, female gender, congestive heart failure, peripheral vascular disease, renal insufficiency, and smoking. Firm recommendations for routine screening renal angiography in patients undergoing peripheral or coronary angiography will need further studies.

  6. Impact of Clinical Presentation (Stable Angina Pectoris vs Unstable Angina Pectoris or Non-ST-Elevation Myocardial Infarction vs ST-Elevation Myocardial Infarction) on Long-Term Outcomes in Women Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents

    DEFF Research Database (Denmark)

    Giustino, Gennaro; Baber, Usman; Stefanini, Giulio Giuseppe

    2015-01-01

    ,577 women included in the pooled database, 10,133 with known clinical presentation received a DES. Of them, 5,760 (57%) had stable angina pectoris (SAP), 3,594 (35%) had unstable angina pectoris (UAP) or non-ST-segment-elevation myocardial infarction (NSTEMI), and 779 (8%) had ST...

  7. Myocardial oxygen supply/demand ratio in aortic stenosis: hemodynamic and echocardiographic evaluation of patients with and without angina pectoris.

    Science.gov (United States)

    Nadell, R; DePace, N L; Ren, J F; Hakki, A H; Iskandrian, A S; Morganroth, J

    1983-08-01

    Angina pectoris is a common symptom in patients with aortic stenosis without coronary artery disease. To investigate the correlates of angina pectoris, echocardiographic and hemodynamic data from 44 patients with aortic stenosis and no coronary artery disease (mean age 56 +/- 10 years) were analyzed. Twenty-three patients had no angina pectoris and 21 patients had angina pectoris. The ratio of the diastolic pressure-time index (area between the aortic and left ventricular pressure curves during diastole) to the systolic pressure-time index (area under the left ventricular pressure curve during systole), an index of the oxygen supply/demand ratio, was not different in patients with or without angina pectoris. There were no differences between patients with and without angina pectoris in echocardiographically determined wall thickness, chamber size, systolic and diastolic wall stress and left ventricular mass; in electrocardiographically defined voltage; and in hemodynamically defined aortic valve area, transaortic gradient and stroke work index. Thus, echocardiographic and hemodynamic measurements at rest are not significantly different in the presence or absence of angina pectoris in patients with aortic stenosis. Dynamic data appear to be essential for evaluation of the mechanisms of angina pectoris in patients with aortic stenosis.

  8. Ventetid og omkostninger ved diagnostik og behandling af stabil angina pectoris

    DEFF Research Database (Denmark)

    Søgaard, Rikke; Sanchez, Ricardo

    Introduction: The objective of this pilot study was to examine possible consequences of a logistically non-optimal regimen, for the diagnosis and treatment of stable angina pectoris, on waiting time and costs to inform whether a larger study is warranted. Material and methods: Retrospective cohort...... study among 104 consecutive patients referred on suspected stable angina pectoris. Data on the diagnostic regimen was systematically collected from patient files and data on other resource use was collected using a questionnaire for self- reporting. Non-parametric bootstrapping was applied. Results...... of stable angina pectoris, which ceteris paribus would be associated with cost savings in the health care sector. However, these potentials should be examined in a larger- scale study....

  9. The efficacy of trimetazidine on stable angina pectoris: a meta-analysis of randomized clinical trials.

    Science.gov (United States)

    Peng, Song; Zhao, Min; Wan, Jing; Fang, Qi; Fang, Dong; Li, Kaiyong

    2014-12-20

    This meta-analysis aimed to evaluate the efficacy of trimetazidine in combination with other anti-anginal drugs versus other anti-anginal drugs in the treatment of stable angina pectoris (SAP). Randomized controlled trials (RCTs) published in English and Chinese were retrieved from computerized databases: Embase, PubMed, and CNKI. Primary outcomes consist of clinical parameters (numbers of weekly angina attacks and nitroglycerin use) and ergometric parameters (time to 1mm ST-segment depression, and total work (in Mets) and exercise duration (in seconds) at peak exercise) in stable angina pectoris treated by trimetazidine or not. The quality of studies was evaluated using Jadad score. Data analysis of 13 studies was performed using Stata 12.0 software. Results showed that treatment of trimetazidine and other anti-anginal drugs was associated with a smaller weekly mean number of angina attacks (WMD=-0.95, 95%CI: -1.30 to -0.61, Z=5.39, Pangina pectoris. Sensitivity analysis was performed. Sub-group analysis showed that treatment duration was not a significant moderator and patients treated within 8 weeks and above 12 weeks had no difference in the outcomes addressed in this meta-analysis. No publish bias was detected. This meta-analysis confirms the efficacy of trimetazidine in the treatment of stable angina pectoris, in comparison with conventional antianginal agents, regardless of treatment duration.

  10. [Diltiazem versus intravenous nitroglycerin in the treatment of unstable angina pectoris. A randomized study].

    Science.gov (United States)

    Castro, P; Corbalán, R; Vergara, I; Kunstmann, S

    1995-07-01

    Prognosis of unstable angina pectoris is related to admission EKG changes and prompt symptom control. The aim of this study was to compare the clinical effects of intravenous diltiazem (DTZ) or nitroglycerin (NTG) in patients with unstable angina pectoris. We studied 43 patients admitted to the hospital with a history of rest angina within the last 48 hours, associated with EKG evidence of ischemia. All subjects received intravenous heparin and oral aspirin, 23 were randomly assigned to receive intravenous DTZ and 20 to receive intravenous NTG. Both groups had similar baseline features and the endpoints of treatment were recurrence of angina, myocardial infarction, death during hospitalization and secondary side effects. Treatment with DTZ, when compared to NTG, resulted in a significant reduction of recurrent angina (8.7 and 59% respectively; p bradicardia with DTZ (28% of patients). In each group, one patient had a myocardial infarction and one patient died. It is concluded that intravenous DTZ reduces myocardial ischemia to a greater extent than NTG and can be safely used in patients with unstable angina pectoris.

  11. SAFETY AND EFFICACY OF BETA-BLOCKERS IN THE TREATMENT OF STABLE ANGINA-PECTORIS

    NARCIS (Netherlands)

    DEMUINCK, ED; LIE, KI

    1990-01-01

    In stable exercise-induced angina pectoris, beta-blockers exert their beneficial effects mainly through a reduction in heart rate, blood pressure, and contractility. Additional beneficial effects are an improvement in myocardial oxygen supply through a redistribution of coronary flow, a lengthening

  12. Spinal cord stimulation in refractory angina pectoris - Clinical results and mechanisms

    NARCIS (Netherlands)

    Oosterga, M; tenVaarwerk, IAM; DeJongste, MJL; Staal, MJ

    1997-01-01

    Patients with therapeutically refractory angina pectoris do not respond to adequate anti-anginal medication and are not suitable anymore for revascularisation procedures. This group of patients has a poor quality of Life, since their exercise capacity is severely afflicted. A new additional therapy

  13. Tissue Doppler echocardiography improves the diagnosis of coronary artery stenosis in stable angina pectoris

    DEFF Research Database (Denmark)

    Hoffmann, Soren; Jensen, Jan Skov; Iversen, Allan Zeeberg

    2012-01-01

    Aim To determine if colour tissue Doppler imaging (TDI) performed at rest in patients with suspected stable angina pectoris (SAP) is able to predict the presence of significant coronary artery disease (CAD). METHODS AND RESULTS: This study comprises 296 consecutive patients with clinically...

  14. [INTERVENTIONAL AND SURGICAL TREATMENT OF THE ANGINA PECTORIS RECURRENCE AFTER CORONARY SHUNTING OPERATION].

    Science.gov (United States)

    Fanta, S M

    2015-12-01

    There were examined 134 patients, in whom in the clinic in 2005-2014 yrs a coronary shunting operation was performed. In patients with the angina pectoris recurrence a reoperation is indicated. The data of repeated coronaroventriculography and shuntography were analyzed. Efficacy of the surgical and interventional methods application in the patients was proved.

  15. Mechanisms of angina pectoris in syndrome X assessed by myocardial perfusion dynamics and heart rate variability

    NARCIS (Netherlands)

    Meeder, JG; Blanksma, PK; Crijns, HJGM; Anthonio, RL; Pruim, J; Brouwer, J; DeJong, RM; VanderWall, EE; Vaalburg, W; Lie, KI

    1995-01-01

    The fundamental abnormality in syndrome X (angina pectoris, ischaemia-like stress ECG despite angiographically normal coronary arteries) might be patchily distributed increased tone in pre-arteriolar coronary vessels with compensatory release of adenosine. The aim of this study was to confirm this h

  16. Long-term effects of spinal cord stimulation on angina symptoms and quality of life in patients with refractory angina pectoris--results from the European Angina Registry Link Study (EARL)

    DEFF Research Database (Denmark)

    Andréll, P; Yu, W; Gersbach, P;

    2010-01-01

    To assess the long-term effect of spinal cord stimulation (SCS) on angina symptoms and quality of life in patients with refractory angina pectoris defined as severe angina due to coronary artery disease resistant to conventional pharmacological therapy and/or revascularisation.......To assess the long-term effect of spinal cord stimulation (SCS) on angina symptoms and quality of life in patients with refractory angina pectoris defined as severe angina due to coronary artery disease resistant to conventional pharmacological therapy and/or revascularisation....

  17. Erhöhter oxidativer Streß bei Patienten mit instabiler Angina pectoris

    Directory of Open Access Journals (Sweden)

    Bodlaj G

    1998-01-01

    Full Text Available Die instabile Angina pectoris führt oft zum akuten Myokardinfarkt. Da die Lipid-Peroxidation im Verdacht steht, chronische und akute Ereignisse der Atherosklerose und der koronaren Herzkrankheit zu fördern, untersuchten wir die Lipid-Peroxidations-Parameter und alpha-Toco-pherol-Spiegel bei 100 KHK-Patienten und verglichen sie mit denen einer entprechenden Kontrollgruppe. 50 konsekutive Patienten mit stabiler Angina pectoris (SAP und 50 konsekutive Patienten mit instabiler Angina pectoris (IAP wurden untersucht und mit 100 klinisch gesunden Personen verglichen. Zusätzlich zur herkömmlichen Lipid- und Lipoprotein-Analyse wurden die Lipid-Peroxidations-Produkte als Hydroperoxide und Thiobarbituric acid reactive substances (TBARS gemessen. Die konjugierten Diene wurden nur bei den Patienten bestimmt. Da alpha-Tocopherol eines der wichtigsten Antioxidantien ist, wurde es ebenfalls quantifiziert. Wie erwartet hatten die Patienten wesentlich höhere Cholesterin-, Triglyzerid-, LDL-C- und Lp(a-Spiegel und niedrigere HDL-C-Spiegel als die Kontrollgruppe. Als die Patienten in Gruppen mit stabiler und instabiler Angina pectoris geteilt wurden, waren Peroxide und TBARS in der letzteren Gruppe wesentlich höher als bei den anderen Patienten und der Kontrollgruppe. Auch konjugierte Diene waren eindeutig höher bei den Patienten mit instabiler Angina pectoris. Der alpha-Tocopherol-Gesamtspiegel war in allen 3 Gruppen vergleichbar, aber der alpha-Tocopherol-Gehalt pro LDL-Partikel war bei den Patienten mit IAP am niedrigsten, gefolgt von denen mit SAP und der Kontrollgruppe. Wir schließen daraus, daß die Lipid-Peroxidations-Parameter bei Patienten mit IAP erhöht sind und SAP-Patienten von IAP-Patienten unterscheiden.

  18. A case of reninoma with variant angina

    Directory of Open Access Journals (Sweden)

    Hyung Ah Jo

    2014-06-01

    Full Text Available Reninoma is a tumor of the renal juxtaglomerular cell apparatus that causes hypertension and hypokalemia because of hypersecretion of renin. We present a case of a 29-year-old female patient with reninoma and concomitant variant angina. The patient had uncontrolled hypertension and elevated plasma renin activity and aldosterone levels. Imaging studies revealed a mass in the left kidney, which was further confirmed as a renin-producing lesion via selective venous catheterization. During the evaluation, the patient had acute-onset chest pain that was diagnosed as variant angina after a provocation test. After partial nephrectomy, the plasma renin activity and plasma aldosterone levels decreased and blood pressure normalized. We report a case of reninoma with variant angina.

  19. TREATMENT OPTIMIZATION IN PATIENTS WITH STABLE ANGINA PECTORIS: FOCUS ON VERAPAMIL SR

    Directory of Open Access Journals (Sweden)

    I. M. Sokolov

    2011-01-01

    Full Text Available Possibilities of angina pectoris pharmacotherapy are analyzed. Achievement of target heart rate (HR 55-60 beats per minute in these patients is possible due to three classes of antianginal medications that slow down HR: beta blockers (BB, If-channel inhibitors, nondihydropyridine calcium channel blockers (CCB. Nondihydropyridine CCB verapamil in slow release (SR formulation is focused. The main results of randomized clinical trials (APSIS, VHAS, CRIS, EVERESTH, VAMPHYRE, INVEST, VESPA, DAVIT-1, DAVIT-2, which have proven efficacy and safety, are presented. Verapamil SR is indicated for the treatment of angina pectoris in patients without history of myocardial infarction (MI; angina patients experienced MI without systolic heart failure and with contraindications to BB; angina with arterial hypertension; left ventricular diastolic dysfunction; peripheral arteries obliterating atherosclerosis; silent myocardial ischemia; vasospastic angina; angina associated with supraventricular cardiac arrhythmias (especially in permanent atrial fibrillation except Wolff-Parkinson-White and Lown-Ganong-Levine syndromes; after coronary angioplasty and the placement of bare metal stents.

  20. Spinal cord stimulation for long-term treatment of severe angina pectoris: what does the evidence say?

    Science.gov (United States)

    Börjesson, Mats; Andréll, Paulin; Mannheimer, Clas

    2011-11-01

    Patients who continue to suffer from severe and disabling angina pectoris, despite optimum treatment in terms of conventional pharmacological therapy and/or revascularization procedures, have been termed as having refractory angina pectoris. The future group of patients with refractory angina pectoris will be different from today's patients and represent a 'moving target' as risk factors, efficacy of treatment and indications continue to change. Spinal cord stimulation (SCS) is today considered as first-line treatment of refractory angina pectoris, by the European Society of Cardiology, with an anti-ischemic effect. There is strong evidence for SCS giving symptomatic benefits (decrease in anginal attacks), improved quality of life and improvement of functional status. In addition, SCS seems to be cost effective with a 'break-even' after approximately 15-16 months.

  1. A risk score for predicting coronary artery disease in women with angina pectoris and abnormal stress test finding.

    Science.gov (United States)

    Lo, Monica Y; Bonthala, Nirupama; Holper, Elizabeth M; Banks, Kamakki; Murphy, Sabina A; McGuire, Darren K; de Lemos, James A; Khera, Amit

    2013-03-15

    Women with angina pectoris and abnormal stress test findings commonly have no epicardial coronary artery disease (CAD) at catheterization. The aim of the present study was to develop a risk score to predict obstructive CAD in such patients. Data were analyzed from 337 consecutive women with angina pectoris and abnormal stress test findings who underwent cardiac catheterization at our center from 2003 to 2007. Forward selection multivariate logistic regression analysis was used to identify the independent predictors of CAD, defined by ≥50% diameter stenosis in ≥1 epicardial coronary artery. The independent predictors included age ≥55 years (odds ratio 2.3, 95% confidence interval 1.3 to 4.0), body mass index angina pectoris and abnormal stress test findings. This tool, if validated, could help to guide testing strategies in women with angina pectoris.

  2. Ranolazin--ny behandling af kronisk stabil angina pectoris

    DEFF Research Database (Denmark)

    Ahlehoff, Ole; Hansen, Peter Riis

    2009-01-01

    Ranolazine sustained-release tablets were recently approved in the EU for chronic stable angina as add-on therapy when symptoms are not controlled with first-line agents. The mechanism of action is thought to involve inhibition of late sodium influx in the heart, which can reduce abnormalities...... of contractility and repolarisation associated with ischaemia. Ranolazine increases the exercise capacity, reduces angina, and diminishes the use of nitroglycerine. The drug has an excellent safety profile and may be a valuable addition to the treatment of chronic stable angina....

  3. Persistent angina: highly prevalent and associated with long-term anxiety, depression, low physical functioning, and quality of life in stable angina pectoris

    DEFF Research Database (Denmark)

    Jespersen, L.; Abildstrom, S. Z.; Hvelplund, Anders;

    2013-01-01

    To evaluate persistent angina in stable angina pectoris with no obstructive coronary artery disease (CAD) compared to obstructive CAD and its relation to long-term anxiety, depression, quality of life (QOL), and physical functioning. We invited 357 patients (men = 191; women = 166; response rate ...

  4. [Clinical trial by perexiline maleate in treatment of angina pectoris (author's transl)].

    Science.gov (United States)

    Corsini, G; Correale, E; Oriani, G; Persico, S; Tritto, C

    1975-01-01

    A controlled double blind clinical trial has been conducted in 16 patients with "angina pectoris" in order to investigate the effect of Perexiline maleate as compared with prenilamine. Perexiline at the dose of 400 mg/die and prenilamine at the dose of 120 mg/die have been administered over a period of 4 weeks each. Between these periods placebo has been administered for two weeks. The number of attacks of angina and the number of tablets of nitroglycerine used per week by the patient during each period has been used for the evaluation. Furthermore ECG at rest and after exercise has been performed every two weeks. Our results statistically evaluated show a definite antianginal effect of Perexiline. According to our experience Perexiline should be considered the drug of choise in the treatment of angina complicated by bradicardia, left ventricular failure, bronchospasm, and in angina unresponsive to other drugs.

  5. Narrowing of the Coronary Sinus: A Device-Based Therapy for Persistent Angina Pectoris.

    Science.gov (United States)

    Konigstein, Maayan; Verheye, Stefan; Jolicœur, E Marc; Banai, Shmuel

    2016-01-01

    Alongside the remarkable advances in medical and invasive therapies for the treatment of ischemic heart disease, an increasing number of patients with advanced coronary artery disease unsuitable for revascularization continue to suffer from angina pectoris despite optimal medical therapy. Patients with chronic angina have poor quality of life and increased levels of anxiety and depression. A considerable number of innovative therapeutic modalities for the treatment of chronic angina have been investigated over the years; however, none of these therapeutic options has become a standard of care, and none are widely utilized. Current treatment options for refractory angina focus on medical therapy and secondary risk factor modification. Interventions to create increased pressure in the coronary sinus may alleviate myocardial ischemia by forcing redistribution of coronary blood flow from the less ischemic subepicardium to the more ischemic subendocardium, thus relieving symptoms of ischemia. Percutaneous, transvenous implantation of a balloon expandable, hourglass-shaped, stainless steel mesh in the coronary sinus to create a fixed focal narrowing and to increase backwards pressure, may serve as a new device-based therapy destined for the treatment of refractory angina pectoris.

  6. Treatment of Unstable Angina Pectoris with Modified Nuan Gan Jian - A Report of 33 Cases

    Institute of Scientific and Technical Information of China (English)

    贺敬波; 黄绵清; 张勤; 廖万柏; 王立军; 张玉英

    2004-01-01

    Objective: To observe the effectiveness of Modified Nuan Gan Jian Jiao Nang (MNGJ 加减暖肝煎胶囊Modified Liver-Warming Capsule) in treating unstable angina pectoris. Method: Sixty-six eligible cases were assigned randomly into a treatment group and a control group and treated for 3 weeks. Results:MNGJ produced an effect in reducing episodes, improving the abnormal findings in electro-cardiogram (ECG) (P<0.05) significantly, and decreasing myocardial oxygen consumption (P<0.05). In addition, it could decrease the plasma TXB2 level and increase 6-keto-prostaglandin F1α (6-Keto-PGF1α) level (P<0.01). Conclusion: MNGJ was quite effective in treating unstable angina pectoris, suggesting that the treatment of the disease could start from the liver.

  7. A Destabilized Case of Stable Effort Angina Pectoris Induced by Low-dose Adenosine Triphosphate

    Science.gov (United States)

    Sueta, Daisuke; Kojima, Sunao; Izumiya, Yasuhiro; Yamamuro, Megumi; Kaikita, Koichi; Hokimoto, Seiji; Ogawa, Hisao

    2016-01-01

    A 79-year-old man was diagnosed with sudden deafness. He had previously experienced a suspected episode of angina pectoris. At a local hospital, after 500 mg of hydrocortisone and 80 mg adenosine triphosphate (ATP) were administered, he became aware of chest discomfort. An electrocardiogram revealed serious ST-segment depressions. He was diagnosed with a non-ST elevated myocardial infarction (NSTEMI). Emergency coronary angiography revealed triple vessel disease, and the lesion was successfully stented. The mechanisms whereby the stable effort angina pectoris destabilized in this case were thought to include a reduction of the local blood flow because of an ATP product and probable thrombus formation in response to the administered steroids. PMID:27853071

  8. Variant angina and coronary artery spasm: the clinical spectrum, pathophysiology, and management.

    Science.gov (United States)

    Kusama, Yoshiki; Kodani, Eitaro; Nakagomi, Akihiro; Otsuka, Toshiaki; Atarashi, Hirotsugu; Kishida, Hiroshi; Mizuno, Kyoichi

    2011-01-01

    Variant angina is a form of angina pectoris that shows transient ST-segment elevation on electrocardiogram during an attack of chest pain. Ischemic episodes of variant angina show circadian variation and often occur at rest from midnight to early morning. Ischemic episodes also occur during mild exercise in the early morning. However, they are not usually induced by strenuous exercise in the afternoon. Other important clinical features of variant angina include the high frequency of asymptomatic ischemic episodes and the syncope that sometimes occur during the ischemic episodes. Syncope is due to severe arrhythmias, including ventricular tachycardia, ventricular fibrillation, and high-degree atrioventricular block. Coronary artery spasm is the mechanism of ischemic episodes in variant angina. The incidence of coronary artery spasm shows a racial difference and is higher in Japanese than in Caucasians. Coronary arteriograms are normal or near-normal in most Japanese patients with variant angina. Deficient basal release of nitric oxide (NO) due to endothelial dysfunction, and enhanced vascular smooth muscle contractility with the involvement of the Rho/Rho-kinase pathway are reported to play important roles in the pathogenesis of coronary artery spasm. Other precipitating factors of coronary artery spasm include imbalance in autonomic nervous activity, increased oxidative stress, chronic low-grade inflammation, magnesium deficiency, and genetic susceptibility. The genetic risk factors associated with coronary artery spasm include gene polymorphisms of endothelial NO synthase (NOS), paraoxonase, and other genes. Calcium channel blockers are extremely effective in preventing coronary spasm. The long-acting nitrate, nicorandil, and Rho-kinase inhibitor are also useful for inhibiting coronary artery spasm. Because variant angina can lead to acute myocardial infarction, fatal arrhythmias, and sudden death, early treatment is important. The prognosis of patients with

  9. Acetylcholine test in patients with angina pectoris and normal coronary angiography

    Science.gov (United States)

    Barbieri, Enrico; Destro, Gianni; Oliva, Massimo; Zardini, Piero

    1994-02-01

    Angina pectoris with normal coronary artery on the coronary angiography is an intriguing issue. Intracoronary infusion of acetylcholine has recently been used to test the integrity of endothelial cells. We studied 16 patients with this syndrome. A relationship has been found between the acetylcholine test and the exercise stress test in normotensive patients. The presence of hypertension makes the evaluation of the test more unpredictable, probably because of the damage on the endothelial cells related to systemic hypertension.

  10. Angiotensin-converting enzyme in acute myocardial infarction and angina pectoris.

    Science.gov (United States)

    Rømer, F K; Kornerup, H J

    1981-06-01

    Serum activity of angiotensin-converting enzyme was measured by serial analysis in 19 patients with acute myocardial infarction and in eight patients with angina pectoris. As a rule no changes in enzyme activity occurred during 6 days observations. However, two patients with infarction exhibited a pronounced fall of enzyme activity which could not be related to clinical events. The analysis seems to have no place in the diagnosis and management of patients with myocardial infarction.

  11. Comparison of coronary artery specific leukocyte-platelet conjugate formation in unstable versus stable angina pectoris.

    Science.gov (United States)

    Patel, Parag B; Pfau, Steven E; Cleman, Michael W; Brennan, Joseph J; Howes, Christopher; Remetz, Michael; Cabin, Henry S; Setaro, John F; Rinder, Henry M

    2004-02-15

    This study evaluates transcoronary changes in neutrophil and platelet activation and conjugate formation in patients with angina pectoris secondary to coronary artery disease. We examined parameters of neutrophil and platelet activation as well as the neutrophil-platelet conjugate formation in patients who underwent diagnostic coronary angiography. Thirty-nine patients with chest pain referred for cardiac catheterization were studied (23 patients with unstable angina pectoris [UAP] and 16 with stable angina pectoris [SAP]). Before coronary angiography, blood samples were obtained simultaneously from the aortic root and coronary sinus to assess leukocyte (CD11b) and platelet (CD62P) activation and leukocyte-platelet conjugates. There was a 94% increase in CD62-expressing platelets from the aorta to the coronary sinus in patients with UAP compared with a 49% increase in patients with SAP. The percentage of neutrophil-platelet conjugates increased by 22% in patients with UAP compared with a 16% decrease in those with SAP (p <0.01). In contrast, monocyte-platelet binding across the coronary bed increased to a similar degree in both groups. This study demonstrates an increase in neutrophil-platelet conjugates across the coronary circulation in UAP, compatible with a higher activation state in both cell types.

  12. Heart rate dynamics in patients with stable angina pectoris and utility of fractal and complexity measures

    Science.gov (United States)

    Makikallio, T. H.; Ristimae, T.; Airaksinen, K. E.; Peng, C. K.; Goldberger, A. L.; Huikuri, H. V.

    1998-01-01

    Dynamic analysis techniques may uncover abnormalities in heart rate (HR) behavior that are not easily detectable with conventional statistical measures. However, the applicability of these new methods for detecting possible abnormalities in HR behavior in various cardiovascular disorders is not well established. Conventional measures of HR variability were compared with short-term ( 11 beats, alpha2) fractal correlation properties and with approximate entropy of RR interval data in 38 patients with stable angina pectoris without previous myocardial infarction or cardiac medication at the time of the study and 38 age-matched healthy controls. The short- and long-term fractal scaling exponents (alpha1, alpha2) were significantly higher in the coronary patients than in the healthy controls (1.34 +/- 0.15 vs 1.11 +/- 0.12 [p angina pectoris have altered fractal properties and reduced complexity in their RR interval dynamics relative to age-matched healthy subjects. Dynamic analysis may complement traditional analyses in detecting altered HR behavior in patients with stable angina pectoris.

  13. Breviscapine Injection Improves the Therapeutic Effect of Western Medicine on Angina Pectoris Patients.

    Science.gov (United States)

    Wang, Chuan; Li, Yafeng; Gao, Shoucui; Cheng, Daxin; Zhao, Sihai; Liu, Enqi

    2015-01-01

    To evaluate the beneficial and adverse effects of breviscapine injection in combination with Western medicine on the treatment of patients with angina pectoris. The Cochrane Central Register of Controlled Trials, Medline, Science Citation Index, EMBASE, the China National Knowledge Infrastructure, the Wanfang Database, the Chongqing VIP Information Database and the China Biomedical Database were searched to identify randomized clinical trials (RCTs) that evaluated the effects of Western medicine compared to breviscapine injection plus Western medicine on angina pectoris patients. The included studies were analyzed using RevMan 5.1.0 software. The literature search yielded 460 studies, wherein 16 studies matched the selection criteria. The results showed that combined therapy using Breviscapine plus Western medicine was superior to Western medicine alone for improving angina pectoris symptoms (OR=3.77, 95% Cl: 2.76~5.15) and also resulted in increased electrocardiogram (ECG) improvement (OR=2.77, 95% Cl: 2.16~3.53). The current evidence suggests that Breviscapine plus Western medicine achieved a superior therapeutic effect compared to Western medicine alone.

  14. The Study of hemodynamics and coronary arteriography of Patients with Different Types of Unstable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    谢小鲁; 王燕妮; 祝家庆; 袁祖贻

    2003-01-01

    Objectives To explore the basic heart functional state and cardiac reserve function of patients with different types of unstable angina pecto ris (UAP) and observe the relations between the heart function and severity of coronary arterial disease. Methods 70 eases with UAP were enrolled including 25 patients with angina decubitus (AD), 23 patients with mixed angina (MA) , and 22 patients with accelerated effort angina (AEA). All patients underwent a series of examination such as UCG, ECT, hemodynamics and volume-loading test. The patients were divided group. We assessed the basic heart function and cardiac reserve function of patients with different types of UAP and also observed the relations between coronary (48%). 43 percent of the patients with mixed angina had systolic dysfunction and other 43 percent of them had normal cardiac function. However, patients with nary capillary wedge pressure of positive patients rose,at the same time cardiac index fell to the extreme instantaneously after loading in volume-loading test and then they restored to the basic level until 60 minutes.However, both PCWP and CI of the negative patients arteriography show: there are 41% of patient with three-vessel disease, 50% with two-vessel disease,9% single vessel disease and left main narrowing 22.7% in AEA. There are separately 76%, 24%,were separately compared with AD, AEA/AD: P < 0. 05(P = 0.031); MA/AD: P < 0.01 (P = 0. 000313). Conclusions Most of patients with the above three types of unstable angina pectoris suffered from the basic heart dysfunction and cardiac reserve dysfunction which might participate in the occurrence and development of unstable angina pectoris. In angiography, there are the most three-vessel diseases in AD that are, therefore, the most severe UAP.

  15. Immediate and long-term clinical outcome after spinal cord stimulation for refractory stable angina pectoris.

    Science.gov (United States)

    Di Pede, Francesco; Lanza, Gaetano Antonio; Zuin, Guerrino; Alfieri, Ottavio; Rapati, Massimo; Romanò, Massimo; Circo, Antonio; Cardano, Paola; Bellocci, Fulvio; Santini, Massimo; Maseri, Attilio

    2003-04-15

    The treatment of patients with angina pectoris refractory to medical therapy and unsuitable for revascularization procedures has yet not been well standardized. Previous retrospective studies and small prospective studies have suggested beneficial effects of spinal cord stimulation (SCS) in these patients. We created a Prospective Italian Registry of SCS to evaluate the short- and long-term clinical outcome of patients who underwent SCS device implantation because of severe refractory angina pectoris. Overall, 104 patients were enrolled in the registry (70 men, aged 68 +/- 17 years), most of whom (83%) had severe coronary artery disease. Average follow-up was 13.2 +/- 8 months. Overall, 17 patients (16%) died, 8 (8%) due to cardiac death. Among clinical variables, only age was found to be significantly associated both with total mortality (p = 0.04) and cardiac mortality (p = 0.02) on Cox regression analysis. A significant improvement of anginal symptoms (> or =50% reduction of weekly anginal episodes, compared with baseline) occurred in 73% of patients, and Canadian Cardiovascular Society angina class improved by > or =1 class in 80% and by > or =2 classes in 42% of patients, with a relevant reduction in the rate of hospital admission and days spent in the hospital because of angina (p <0.0001 for both). No life-threatening or clinically serious complications were observed. The most frequent side effect consisted of superficial infections, either at the site of puncture of electrode insertion or of the abdominal pocket, which occurred in 6 patients. In conclusion, our prospective data point out that SCS can be performed safely and is associated with a sustained improvement of anginal symptoms in a relevant number of patients with refractory stable angina pectoris.

  16. Visceral chest pain in unstable angina pectoris and effects of transcutaneous electrical nerve stimulation. (TENS). A review.

    Science.gov (United States)

    Börjesson, M

    1999-04-01

    A substantial proportion of patients with chest pain referred to hospital, show signs of coronary artery disease. Anginal pain could be conceptualized as a warning signal for coronary artery disease and impending death. But, for many reasons this theory is partly disputed. Firstly, not all ischemic episodes are accompanied by anginal pain (silent ischemia). Secondly, chest pain indistinguishable from true angina pectoris may be the result of other abnormalities of thoracic viscera. Nevertheless acute severe cardiac ischemia often gives rise to anginal chest pain. Unstable angina pectoris is carrying a higher risk for future events in spite of intensive medical treatment. A special problem are patients awaiting coronary intervention because of severe ischemia and maximum medical treatment, who experience ischemic pain. New treatment regimens are needed for these patients. This review discusses the symptom of visceral pain from the heart, angina pectoris, its relation to ischemia and unstable angina pectoris. It also addresses the role of afferent nerve stimulation (transcutaneous electrical nerve stimulation, TENS) in the treatment of severe angina pectoris as well as recent findings of TENS applicability in unstable angina.

  17. Emerging treatment options for refractory angina pectoris: ranolazine, shock wave treatment, and cell-based therapies.

    Science.gov (United States)

    Gennari, Marco; Gambini, Elisa; Bassetti, Beatrice; Capogrossi, Maurizio; Pompilio, Giulio

    2014-01-01

    A challenge of modern cardiovascular medicine is to find new, effective treatments for patients with refractory angina pectoris, a clinical condition characterized by severe angina despite optimal medical therapy. These patients are not candidates for surgical or percutaneous revascularization. Herein we review the most up-to-date information regarding the modern approach to the patient with refractory angina pectoris, from conventional medical management to new medications and shock wave therapy, focusing on the use of endothelial precursor cells (EPCs) in the treatment of this condition. Clinical limitations of the efficiency of conventional approaches justify the search for new therapeutic options. Regenerative medicine is considered the next step in the evolution of organ replacement therapy. It is driven largely by the same health needs as transplantation and replacement therapies, but it aims further than traditional approaches, such as cell-based therapy. Increasing knowledge of the role of circulating cells derived from bone marrow (EPCs) on cardiovascular homeostasis in physiologic and pathologic conditions has prompted the clinical use of these cells to relieve ischemia. The current state of therapeutic angiogenesis still leaves many questions unanswered. It is of paramount importance that the treatment is delivered safely. Direct intramyocardial and intracoronary administration has demonstrated acceptable safety profiles in early trials, and may represent a major advance over surgical thoracotomy. The combined efforts of bench and clinical researchers will ultimately answer the question of whether cell therapy is a suitable strategy for treatment of patients with refractory angina.

  18. Selection of drug therapy in stable angina pectoris.

    Science.gov (United States)

    Savonitto, S; Ardissino, D

    1998-05-01

    Drug therapy in stable angina has two aims: the prevention of major cardiac events (such as unstable angina, myocardial infarction, or death) and the control of chest pain and transient myocardial ischemia. Given the low incidence of major cardiac events in patients with stable angina, primary preventive studies are scarce because they require a large sample size and long-term follow-up. Thus far, only aspirin and some lipid-lowering agents have been shown to be effective for this purpose. Antiischemic drugs reduce the imbalance between myocardial oxygen demand and supply, either by reducing oxygen consumption or by increasing coronary blood flow. The ideal approach would be to target drug therapy against the ischemia-inducing factor in each patient. The characteristics of anginal symptoms do not seem to help in selecting medical therapy, whereas a standard exercise test and a provocative test of coronary vasoconstriction may provide useful information in order to select patients who will preferentially respond to either a beta-blocker or a calcium antagonist. The combination of two or more anti-ischemic drugs does not seem to be any more effective than an adequately titrated monotherapy in reducing the occurrence of myocardial ischemia in individual patients. Combination therapy in stable coronary artery disease should include an individually selected and optimally titrated anti-ischemic agent and aspirin, with the addition of a lipid-lowering agent in patients with even mild hypercholesterolemia.

  19. Diurnal variation in exercise responses in angina pectoris.

    Science.gov (United States)

    Joy, M; Pollard, C M; Nunan, T O

    1982-01-01

    Thirty caucasian male patients with stable angina were investigated in two groups of nine and one group of 12. Nine normal subjects were also studied. Patients in the first group (on no treatment) underwent symptom-limited exercise electrocardiography at 0800, 1200, and 1600 hours on the same day. Their heart rates and ST segment displacements at 1600 hours were significantly greater than at 0800 hours and the same phenomenon was seen in the second group who had been receiving propranolol 40 mg four times a day. A similar effect was noted for ST segment displacement but not for heart rate in the third group (on no treatment) tested at 0800 hours and 1600 hours on separate days, two to three weeks apart. Normal control subjects showed no diurnal variation in heart rate and their heart rate responses at 1600 hours were reduced by propranolol. The observations show a circadian variation in the ST segment response to exercise in patients with angina and a possible training effect on heart rate with multiple exercise testing on the same day. This variation is associated with a reduction in vagal parasympathetic tone to the heart and should be taken into account in the assessment of patients with angina and in particular when comparing responses to treatment. PMID:7201319

  20. Combination therapy with metoprolol and nifedipine versus monotherapy in patients with stable angina pectoris. Results of the International Multicenter Angina Exercise (IMAGE) Study

    DEFF Research Database (Denmark)

    Savonitto, S; Ardissiono, D; Egstrup, K

    1996-01-01

    10, the groups randomized to combination therapy had a further increase in time to 1-mm ST segment depression (p ...OBJECTIVES: This study was designed to investigate whether combination therapy with metoprolol and nifedipine provides a greater anti-ischemic effect than does monotherapy in individual patients with stable angina pectoris. BACKGROUND: Combination therapy with a beta-adrenergic blocking agent...... (which reduces myocardial oxygen consumption) and a dihydropyridine calcium antagonist (which increases coronary blood flow) is a logical approach to the treatment of stable angina pectoris. However, it is not clear whether, in individual patients, this combined therapy is more effective than monotherapy...

  1. Pulmonary artery dilatation: an overlooked mechanism for angina pectoris.

    Science.gov (United States)

    Ginghina, Carmen; Popescu, Bogdan A; Enache, Roxana; Ungureanu, Catalina; Deleanu, Dan; Platon, Pavel

    2008-07-01

    Dilatation of the pulmonary artery may lead to the compression of adjacent structures. Of those, the extrinsic compression of the left main coronary artery is the most worrisome. We present the case of a 48-year-old woman who was diagnosed with pulmonary artery dilatation due to severe, thromboembolic pulmonary hypertension. She also had angina and coronary angiography revealed a 70% ostial stenosis of the left main coronary artery. The presence of this isolated lesion in a young woman without risk factors for atherosclerosis suggests extrinsic compression of the left main coronary artery by the dilated pulmonary artery as the likely mechanism. The patient underwent direct stenting of the left main coronary stenosis with a good result.

  2. Comparing systems for costing hospital treatments. The case of stable angina pectoris.

    Science.gov (United States)

    Larsen, Jytte; Skjoldborg, Ulla Slothuus

    2004-03-01

    This paper demonstrates the basic properties in the systems most commonly considered for costing treatments in the Danish hospitals. The differences between the traditional charge system, the DRG system and the ABC system are analysed, and difficulties encountered in comparing these systems are discussed. A sample of patients diagnosed with stable angina pectoris (SAP) at Odense University Hospital was used to compare the three systems when costing an entire treatment path, costing single hospitalisations and studying the effects of length of stay. Furthermore, it is illustrated that the main idea behind each system is reflected in how the systems over- or underestimate costs. Implications when managing the hospitals, particularly reimbursement, are discussed.

  3. Association between thyroid dysfunction and incidence of atrial fibrillation in patients with stable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    徐予

    2014-01-01

    Objective To explore the correlation between incidence of atrial fibrillation(AF)and thyroid dysfunction.Methods Patients with stable angina pectoris with thyroid function test results hospitalized at Fuwai Hospital from2011 Jan to 2011 Dec were included in this analysis(n=2 541).General clinical data and related biochemical parameters were analyzed.We divided patients into 5subgroups according to TSH levels:<0.55 mI U/L(n=105),0.55-2.49 mI U/L(n=1 599),2.50-4.77

  4. Percutaneous coronary intervention for poor coronary microcirculation reperfusion of patients with stable angina pectoris.

    Science.gov (United States)

    Li, J S; Zhao, X J; Ma, B X; Wang, Z

    2016-01-01

    Percutaneous coronary intervention (PCI) has been extensively applied to repair the forward flow of diseased coronary artery and can achieve significant curative results. However, some patients with acute myocardial infarction (AMI) develop non-perfusion or poor perfusion of cardiac muscle tissue after PCI, which increases the incidence of cardiovascular events and the death rate. PCI can dredge narrowed or infarct-related artery (IRA) and thus induce full reperfusion of ischemic myocardium. It is found in practice that some cases of AMI still have no perfusion or poor perfusion in myocardial tissue even though coronary angiography suggests opened coronary artery after PCI, which increases the incidence of vascular events and mortality. Therefore, to explore the detailed mechanism of PCI in treating coronary microcirculation of patients with stable angina pectoris, we selected 140 patients with stable angina pectoris for PCI, observing the index of microcirculatory resistance (IMR) of descending branch and changes of myocardial injury markers and left ventricular systolic function, and made a subgroup analysis based on the correlation between clinical indexes, IMR and other variables of diabetic and non-diabetic patients, PCI-related and non-PCI-related myocardial infarction patients. The results suggest that IMR of anterior descending branch after PCI was higher compared to that before PCI, and the difference was significant (P less than 0.05); creatine kinase-MB (CK-MB), myohemoglobin and high sensitive troponin T were all increased after PCI, and the difference was also significant (P less than 0.05); brain natriuretic peptide (BNP) level became higher after PCI, with significant difference (P less than 0.05); left ventricular ejection fraction (LVEF) declined after PCI, and the difference before and after PCI was statistically significant (P less than 0.05). Moreover, subgroup analysis results of the three groups all demonstrated statistically significant

  5. Angina pectoris during daily activities and exercise stress testing: The role of inducible myocardial ischemia and psychological distress.

    Science.gov (United States)

    Sullivan, Mark D; Ciechanowski, Paul S; Russo, Joan E; Spertus, John A; Soine, Laurie A; Jordan-Keith, Kier; Caldwell, James H

    2008-10-31

    Physicians often consider angina pectoris to be synonymous with myocardial ischemia. However, the relationship between angina and myocardial ischemia is highly variable and we have little insight into the sources of this variability. We investigated the relationship of inducible myocardial ischemia on SPECT stress perfusion imaging to angina reported with routine daily activities during the previous four weeks (N=788) and to angina reported during an exercise stress test (N=371) in individuals with confirmed or suspected coronary disease referred for clinical testing. We found that angina experienced during daily life is more strongly and consistently associated with psychological distress and the personal threat associated with angina than with inducible myocardial ischemia. In multivariable models, the presence of any angina during routine activities over the prior month was significantly associated with age, perceived risk of myocardial infarction, and anxiety when compared to those with no reported angina in the past month. Angina during daily life was not significantly associated with inducible myocardial ischemia on stress perfusion imaging in bivariate or multivariable models. In contrast, angina experienced during exercise stress testing was significantly related to image and ECG ischemia, though it was also significantly associated with anxiety. These results suggest that angina frequency over the previous four weeks is more strongly associated with personal threat and psychosocial distress than with inducible myocardial ischemia. These results lend support to angina treatment strategies that aim to reduce threat and distress as well as to reduce myocardial ischemia.

  6. [Clinical presentation and coronary angiographic results in unstable angina pectoris].

    Science.gov (United States)

    Weber, T; Kirchgatterer, A; Auer, J; Wimmer, L; Lang, G; Mayr, H; Maurer, E; Punzengruber, C; Eber, B

    1999-01-01

    The syndrome "unstable angina" (UA) covers a broad spectrum of patients. In this study we tried to determine the relationship between the severity of UA and angiographic findings. We evaluated 1000 consecutive patients undergoing coronary angiography. Those with the clinical diagnosis "UA" were included in the study. In a retrospective analysis of their records we categorized them, using the Braunwald-classification for determination of the severity of the disease. 352 patients were include, 209 men and 143 women, the mean age was 65 years. 47% met Braunwald-Class I, 26% Class II and 27% Class III. Coronary single-vessel disease was present in 29%, two-vessel disease in 20%, three-vessel disease in 25%, normal coronaries in 13% and coronary atherosclerosis without critical narrowing in 13%. Left ventricular function was preserved in 72%, mild systolic dysfunction was found in 10%, moderate in 13% and severe in 5%. There was no overall correlation between clinical presentation (Braunwald-Classes) and angiographic findings. Women showed a similar distribution of Braunwald-Classes, but significantly more coronary arteries without critical obstruction. In patients with reduced systolic function the percentage of multi-vessel disease was significantly higher, the percentage without relevant coronary artery narrowing was significantly lower. 1) The lack of overall correlation between clinical presentation and angiographic findings supports the importance of coronary angiography in the evaluation of patients with UA. 2) The assessment of women with chest pain is more difficult than of men with regard to coronary heart disease. 3) UA in patients with impaired left ventricular function is a predictor of severe coronary artery disease.

  7. Aspiration Thrombectomy and Drug-Eluting Stent Implantation Decrease the Occurrence of Angina Pectoris One Year After Acute Myocardial Infarction.

    Science.gov (United States)

    Lee, Wei-Chieh; Fang, Chih-Yuan; Chen, Huang-Chung; Hsueh, Shu-Kai; Chen, Chien-Jen; Yang, Cheng-Hsu; Yip, Hon-Kan; Hang, Chi-Ling; Wu, Chiung-Jen; Fang, Hsiu-Yu

    2016-04-01

    Angina pectoris is a treatable symptom that is associated with mortality and decreased quality of life. Angina eradication is a primary care goal of care after an acute myocardial infarction (AMI). Our aim was to evaluate factors influencing angina pectoris 1 year after an AMI.From January 2005 to December 2013, 1547 patient received primary percutaneous intervention in our hospital for an acute ST-segment elevation myocardial infarction (MI). Of these patients, 1336 patients did not experience post-MI angina during a 1-year follow-up, and 211 patients did. Univariate and multivariate logistic regression analyses were performed to identify the factors influencing angina pectoris 1 year after an AMI. Propensity score matched analyses were performed for subgroups analyses.The average age of the patients was 61.08 ± 12.77 years, with a range of 25 to 97 years, and 82.9% of the patients were male. During 1-year follow-up, 13.6% of the patients experienced post-MI angina. There was a longer chest pain-to-reperfusion time in the post-MI angina group (P = 0.01), as well as a higher fasting sugar level, glycohemoglobin (HbA1C), serum creatinine, troponin-I and creatine kinase MB (CK-MB). The post-MI angina group also had a higher prevalence of multiple-vessel disease. Manual thrombectomy, and distal protective device and intracoronary glycoprotein IIb/IIIa inhibitor injection were used frequently in the no post-MI angina group. Antiplatelet agents and post-MI medication usage were similar between the 2 groups. Multivariate logistic regression analyses demonstrated that prior MI was a positive independent predictor of occurrence of post-MI angina. Manual thrombectomy use and drug-eluting stent implantation were negative independent predictors of post-MI angina. Higher troponin-I and longer chest pain-to-reperfusion time exhibited a trend toward predicting post-MI angina.Prior MIs were strong, independent predictors of post-MI angina. Manual thrombectomy and drug

  8. [Percutaneous myocardial laserrevascularization (PMR), a new therapy for patients with refractory angina pectoris].

    Science.gov (United States)

    Lauer, B; Stahl, F; Bratanow, S; Schuler, G

    2000-10-01

    In patients with severe angina pectoris due to coronary artery disease, who are not candidates for either percutaneous coronary angioplasty or coronary artery bypass surgery, transmyocardial laser revascularization (TMR) often leads to improvement of clinical symptoms and increased exercise capacity. One drawback of TMR is the need for surgical thoracotomy in order to gain access to the epicardial surface of the heart. Therefore, a catheter-based system has been developed, which allows creation of laser channels into the myocardium from the left ventricular cavity.Between January 1997 and November 1999, this "percutaneous myocardial laser-revascularization" (PMR) was performed in 85 patients at the Herzzentrum Leipzig. In 43 patients, only one region of the heart (anterior, lateral, inferior or septal) was treated with PMR; in 42 patients two or three regions were treated in one session. 12.3±4.3 (range 4-22) channels/region were created into the myocardium.Six months after PMR, the majority of patients reported significant improvement of clinical symptoms (CCS class at baseline: 3.3±0.4; after 6 months: 1.6±0.9) (p PMR treated regions.PMR seems to be a safe and feasible new therapeutic option for patients with refractory angina pectoris due to end-stage coronary artery disease. The first results indicate improvement of clinical symptoms and increased exercise capacity; evidence of increased perfusion in the laser-treated regions is still lacking.

  9. [Percutaneous myocardial laser revascularization (PMR), a new therapeutic procedure for patients with refractory angina pectoris].

    Science.gov (United States)

    Lauer, B; Stahl, F; Bratanow, S; Schuler, G

    2000-01-01

    In patients with severe angina pectoris due to coronary artery disease, who are not candidates for either percutaneous coronary angioplasty or coronary artery bypass surgery, transmyocardial laser revascularization (TMR) often leads to improvement of clinical symptoms and increased exercise capacity. One drawback of TMR is the need for surgical thoracotomy in order to gain access to the epicardial surface of the heart. Therefore, a catheter-based system has been developed, which allows creation of laser channels into the myocardium from the left ventricular cavity. Between January 1997 and November 1999, this "percutaneous myocardial laser-revascularization" (PMR) was performed in 85 patients at the Herzzentrum Leipzig. In 43 patients, only one region of the heart (anterior, lateral, inferior or septal) was treated with PMR; in 42 patients two or three regions were treated in one session. 12.3 +/- 4.3 (range 4-22) channels/region were created into the myocardium. Six months after PMR, the majority of patients reported significant improvement of clinical symptoms (CCS class at baseline: 3.3 +/- 0.4; after 6 months: 1.6 +/- 0.9) (p PMR treated regions. PMR seems to be a safe and feasible new therapeutic option for patients with refractory angina pectoris due to end-stage coronary artery disease. The first results indicate improvement of clinical symptoms and increased exercise capacity; evidence of increased perfusion in the laser-treated regions is still lacking.

  10. Clinical evaluation of efonidipine hydrochloride in angina pectoris. Evaluation in exercise {sup 201}Tl myocardial scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Hori, Masatsugu; Nishimura, Tsunehiko [Osaka Univ., Suita (Japan). Medical School

    1996-12-01

    Clinical usefulness of once-daily administration of 20 to 60 mg of efonidipine hydrochloride and coronary hemodynamics during exercise {sup 201}Tl myocardial scintigraphy were investigated in patients with angina pectoris. Out of 11 patients enrolled in this study, 9 patients were included in the evaluation of patients` impression, in improvement rating in subjective symptoms, in the analysis of the exercise test, in the improvement rating of images on {sup 201}Tl myocardial scintigraphy, and in the global improvement rating, while 10 patients were included in the overall safety rating. Four patients in improvement rating in subjective symptoms, 2 in improving rating in the exercise test, and 5 in the global improvement rating were rated `improved` or better. In the improvement rating on the exercise {sup 201}Tl myocardial scintigraphy image, reduction of the image was observed in 5 patients, 3 out of which were evaluated as `improved` or better. A distinctive reduction of ischemic regions was observed in 2 patients out of the 3. A significant decrease in the number of angina pectoris events and a decreasing tendency in consumption of fast-acting nitrates were observed in spite of the low number of the patients studied. An adverse effect was observed in 1 patient and abnormal laboratory values were observed in 2 patients which were improved promptly after withdrawal of the drug. It was in 7 patients evaluated as `no problem`, while in 4 patients it was evaluated as `useful` or more. (author)

  11. Efficacy of Ligustrazine Injection as Adjunctive Therapy for Angina Pectoris: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Shao, Huikai; Zhao, Lingguo; Chen, Fuchao; Zeng, Shengbo; Liu, Shengquan; Li, Jiajia

    2015-11-29

    BACKGROUND In the past decades, a large number of randomized controlled trials (RCTs) on the efficacy of ligustrazine injection combined with conventional antianginal drugs for angina pectoris have been reported. However, these RCTs have not been evaluated in accordance with PRISMA systematic review standards. The aim of this study was to evaluate the efficacy of ligustrazine injection as adjunctive therapy for angina pectoris. MATERIAL AND METHODS The databases PubMed, Medline, Cochrane Library, Embase, Sino-Med, Wanfang Databases, Chinese Scientific Journal Database, Google Scholar, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, and the Chinese Science Citation Database were searched for published RCTs. Meta-analysis was performed on the primary outcome measures, including the improvements of electrocardiography (ECG) and the reductions in angina symptoms. Sensitivity and subgroup analysis based on the M score (the refined Jadad scores) were also used to evaluate the effect of quality, sample size, and publication year of the included RCTs on the overall effect of ligustrazine injection. RESULTS Eleven RCTs involving 870 patients with angina pectoris were selected in this study. Compared with conventional antianginal drugs alone, ligustrazine injection combined with antianginal drugs significantly increased the efficacy in symptom improvement (odds ratio [OR], 3.59; 95% confidence interval [CI]: 2.39 to 5.40) and in ECG improvement (OR, 3.42; 95% CI: 2.33 to 5.01). Sensitivity and subgroup analysis also confirmed that ligustrazine injection had better effect in the treatment of angina pectoris as adjunctive therapy. CONCLUSIONS The 11 eligible RCTs indicated that ligustrazine injection as adjunctive therapy was more effective than antianginal drugs alone. However, due to the low quality of included RCTs, more rigorously designed RCTs were still needed to verify the effects of ligustrazine injection as adjunctive therapy for

  12. Angina pectoris em paciente com hipertireoidismo e coronárias angiograficamente normais Angina pectoris in patient with hyperthyroidism and normal angiography coronary

    Directory of Open Access Journals (Sweden)

    Alessandra Ferri Casini

    2006-11-01

    Full Text Available A presença de angina pectoris em mulher pré-menopausa sem outros fatores de risco para doença arterial coronariana, obriga-nos a descartar outras causas de lesão coronariana não aterosclerótica. A relação entre o hipertireoidismo e as alterações no sistema cardiovascular está bem estabelecida, contudo o hipertireoidismo responde por menos de 5% dos casos de dor torácica. Apresenta-se um caso de uma mulher, 47 anos, com sintomas de precordialgia típica e eletrocardiograma (ECG sugestivo de isquemia coronariana, mas sem alteração laboratorial sugestiva de lesão miocárdica. Anamnese, exame físico e resultados laboratoriais permitiram firmar o diagnóstico de hipertireoidismo. Investigação subseqüente com o cateterismo cardíaco não demonstrou lesões obstrutivas. Após tratamento com iodo radioativo e retorno ao eutireoidismo, a paciente manteve-se assintomática e o ECG e a cintilografia miocárdica foram negativos para isquemia. Esses resultados sugerem uma interação entre hiperatividade tireoidiana e isquemia miocárdica, tendo o hipertireoidismo como provável etiologia dos achados clínicos e eletrocardiográficos.In the presence of angina pectoris in a premenopausal woman without significant risk factors for coronary disease, we have to rule out other causes of coronary lesion of non atherosclerotic origin. The relations between hyperthyroidism and the cardiovascular system are well known, but hyperthyroidism is responsable for less than 5% of all causes of chest pain. We present a clinical case of a 47 year old woman with typical chest pain and eletrocardiogram (EKG suggesting coronary ischemia but with normal laboratory data. Anamnesis, clinical and the laboratory data confirmed the diagnosis of hyperthyroidism. Further investigation showed a normal coronary angiography. After treatment with radioiodine and the establishment of euthyroidism, the patient remained asymptomatic and EKG and myocardial scintilography were

  13. Effects of successful percutaneous transluminal coronary angioplasty on global and regional left ventricular function in unstable angina pectoris

    NARCIS (Netherlands)

    P.J. de Feyter (Pim); H. Suryapranata (Harry); P.W.J.C. Serruys (Patrick); K.J. Beatt (Kevin); M.J.B.M. van den Brand (Marcel); P.G. Hugenholtz (Paul)

    1987-01-01

    textabstractSixty-eight patients (58 men, 10 women, mean age 56.3 years, range 31 to 72) with unstable angina pectoris, either initially stabilized with or refractory to optimal pharmacologic treatment, were studied to determine whether regional dysfunction due to stunning of the myocardium caused b

  14. Electrical neuromodulation improves myocardial perfusion and ameliorates refractory angina pectoris in patients with syndrome X : fad or future?

    NARCIS (Netherlands)

    Jessurun, G; Hautvast, RWM; Tio, RA; DeJongste, M

    2003-01-01

    At present, there is no reliable antianginal drug therapy for patients with cardiac syndrome X. Therefore, the effect of electrical neuromodulation on refractory angina pectoris and myocardial perfusion in cardiac syndrome X was assessed. Eight patients (aged 55 +/- 7 years) with heterogeneous myoca

  15. Modulation of intrinsic cardiac neurons by spinal cord stimulation : implications for its therapeutic use in angina pectoris

    NARCIS (Netherlands)

    Foreman, RD; Linderoth, B; Ardell, JL; Barron, KW; Chandler, MJ; Hull, SS; TerHorst, GJ; DeJongste, MJL; Armour, JA

    2000-01-01

    Objective: Electrical stimulation of the dorsal aspect of the upper thoracic spinal cord is used increasingly to treat patients with severe angina pectoris refractory to conventional therapeutic strategies. Clinical studies show that spinal cord stimulation (SCS) is a safe adjunct therapy for cardia

  16. Creatine kinase and creatine kinase subunit-B in coronary sinus blood in pacing-induced angina pectoris

    DEFF Research Database (Denmark)

    Bagger, J P; Ingerslev, J; Heinsvig, E M

    1982-01-01

    In nine out of 10 patients with angiographic documented coronary artery disease, pacing-induced angina pectoris provoked myocardial production of lactate, whereas no significant release of either creatine kinase or creatine kinase subunit-B to coronary sinus and peripheral venous blood could...

  17. Outcomes after revascularisation with everolimus- and sirolimus-eluting stents in patients with acute coronary syndromes and stable angina pectoris

    DEFF Research Database (Denmark)

    Antonsen, Lisbeth; Thayssen, Per; Hansen, Henrik S

    2014-01-01

    Aims: The aim of this substudy of the SORT OUT IV trial was to compare clinical outcomes among patients with acute coronary syndromes (ACS) and stable angina pectoris (SAP) treated with everolimus-eluting stents (EES) or sirolimus-eluting stents (SES). Methods and results: We performed a post hoc...

  18. Cardiac troponin T and CK-MB mass release after visually successful percutaneous transluminal coronary angioplasty in stable angina pectoris

    DEFF Research Database (Denmark)

    Ravkilde, J; Nissen, H; Mickley, H

    1994-01-01

    The incidence of cardiac troponin T (Tn-T) and creatine kinase (CK) isoenzyme MB mass release was studied in 23 patients with stable angina pectoris undergoing visually successful percutaneous transluminal coronary angioplasty (PTCA). Serial blood samples were drawn for measurement of serum Tn...

  19. Burden of Hospital Admission and Repeat Angiography in Angina Pectoris Patients with and without Coronary Artery Disease

    DEFF Research Database (Denmark)

    Jespersen, Lasse; Abildstrom, Steen Z; Hvelplund, Anders

    2014-01-01

    AIMS: To evaluate risk of hospitalization due to cardiovascular disease (CVD) and repeat coronary angiography (CAG) in stable angina pectoris (SAP) with no obstructive coronary artery disease (CAD) versus obstructive CAD, and asymptomatic reference individuals. METHODS AND RESULTS: We followed 11...

  20. The Changes of Vasoactive Substances Originated Endothelium in Patients with Unstable Angina Pectoris Treated by Improved Thrombolytic Therapy

    Institute of Scientific and Technical Information of China (English)

    Wang Congxia; Niu Xiaolin; Li Yongqin; Zhang MingJuan; Ding Kangning

    2004-01-01

    Objectives To analyze the changes of vasoactive substances originated from endothelium in patients with unstable angina pectoris treated by modified thrombolytic therapy and explore the mechanisms of the drug to treat unstable angina pectoris.Methods 120 patients with unstable angina pectoris who were not well responsed to common medication were studied. Their ECG stress tests were abnormal and there were ischemic changes in Holter. Urokinase 300,000 U was added in 100 ml normal saline and injected within 30 min once a day for 3 days. 300 mg aspirin was administrated a day before and during urokinase applications. Before and after urokinase treatments, endothelin-1, plasma tissue plasminogen activator and its inhibitor-1were determined. Results Compared with pretreatments, after treatments, the activities of tissue plasminogen activator increased, endothelin-1 and the inhibitor-1 decreased. The changes were significant. Conclusions Modified thrombolytic therapy can regulate the vasoactive substances originated endothelium in patients with unstable angina pectoris . The major substances include endothelin-1 ,plasma tissue plasminogen activator and inhibitor-1. This mechanism may suggest that urokinase can treat coronary heart disease effectively.

  1. Antianginal efficacy of the combination of felodipine-metoprolol 10/100 mg compared with each drug alone in patients with stable effort-induced angina pectoris

    DEFF Research Database (Denmark)

    Emanuelsson, H; Egstrup, K; Nikus, K

    1999-01-01

    -induced angina pectoris. The secondary objective was to compare the tolerability of the 3 treatments. METHODS: The main criteria for inclusion were stable effort-induced angina pectoris for at least 2 months before the enrollment and a positive bicycle exercise test result. Patients were allocated to once...... was significantly lower in the groups receiving felodipine-metoprolol and metoprolol than in the group receiving felodipine alone. The combination and metoprolol were better tolerated than felodipine alone. CONCLUSIONS: In stable angina pectoris, the combination felodipine-metoprolol 10/100 mg and felodipine 10 mg...

  2. Effect of Enhanced External Counterpulsation (EECP on Exercise Time Duration and Functional Capacity in Patients with Refractory Angina Pectoris

    Directory of Open Access Journals (Sweden)

    Ali Bozorgi

    2015-10-01

    Full Text Available Background: Enhanced external counterpulsation (EECP is a noninvasive technique used for patients with refractory angina pectoris. There are controversial data on the effectiveness of EECP in improving patients with refractory stable angina. The aim of the present study was to evaluate the effectiveness and safety of EECP for the treatment of patients with refractory angina pectoris.Methods: Twenty consecutive patients with refractory angina pectoris were treated with EECP, and their symptoms, echocardiographic measures, treadmill exercise test parameters, and Canadian Cardiovascular Society Class were evaluated before and immediately after EECP. The patients were followed up for 6months post treatment.Results: There were significant differences regarding total exercise time before and after treatment (p value < 0.001. The patients showed a significant reduction in angina classes III and IV immediately after EECP (p value < 0.001; for most of the patients, these beneficial effects were sustained for 6 months (p value = 0.010. There was no significant improvement in the echocardiographic parameters.Conclusion: EECP decreased symptoms and increased total exercise time in our study population. These beneficial effectswere sustained for 6 months.

  3. Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular events

    DEFF Research Database (Denmark)

    Jespersen, Lasse; Hvelplund, Anders; Abildstrøm, Steen Z

    2012-01-01

    AimsPatients with chest pain and no obstructive coronary artery disease (CAD) are considered at low risk for cardiovascular events but evidence supporting this is scarce. We investigated the prognostic implications of stable angina pectoris in relation to the presence and degree of CAD...... with no obstructive CAD in focus.Methods and resultsWe identified 11 223 patients referred for coronary angiography (CAG) in 1998-2009 with stable angina pectoris as indication and 5705 participants from the Copenhagen City Heart Study for comparison. Main outcome measures were major adverse cardiovascular events.......ConclusionPatients with stable angina and normal coronary arteries or diffuse non-obstructive CAD have elevated risks of MACE and all-cause mortality compared with a reference population without ischaemic heart disease....

  4. Detection of culprit lesion in patients with unstable angina pectoris by using ATP thallium-201 myocardial SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Kasai, Tokuo; Mori, Yutaka [Jikei Univ., Tokyo (Japan). School of Medicine; Yamashina, Akira; Kubo, Toru; Usui, Yasuhiro

    1999-10-01

    The purpose of this study is to determine the diagnostic accuracy for detection of culprit lesions in patients with unstable angina. Both ATP {sup 201}Tl SPECT and coronary angiography were performed in 51 patients with unstable angina pectoris within a week since the last attack. SPECT images were divided into 17 segments and the regional uptakes were scored semiquantitatively (0=normal to 3=no activity) and compared with the coronary angiographic findings. ATP {sup 201}Tl SPECT revealed decreased uptakes in 54 of 56 culprit lesions. The sensitivity, specificity and accuracy for detection of culprit lesions were 96.4%, 89.5% and 92.4%, respectively. Although adverse effects during ATP administration were complicated in 28 (54.9%) patients, all the complications were mild and resolved within two minutes. ATP {sup 201}Tl SPECT is sensitive and reliable method for detecting culprit lesions and can be performed safely even at acute phase in patients with unstable angina pectoris. (author)

  5. The efficacy and safety of dilevalol in patients with chronic stable angina pectoris.

    Science.gov (United States)

    Glasser, S P; Bittar, N; Kinhal, V; Bennett, W T; Koehn, D K

    1989-11-01

    This is the first reported large clinical trial of the antianginal and acute ischemic effectiveness and safety of dilevalol (the R, R-isomer of labetalol) in patients with chronic stable angina pectoris. This was a multicenter double blind fixed-dose parallel group placebo controlled trial. Patients with chronic stable angina and positive and reproducible exercise tests (+/- 20%) were included. If randomized, patients entered one of four fixed dose groups (twice a day placebo, 100 mgm, 200 mgm and 400 mgm bid for 2 weeks). Exercise testing was performed at 2 hours (peak) and 12 hours (trough) postdosing. This was followed by a 2-week once-a-day dosing regimen in which patients received the same total daily dose as the prior 2 weeks, with the full dose in the morning and a matched placebo in the evening. Exercise testing was performed at 2 hours (peak) and 24 hours (trough) postdosing. Anginal frequency and NTG consumption were significantly reduced, and equally so, by qd and bid regimens. The time of exercise to the onset of angina increased and the proportion of patients terminating exercise because of moderate angina decreased in a dose response fashion for both peak and trough tests and for both qd and bid regimens. There was also a dose related decrease in exercise induced ST segment depression and an increase in time to 1 mm ST depression. In 15 patients, 24-hour ambulatory monitoring also revealed a decrease in episodes of silent ischemia. No significant side effects related to the study drug occurred.(ABSTRACT TRUNCATED AT 250 WORDS)

  6. Diagnosis of Unstable Angina Pectoris Has Declined Markedly with the Advent of More Sensitive Troponin Assays

    DEFF Research Database (Denmark)

    D'Souza, Maria; Sarkisian, Laura; Saaby, Lotte

    2015-01-01

    in unselected hospital patients. METHODS: During 2010 we evaluated all patients in whom cardiac troponin I had been measured at a single university hospital. The diagnosis of acute myocardial infarction (ST-elevation myocardial infarction [STEMI] or non-ST-elevation myocardial infarction [NSTEMI......BACKGROUND: Since the arrival of the universal definition of myocardial infarction more sensitive troponin assays have been developed. How these occurrences have influenced the proportions and clinical features of the components of acute coronary syndrome have not been studied prospectively......]) was established in cases of a rise and/or fall of cardiac troponin I together with cardiac ischemic features. Patients with unstable chest discomfort and cardiac troponin I values below the decision limit of myocardial infarction were diagnosed as having unstable angina pectoris. The definition of acute coronary...

  7. A Becker myotonia patient with compound heterozygosity for CLCN1 mutations and Prinzmetal angina pectoris.

    Science.gov (United States)

    Zielonka, Daniel; Jurkat-Rott, Karin; Stachowiak, Paweł; Bryl, Anna; Marcinkowski, Jerzy T; Lehmann-Horn, Frank

    2012-04-01

    Becker myotonia is a recessive muscle disease with prevalence of > 1:50,000. It is caused by markedly reduced function of the chloride channel encoded by CLCN1. We describe a Polish patient with severe myotonia, transient weakness, and muscle cramps who only responds to lidocaine. In addition, the patient has Prinzmetal angina pectoris and multiple lipomatosis. He is compound heterozygeous for a novel p.W303X and a frequent p.R894X CLCN1 mutation. CLCN1 exon number variation was excluded by MLPA. His son with latent myotonia was heterozygeous for p.R894X. We discuss the potential relations of the three rare diseases and the inheritance of p.R894X.

  8. Relationship between resistin level in serum and acute coronary syndrome or stable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective: To investigate the relationship between serum resistin level and acute coronary syndrome (ACS) or stable angina pectoris (SAP). Methods: Sixty-five patients, with coronary artery disease, were enrolled and divided into three subgroups:acute myocardial infarction (AMI), unstable angina pectoris (UAP) and SAP, and 26 healthy people were recruited as controls in the cross-sectional study. Serum resistin levels were determined by ELISA (enzyme-linked immunosorbent assay), and WBC (white blood cell count), hsCRP (high sensitive C-reaction protein), CKmax (maximum ofcreatinkinase), CK-MBmax (maximum of isozyme of creatinkinase) and cTnImax (maximum oftroponin) were measured by standard laboratory methods. Results: The serum resistin levels were 4 folds higher in AMI patients, 2.43 folds in UAP patients and 1.12 folds in SAP patients than in the healthy controls (P<0.05). The resistin levels were also significantly different between AMI [(8.16±0.79) ng/ml], UAP [(5.59±0.75) ng/ml]and SAP [(3.45±0.56) ng/ml] groups (P<0.01); WBC, hsCRP, CKmax, CK-MBmax and cTnImax were significantly increased in AMI patients over UAP and SAP patients. Spearman analysis showed that serum resistin levels were positively correlated with WBC (r=0.412, P=0.046), hsCRP (r=0.427, P=0.037), CKmax, CK-MBmax and cTnImax (r=0.731, 0.678, 0.656; P<0.01). Conclusion:Serum resistin levels increased with inflammatory factors and myocardial impairment. The results suggest that human resistin might play an important role in the pathogenesis of atherosclerosis and AMI as an inflammatory factor.

  9. SERUM LEVELS OF VASCULAR ENDOTHELIAL GROWTH FACTOR IN PATIENTS WITH ANGINA PECTORIS AND ACUTE MYOCARDIAL INFARCTION

    Institute of Scientific and Technical Information of China (English)

    尹瑞兴; 冯建章; 陈旦红; 乌汉东

    2000-01-01

    Objective. To determine whether serum vascular endothelial growth factor (VEGF) concontrafions are altered in several kinds of coronary heart disease patients. Materials and methods. Using a VEGF enzyme-linked immunosorbent assay (ELISA), serum VEGF concemra-tions were determined in anteotbital venous blood of 16 patients with stable angina pectoris(SAP), 16 with unstable angina pectoris(UAP) and 16 with acute myocardial infarcfion (AMI) before and after thrombolytic therapy, and d 16 age- and sex-matched healthy volunteers who used as controls. Results. The concentrations of serum VEGF in patients with SAP(98.60 ± 26.99pg/ml) and UAP ( 103.61 ± 24.89pg/ml) tended to be higher than those in control subjects(80.44 ± 24.57pg/ml), but the differences did notreach statistical significance ( P > 0.05 for each). Before thrombolyfie therapy, the concentrations of serum VEGF in patients with AM1 (285.92 ± 125.15pg/ml) were significantly higher than those in patients with SAP, UAP or control subjects ( P < 0.01 ,respectively), and correlated with synchronous serum ereafine kinase (CK) and its MB iscenzyme (CK-MB) contents( r = 0.866, P < 0.001 and r = 0.948, P < 0.001 ;respectively). Three hours after thrombolysis,the concentrations of VEGF had fallen to 111.57 ± 31.29pg/ml ( P < 0.01 vs. before thrombelytie therapy and P <0. 05 vs. control subjects). Condusion. The present study shows that serum concentrafiom of VEGF in patients with AMI are markedly ele-vated and that increased serum VEGF levels may be one of the most sensitive indexes in diagnosing AMI and judging reperfnsion.

  10. SERUM LEVELS OF VASCULAR ENDOTHELIAL GROWTH FACTOR IN PATIENTS WITH ANGINA PECTORIS AND ACUTE MYOCARDIAL INFARCTION

    Institute of Scientific and Technical Information of China (English)

    尹瑞兴; 冯建章; 陈旦红; 乌汉东

    2000-01-01

    Objective. To determine whether serum vascular endothelial growth factor(VEGF)concentrations are altered in several kinds of coronary heart disease patients. Materials and methods. Using a VEGF enzyme-linked immunosorbent assay(ELISA), serum VEGF concentra tions were determined in antecubital venous blood of 16 patients with stable angina pectoris(SAP), 16 with unstable angina pectoris(UAP) and 16 with acute myocardial infarction(AMI) before and after thrombolytic therapy, and of 16 age and sex-matched healthy volunteers who used as controls. Results. The concentrations of serum VEGF in patients with SAP(98.60 ± 26.99pg/ml) and UAP (103.61 ± 24.89pg/ml) tended to be higher than those in control subjects(80.44 ± 24.57pg/ml), but the differences did not reach statistical significance (P > 0.05 for each). Before throm bolytic therapy, the concentrations of serum VEGF in patients with AMI (285.92 ± 125.15pg/ml) were significantly higher than those in patients with SAP, UAP or control subjects ( P < 0.01 ,respectively), and correlated with synchronous serum creatine kinase (CK) and its MB isoenzyme (CK-MB) contents(r=0.866, P < 0.001 and r =0.948,P < 0.001;respectively). Three hours after thrombolysis, the concentrations of VEGF had fallen to 111.57 ± 31.29pg/ml ( P <0.01 vs. before thrombolytic therapy and P< 0.05 vs .control subjects). Conclusion. The present study shows that serum concentrations of VEGF in patients with AMI are markedly ele vated and that increased serum VEGF levels may be one of the most sensitive indexes in diagnosing AMI and judging reperfusion.

  11. The treatment of angina pectoris with nitroglycerin plasters. A multicenter study involving 6,986 patients.

    Science.gov (United States)

    Agabiti Rosei, E; Muiesan, M L; Pollavini, G; Bichisao, E; Muiesan, G

    1987-10-01

    A multicenter study was carried out in order to evaluate the efficacy and tolerability of 2 doses of a nitroglycerin transdermal system (TTS-NG 5 mg/24 h and TTS-NG 10 mg/24 h) on a large population of patients affected by angina pectoris. Nine hundred and seventy three cardiologists enrolled a total of 6,986 patients, 4,290 males and 2,696 females, mean age 61.7 years (range 26-95), 3,283 with effort-angina, 2,062 with mixed angina and 1,641 with angina at rest. Patients whose angina was not satisfactorily controlled by their previous therapy, were given TTS-NG 5 for 1 week in the morning, while continuing their antianginal treatment, with the exception of nitrates which were gradually withdrawn. At the end of this period, patients who responded to the treatment continued taking the same dose for a further 6 weeks, while poor responders were given a double dose of the study medication over the same period. Six thousand two hundred and sixty patients (90%) completed the study. TTS-NG 5 proved to be effective in 2,091 patients (33%) with a reduction in weekly anginal attacks after only 1 week of treatment (from 5.8 +/- 2.9 to 2.4 +/- 2.3). This reduction improved in the following 2 weeks (from 2.4 +/- 2.3 to 1.2 +/- 1.6) and subsequently remained virtually unchanged. Four thousand one hundred and sixty-nine patients (67%), whose angina was not sufficiently controlled by TTS-NG 5 (from 5.0 +/- 2.4 to 4.3 +/- 2.8), received double the dose at the end of the first week. TTS-NG 10 brought about a reduction in weekly anginal symptoms during the 2nd and the 3rd week (from 4.3 +/- 2.8 to 2.0 +/- 2.2), with a further decrease during the following 2 weeks (from 2.0 +/- 2.2 to 1.1 +/- 1.7). The reduction in anginal attacks was of the same extent both during the day and the night, thus suggesting that the drug is effective throughout 24 hours. A similar pattern was observed in the reduction of the number of anginal attacks weighted by their severity, the severity of attacks

  12. [The practice guideline 'Stable angina pectoris' (second revision) from the Dutch College of General Practitioners; a response from the perspective of general practice].

    Science.gov (United States)

    Mazel, J A

    2004-11-06

    The Dutch College of General Practitioners' (Dutch acronym: NHG) practice guideline 'Stable angina pectoris' (second revision) provides clear guidelines for the diagnosis and treatment of patients who experience chest pains as a result of angina pectoris, especially if coronary artery disease is the underlying cause of the complaints. The practice guideline clearly indicates for which complaints the general practitioner should suspect angina pectoris and which information from the anamnesis, family history and risk factors can contribute to distinguishing between stable and unstable angina pectoris. However, the physical examination should not be omitted because this can provide important indications for coronary or pulmonary dysfunction. According to the practice guideline, the treatment policy is determined by the estimated risk of significant coronary artery disease. However, additional tests can be useful even in the case of a small risk, as these can reassure patients. The indications and contraindications for medicinal substances are clearly presented.

  13. Infuences of Previous Angina Pectoris on Coronary Collateral Circulation and Left Ventricular Function in Patients with Acute Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    罗初凡; 杜志民; 胡承恒; 梅卫义; 伍贵富; 李怡; 马虹

    2001-01-01

    Objective To investigate the influences of previous angina pectoris on coronary collateral circulation and left ventricular function in patients with acute myocardial infarction. Methods 307 patients with a first episode acute myocardial infarction underwent selective coronary angiography and left ventriculography. The relation of previous angina pectoris to coronary collateral circulation, peak creatine kinase and left ventricular function were analyzed.Results ① In the 307 patients, there were 192(62.5 % ) with previous angina [PA ( + ) group] and 115 (37.5 % ) without [PA ( - ) group]. ②The peak creatine kinase (CK) and CK- MB were significantly higher in PA (-) group than in PA (+) group ( P < 0.05 for both comparisons) . ③ Collateral circulation to infarct- related artery was more likely to be present in PA (+) group than in PA (-) group ( P < 0.05) . ④ The left ventricular ejection fraction was significantly increased, and the left ventricular wall motion Cortina score decreased, in PA ( + ) group than in PA ( - ) group ( P < 0.01 for both comparisons) .Conclusion In patients with acute myocardial infarction, previous angina pectoris may have beneficial effects on coronary collateral circulation and left ventricular unction.

  14. Analysis of angina pectoris after pacemaker implantation.%心脏起搏术后患者发生心绞痛的情况分析

    Institute of Scientific and Technical Information of China (English)

    高运来; 吴小庆; 郁志明; 王如兴; 王强

    2011-01-01

    目的 分析心脏起搏术后患者心绞痛的发生情况.方法 35例起搏器术后一年内并发心绞痛的为心绞痛组,选取同期的495例永久心脏起搏患者为非心绞痛组,比较两组的一般情况.并对不同起搏原因及不同起搏方式的心绞痛发作情况进行比较.结果 与非心绞痛组比较,心绞痛组年龄、吸烟、性别构成无差异,但合并高血压、糖尿病、高脂血症比例较高.因房室传导阻滞(AVB)行心脏起搏者较因病窦综合征起搏者术后发生心绞痛比例高(15.4% vs 1.8%,P<0.001),而安置VVI者与DDD者心绞痛发生率相似(6.7% vs 6.3%,P>0.05).结论 起搏术后发生心绞痛患者多合并多种冠心病危险因素,AVB者术后心绞痛发生率高.%Objective To observe the attack of angina pectoris after permanent pacemaker implantation. Methods Thirty-five patients with angina pectoris after pacemaker implantation within 1 year were allocated to angina pectoris group, while 495 patients without angina pectoris were allocated to non-angina pectoris group. General characters of both groups were compared. Incidence of angina pectoris in different pacing cause and different pacing mode were compared. Results There was no difference of age,smoking or sex constituent between two groups,but the angina pectoris group had more hypertension, diabetes mellitus or hyperlipidemia than non-angina pectoris group. The patients with atrioventricle block(AVB) had more occurrence of angina pectoris than the patients with sick sinus syndrome after pacemaker implantation(15.4% vs 1. 8% ,P 0.05). Conclusion Patients developing angina pectoris after pacemaker implantation usually accompany with several risk factors of coronary heart disease,patients with AVB often has coronary heart disease and develop angina pectoris easily.

  15. Innovative Strategy in Treating Angina Pectoris with Chinese Patent Medicines by Promoting Blood Circulation and Removing Blood Stasis: Experience from Combination Therapy in Chinese Medicine.

    Science.gov (United States)

    Xiong, Xing-Jiang; Wang, Zhong; Wang, Jie

    2015-01-01

    Coronary heart disease (CHD) is one of the leading causes of death worldwide. Moreover, angina pectoris is one of the most important types of CHD. Therefore, prevention and effective treatment of angina pectoris is of utmost importance in both China and western countries. However, undesirable effects of antianginal therapy do influence treatment adherence to a certain extent. Therefore, it's not surprising that, complementary and alternative medicine (CAM), including Chinese medicine (CM), are widely welcomed among patients with CHD, hoping that it might complement western medicine. In our previous studies, blood stasis syndrome (BSS) (Xueyu Zheng) was the main syndrome (Zheng-hou) of angina pectoris. Currently, China Food and Drug Administration authoritatively recommended more than 200 Chinese patent medicines (CPMs) as complementary or adjunctive therapies for symptom management and enhancing quality of life along with mainstream care on angina pectoris management in mainland China. This paper reviewed 4 kinds of most frequently-used CPMs by promoting blood circulation and removing blood stasis in the treatment of angina pectoris. It aims to evaluate the current evidence of CPMs in combination therapy for angina pectoris. This review indicated that CPMs as adjunctive treatment to routine antianginal therapy play an active role in reducing the incidence of primary endpoint events, decreasing anginal attack rate, and improving electrocardiogram. Additionally, CPMs have been proven relatively safe. Further rigorously designed clinical trials should be conducted to confirm the results.

  16. Prognostic significance of myocardial imaging with iodine-123 beta-methyl-p-iodophenyl-pentadecanoic acid in patients with angina pectoris

    Energy Technology Data Exchange (ETDEWEB)

    Hatano, Tsuguhisa; Chikamori, Taishiro; Kamada, Tatsuya; Morishima, Takayuki; Hida, Satoshi; Yanagisawa, Hidefumi; Iino, Hitoshi; Yamashina, Akira [Tokyo Medical Coll. (Japan)

    2001-09-01

    To assess the clinical significance of iodine-123 beta-methyl-p-iodophenyl-pentadecanoic acid (BMIPP) single photon emission computed tomography (SPECT), the predictive value of BMIPP imaging in patients with angina pectoris was evaluated. One hundred seventy-four patients who underwent BMIPP imaging in our institution were aged 61.8{+-}11 years. One hundred thirty-five patients had stable angina and 39 had unstable angina at the time of examination. Patients with previous myocardial infarction or myocardial disorders were excluded. Early and delayed images were acquired in BMIPP SPECT, and the images were analyzed visually. Cardiac events were classified into hard and soft events: the former consisted of cardiac death and nonfatal myocardial infarction, and the latter included coronary revascularization and heart failure. The findings of BMIPP imaging were normal in 82 patients and abnormal in 92. During follow-up of 15.5{+-}9.5 months, hard events were observed in 4 patients and soft events in 53. In patients with normal BMIPP imaging, soft events were observed in nine patients, but no hard event was encountered. Furthermore, in patients with both normal BMIPP and stress thallium imagings, no cardiac event was observed during 2 years. In contrast, 4 hard events and 44 soft events occurred in patients with abnormal BMIPP imaging. Patients with abnormal BMIPP imaging had a higher incidence of soft events than those with normal BMIPP imaging, regardless of the type of angina (16/62 vs 3/73, p<0.0005 for stable angina; 28/30 vs 6/9, p<0.0001 for unstable angina). The finding of BMIPP imaging correlates well with the mid-term prognosis of patients with angina pectoris. Since BMIPP SPECT is performed without stress to the patient, this imaging modality is important in evaluating patients with stable or unstable angina. (author)

  17. Coronary Microvascular Function and Cardiovascular Risk Factors in Women With Angina Pectoris and No Obstructive Coronary Artery Disease

    DEFF Research Database (Denmark)

    Mygind, Naja Dam; Michelsen, Marie Mide; Pena, Adam;

    2016-01-01

    BACKGROUND: The majority of women with angina-like chest pain have no obstructive coronary artery disease when evaluated with coronary angiography. Coronary microvascular dysfunction is a possible explanation and associated with a poor prognosis. This study evaluated the prevalence of coronary.......01), hypertension (P=0.02), current smoking (Pheart rate (P.... CONCLUSION: Impaired CFVR was detected in a substantial proportion, which suggests that coronary microvascular dysfunction plays a role in the development of angina pectoris. CFVR was associated with few cardiovascular risk factors, suggesting that CFVR is an independent parameter in the risk evaluation...

  18. Electrocardiogram Diagnosis of Unstable Angina Pectoris%不稳定型心绞痛心电图诊断

    Institute of Scientific and Technical Information of China (English)

    董红晶

    2014-01-01

    目的:探讨不稳定型心绞痛患者心电图及动态心电图表现。方法选取2012年~2013年收治的不稳定型心绞痛患者心电图诊断资料进行分析。结果心绞痛发作时可出现暂时性心肌缺血引起的ST段压低(≥0.1 mV)。心电图负荷实验及24 h动态心电图可显著提高缺血性心脏病的检出率。结论心电图检查是发现心肌缺血、诊断心绞痛最常用的检查方法。%Objective The electrocardiogram and dynamic electrocardiogram of the patients with the unstable angina pectoris are to be investigated.Methods Electrocardiogram diagnosis data of patients with angina pectoris in this hospital from 2012 to 2013 are selected for analysis.ResultsWhen the angina pectoris happens, ST segment depresion (≥0.1 mV) can be caused by transient myocardial ischemia. Electrocardiogram stres test and 24h dynamic electrocardiogram can significantly improve the detection rate of ischemic heart disease.Conclusion Electrocardiogram examination is the most widely used inspection method to detect the myocardial ischemia and diagnose the angina pectoris.

  19. Resting {sup 123}I-BMIPP scintigraphy in diagnosis of effort angina pectoris with reference to subsets of the disease

    Energy Technology Data Exchange (ETDEWEB)

    Yamabe, Hiroshi; Abe, Hiroaki; Yokoyama, Mitsuhiro [Kobe Univ. (Japan). School of Medicine; Shiotani, Hideyuki; Kajiya, Sadashi; Mori, Takao; Hashimoto, Yasunori

    1998-06-01

    This study was undertaken to assess the diagnostic value of resting {sup 123}I-BMIPP scintigraphy in patients with effort angina pectoris. One hundred and four patients underwent scintigraphic and angiographic examinations. The subsets of the patients were stable effort angina pectoris (stable type) in 27 cases, new onset of effort angina pectoris (new onset type) in 21 cases, and worsening effort angina pectoris (worsening type) in 35 cases. The remaining 21 cases were subjects without evidences of coronary artery disease (non-CAD). {sup 123}I-BMIPP was injected under resting and pain free condition, then data for single photon emission tomography (SPECT) were acquired. The positive regional {sup 123}I-BMIPP defects in three coronary territories were visually judged on the tomographic images. The overall sensitivity to diagnose the patients was 62.6% (52/83) and the overall specificity to exclude non-CAD subjects was 95.2% (20/21). The detection rate in each subset of the disease was 48.1% (13/27) in stable type, 47.6% (10/21) in new onset type and 77.1% (27/35) in worsening type (p<0.05 versus two other types). For detection of stenosed vessels, the overall sensitivity was 41.4% (56/148) and the overall specificity was 93.8% (152/164). The rate of detection of stenosed vessels was 31.7% (13/41) in stable type, 31.4% (11/35) in new onset type, and 55.6% (40/72) in worsening type (p<0.05 versus two other types). Vessels with 75% stenosis were more sensitively detected in the worsening type (33.3%; 4/12) compared to the remaining two types (8.3%; 1/12) even though the difference was not significant. The resting {sup 123}I-BMIPP scintigraphy was therefore valuable in diagnosing patients with effort angina pectoris and involved coronary arteries especially in the subset of patients with worsening type. (author)

  20. Asymptomatic myocardial ischemia as a predictor of cardiac events after coronary artery bypass grafting for stable angina pectoris

    DEFF Research Database (Denmark)

    Egstrup, K

    1988-01-01

    Thirty-six patients with chronic stable angina were studied before and after coronary artery bypass grafting (CABG) to assess the prevalence and prognostic implications of asymptomatic myocardial ischemia obtained by ambulatory monitoring. Ambulatory monitoring performed during medical therapy be...... for angina pectoris in some patients, whereas angina did not occur during the follow-up period in others. This study does not reveal whether or not these patients are at higher risk for cardiac events during long-term follow-up.......Thirty-six patients with chronic stable angina were studied before and after coronary artery bypass grafting (CABG) to assess the prevalence and prognostic implications of asymptomatic myocardial ischemia obtained by ambulatory monitoring. Ambulatory monitoring performed during medical therapy...... to 39 episodes after CABG (41%, p less than 0.05). During a follow-up of 9 months, 8 cardiac events occurred: 6 in group 1 comprising sudden death (1), revascularization (2), and angina (3) and 2 in group 2, including revascularization (1) and angina (1) (p = 0.005). Kaplan-Meier analysis demonstrated...

  1. Hemodynamic effects of metoprolol and nifedipine in angina pectoris measured by isotope technique

    Energy Technology Data Exchange (ETDEWEB)

    Bostroem, P.A.

    1988-01-01

    In order to evaluate the therapeutic effects of metoprolol, nifedipine, and their combination, 11 patients with secondary angina pectoris and with thallium tomographic findings indicating coronary artery disease were studied before and after these three treatment regimes in a single-blind cross-over study. The therapeutic effect was measured by standardized working test and isotope angiocardiography, which enabled evaluation of left ventricular ejection fraction, stroke volume, and phase analysis of left ventricular contraction. Treatment with metoprolol and combination therapy increased work performance. Ejection fraction did not differentiate the treatment regimes, whereas stroke volume was significantly lower at work and heart rate higher at rest and at work during nifedipine treatment compared to either metoprolol or combination treatment (p less than 0.05). Cardiac output was significantly reduced during nifedipine and metoprolol treatment during work (p less than 0.05). Phase improved after all therapeutic regimes, but reached significance only during the metoprolol treatment period at rest (p less than 0.05).

  2. Effect of Salvia miltiorrhiza on cytokines in patients with unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    Shi-Lian Chen; Sheng-Bing Huang

    2016-01-01

    Objective:To investigate the effect of Salvia miltiorrhiza (SM) on cytokines in patients with unstable angina pectoris (UAP).Methods: A total of 50 cases of UAP patients from October 2014 to October 2015 as the research object, randomly divided into treatment group and control group, two groups were treated with conventional bed rest, oxygen inhalation, ECG, nitroglycerin intravenous infusion, beta blockers, aspirin, statins, antiplatelet drug therapy, the treatment group on the basis of salvianolate 200 mg+5% glucose 250 mL (neutralization amount of 0.9% sodium chloride was used in patients with diabetes or glucose insulin) intravenous drip, 1 times/d, two groups were treated for 2 weeks; detected before and after treatment of plasma pregnancy associated plasma protein A (PAPP-A), soluble cell differentiation antigen ligand (sCD40L) and the level of serum interleukin-1 (IL-1), interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) level.Results: after the end of treatment, the treatment of PAPP-A and sCD40L levels decreased than the control group, which had statistical significance; treatment group IL-1, IL-6, TNF-α level lower than control group, which had statistical significance.Conclusion:On the basis of conventional treatment combined with salvianolate in treatment of UAP, can inhibit platelet aggregation, control inflammatory reaction, stabilize atherosclerotic plaque, reduce risk of cardiovascular events in therapeutic effect, it is worth clinical promotion.

  3. Does surgical sympathectomy improve clinical outcomes in patients with refractory angina pectoris?

    Science.gov (United States)

    Holland, Luke C; Navaratnarajah, Manoraj; Taggart, David P

    2016-04-01

    A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was: In patients with angina pectoris refractory to medical therapy, does surgical sympathectomy improve clinical outcomes? A total of 528 papers were identified using the search protocol described, of which 6 represented the best evidence to answer the clinical question. There were 5 case series and 1 prospective cohort study. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. All 5 of the case series demonstrated an improvement in symptoms, exercise tolerance or quality of life in patients undergoing surgical sympathectomy. An early case series investigating an open approach had a high morbidity and mortality rate, but the 4 other series used a minimally invasive technique and had low morbidity and zero perioperative mortality rates. The cohort study compared surgical sympathectomy with transmyocardial laser revascularization (TMR) and concluded TMR to be superior. However, this study looked only at unilateral sympathectomy, whereas all 5 case series focused on bilateral surgery. We conclude that the best currently available evidence does suggest that patients report an improvement in their symptoms and quality of life following surgical sympathectomy, but the low level of this evidence does not allow for a statistically proved recommendation.

  4. Exogenous nitric oxide inhibits Rho-associated kinase activity in patients with angina pectoris: a randomized controlled trial.

    Science.gov (United States)

    Maruhashi, Tatsuya; Noma, Kensuke; Fujimura, Noritaka; Kajikawa, Masato; Matsumoto, Takeshi; Hidaka, Takayuki; Nakashima, Ayumu; Kihara, Yasuki; Liao, James K; Higashi, Yukihito

    2015-07-01

    The RhoA/Rho-associated kinase (ROCK) pathway has a key physiological role in the pathogenesis of atherosclerosis. Increased ROCK activity is associated with cardiovascular diseases. Endogenous nitric oxide (NO) has an anti-atherosclerotic effect, whereas the exogenous NO-mediated cardiovascular effect still remains controversial. The purpose of this study was to evaluate the effect of exogenous NO on ROCK activity in patients with angina pectoris. This is a prospective, open-label, randomized, controlled study. A total of 30 patients with angina pectoris were randomly assigned to receive 40 mg day(-1) of isosorbide mononitrate (n=15, 12 men and 3 women, mean age of 63±12 years, isosorbide mononitrate group) or conventional treatment (n=15, 13 men and 2 women, mean age of 64±13 years, control group) for 12 weeks. ROCK activity in peripheral leukocytes was measured by western blot analysis. ROCK activities at 4 and 12 weeks after treatment were decreased in the isosorbide mononitrate group (0.82±0.33 at 0 week, 0.62±0.20 at 4 weeks, 0.61±0.19 at 12 weeks, n=15 in each group, Pangina pectoris.

  5. Prognostic value of fatty acid imaging in patients with angina pectoris without prior myocardial infarction: comparison with stress thallium imaging

    Energy Technology Data Exchange (ETDEWEB)

    Matsuki, Takayuki; Doi, Atsushi; Takahashi, Hiroshi; Iwata, Michihiro; Sakamoto, Takashi; Yamauchi, Kazuaki; Shimazaki, Masaru [Shin-Nittetsu Muroran General Hospital, Department of Cardiology, Muroran (Japan); Tamaki, Nagara; Morita, Koichi [Hokkaido University Graduate School of Medicine, Department of Nuclear Medicine, Sapporo (Japan); Nakata, Tomoaki; Shimamoto, Kazuaki [Sapporo Medical University, Second Department of Internal Medicine, School of Medicine, Sapporo (Japan)

    2004-12-01

    A fatty acid analogue, {sup 123}I-labelled {beta}-methyl iodophenyl pentadecanoic acid (BMIPP), has been used to identify ischaemic and metabolically impaired myocardium. However, the prognostic value of BMIPP imaging, particularly in relation to stress myocardial perfusion imaging, remains unclear. Data from 167 consecutive patients with angina pectoris but without prior myocardial infarction (MI) who had undergone both BMIPP and stress {sup 201}Tl (sTL) imaging were analysed. Tracer uptake was graded using a 13-segment, 4-point scoring model. Patients were followed up for 48 months with primary end points (cardiac death, non-fatal MI) as hard cardiac events and with secondary end points (late revascularisation, recurrent angina and heart failure) as soft events. For overall cardiac events (5 hard and 29 soft events), Kaplan-Meier analysis revealed significantly lower event rates in subgroups with normal BMIPP uptake, a summed difference score of sTL (SDS) of <3 or absence of diabetes mellitus when compared to each counterpart. Multivariate Cox's analysis revealed reduced BMIPP uptake, SDS {>=}3, diabetes and reduced ejection fraction to be significant predictors. Negative predictive values of normal BMIPP and SDS <3 for all events were 91% and 84%, respectively. No hard event occurred in 66 patients with normal BMIPP uptake, whereas two patients with SDS <3 but impaired BMIPP uptake had hard events. In conclusion, normal BMIPP imaging is an excellent prognostic sign, independently of stress myocardial perfusion imaging, in patients with angina pectoris without prior MI. (orig.)

  6. 冠心病稳定性心绞痛与微血管性心绞痛中医证候要素调查%Expert Investigation of Traditional Chinese Medical Syndrome Elements of Microvascular Angina Pectoris and Stable Angina Pectoris Induced by Coronary Artery Disease

    Institute of Scientific and Technical Information of China (English)

    毕颖斐; 毛静远

    2012-01-01

    [目的]对冠心病稳定性心绞痛与微血管性心绞痛的中医证候要素进行专家调查.[方法]运用专家调查( Delphi)法在全国范围内对冠心病稳定性心绞痛与微血管性心绞痛的中医证候要素及证候类型进行专家咨询和调查.[结果]冠心病稳定性心绞痛与微血管性心绞痛的中医证候要素及证候类型分布基本一致,但也存在一定差异,微血管性心绞痛较稳定性心绞痛多见气滞、血虚等证素及气滞心胸证.[结论]本调查结果可为冠心病稳定性心绞痛与微血管性心绞痛的中医临床辨证提供一定的参考.%Objective To investigate the traditional Chinese medical syndrome elements of microvascular angina pectoris and stable angina pectoris induced by coronary artery disease. Methods Delphi method was adopted for the investigation of traditional Chinese medical syndrome elements and syndrome patterns of microvascular angina pectoris and stable angina pectoris induced by coronary artery disease by experts overall the country. Results Syndrome elements and syndrome patterns were similar in patients with microvascular angina pectoris and stable angina pectoris induced by coronary artery disease. However, some differences existed in the two kinds of angina pectoris, microvascular angina pectoris patients were characterized with syndrome elements of Qi stagnation and blood deficiency, and with syndrome pattern of Qi stagnation in heart and chest. Conclusion The results of the investigation will supply certain evidence for syndrome differentiation of microvascular angina pectoris and stable angina pectoris induced by coronary artery disease.

  7. Correlation between Timi Risk Score and Clinical Outcome in Patients with Unstable Angina Pectoris

    Directory of Open Access Journals (Sweden)

    Savovic Zorica

    2016-06-01

    Full Text Available Given Taking that the TIMI score is a major predictor of MACE, this study aimed to determine the value of the TIMI risk score in predicting poor outcomes (death, myocardial infarction, recurrent pain in patients presenting with unstable angina pectoris in short-term observation. A total of 107 patients with APns were examined at the Clinical Centre Kragujevac and were included in the investigation. The TIMI score was determined on the first day of hospitalization. During hospitalization, the following factors were also observed: troponin, ECG evolution, further therapy (pharmacologic therapy and/or emergency PCI or CABG, age, hypertension and hyperlipidaemia. The low-risk group (TIMI 0 - 2 included 30.8% of patients, whereas 47.6% of patients were in the intermediate-risk group (TIMI 3 - 4, and 21.5% of patients were in the high-risk group (TIMI 5 - 7. Good outcomes (without adverse event and poor outcomes (death, myocardial infarction, and recurring chest pain were dependent on the TIMI risk score. The increase in TIMI risk score per one unit increased the risk of a poor outcome by 54%. Troponin and TIMI risk score were positively correlated. Our results suggest that the TIMI risk score may be a reliable predictor of a poor outcome (MACE during the short-term observation of patients with APns. Moreover, patients identified as high-risk benefit from early invasive PCI, enoxaparin and Gp IIb/IIIa inhibitors. Th us, routine use of the TIMI risk score at admission may reduce the number of patients not recognized as high-risk.

  8. Reprising Ramadan-Related Angina Pectoris: A Potential Strategy for Risk Reduction.

    Science.gov (United States)

    Siegel, Arthur J; Bhatti, Nasir A; Wasfy, Jason H

    2016-11-10

    BACKGROUND A preponderance of evidence supports short-term aspirin usage to reduce transiently increased cardiovascular risk in clinical conditions that promote acute myocardial ischemia. CASE REPORT We report on the case of a 69-year-old male of Muslim Indian heritage with multiple cardiovascular risk factors who experienced the onset of angina pectoris while fasting for Ramadan for more than 16 hours daily for 30 days in July 2015. While symptom free for 2 months on medical management after ending his fast, he underwent quadruple coronary artery bypass surgery for severe 4-vessel disease following an acute anterior myocardial infarction. A percutaneous coronary intervention with stent placement was subsequently required for persistent myocardial ischemia on stress-MIBI testing due to occlusion of the graft to left anterior descending artery. Presently asymptomatic, he decided to forgo fasting for Ramadan in June 2016. CONCLUSIONS Based on this case, measures for primary cardiovascular prevention among the 1.2 billion susceptible males at similar high short-term cardiac risk while fasting for Ramadan are proposed. The value of aspirin for attenuating high short-term cardiovascular risk in clinical conditions conferring transient inflammatory stress is considered. Low-dose aspirin usage at evening meals while fasting for Ramadan is prudent for primary cardiovascular protection of males who may have non-obstructive coronary atherosclerosis to mitigate the risk for rupture of potentially vulnerable plaques. Based in part on conclusive evidence for protection of middle-aged males from first myocardial infarction in a randomized prospective primary prevention trial, this measure is concordant with recommendations from sub-specialty societies for primary cardiovascular prevention for persons at above-average risk demonstrated by validated biomarkers and from the United States Preventive Services Task Force.

  9. Effects of Salvia miltiorrhiza on Hemorheology and vascular endothelial function in patients with unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    Shi-Lian Chen; Sheng-Bing Huang

    2016-01-01

    Objective:To investigate the effect of Salvia miltiorrhiza (SM) on vascular endothelial function and hemorheology in patients with unstable angina pectoris (UAP).Methods: A total of 60 cases of UAP patients from October 2014 to October 2015 as the research object, randomly divided into treatment group and control group; the two groups were treated with conventional bed rest, ECG monitoring, oxygen inhalation, application of nitroglycerin, beta blockers, aspirin and antiplatelet, statin therapy, the treatment group based on the use of salvianolate 200 mg+5% glucose 250 mL (neutralization amount of 0.9% sodium chloride was used in patients with diabetes or glucose insulin) intravenous drip, 1 times/d, two groups were treated for 2 weeks; the two groups before and after treatment and take venous blood in the morning fasting peripheral blood viscosity, plasma viscosity, measured by automatic blood rheometer (low and middle shear and high shear rate), hematocrit and erythrocyte aggregation index, serum endothelin (ET) and nitric oxide (NO) level was measured by nitrate reductase Set.Results:after the treatment, the treatment group, the plasma viscosity, whole blood viscosity (low shear, cut and high shear rate), red blood cell hematocrit and red blood cell aggregation index decreased than the control group, there is statistical significance; after treatment, in treatment group, the serum NO level, et reduce degree is significantly better than the contrast group, there is statistical significance.Conclusion: Salvia miltiorrhiza can effectively improve blood rheology, improve microcirculation, regulate vascular endothelial function, effectively reduce the risk of cardiovascular events in UAP patients, it is worthy of clinical application.

  10. Therapeutic effects of nicorandil on stubborn angina pectoris%尼可地尔治疗顽固性心绞痛疗效观察

    Institute of Scientific and Technical Information of China (English)

    沈鹃琴; 屈百鸣

    2011-01-01

    目的 观察口服尼可地尔治疗顽固性心绞痛的临床效果.方法 采用随机、临床对照实验方法.选择确诊为顽固性心绞痛的32例患者作为研究对象.随机分为2组,即尼可地尔治疗组、对照组,每组各16例,2组患者均接受心绞痛的常规治疗,其中治疗组在常规治疗基础上加用尼可地尔.研究主要终点为治疗后心绞痛发生情况.结果 治疗组与对照组比较有较低的心绞痛发生率(P<0.05).结论 对顽固性心绞痛患者,在常规治疗的同时加服尼可地尔可获得良好的疗效.%Objective To observe the effects of taking nicorandil on stubborn angina pectoris. Methods Random and clinical control experiment were applied. Thirty - two patients who were diagnosed stubborn angina pectoris were divided into two groups according to whether or not oral nicorandil therapy including therapy group and control group. Each group had 16 cases. All patients were treated with routine treatments of stubborn angina pectoris. The nicorandil therapy group took not only the normal therapy but also nicorandil. The primary end point of the study was to measure the incidence of angina pectoris after therapy. Results The incidence of angina pectoris in the group of nicorandil was lower than control group ( P < 0. 05 ) . Conclusions Stubborn angina pectoris can be relieved by taking nicorandil combing with routine treatments.

  11. N-acetylcysteine modifies the acute effects of isosorbide-5-mononitrate in angina pectoris patients evaluated by exercise testing

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Klarlund, K; Aldershvile, J

    1989-01-01

    , given together with a single oral dose of the long-acting nitrate, isosorbide-5-mononitrate (5-ISMN, 60 mg), would modify the nitrate effect evaluated by exercise testing before and after additional sublingual doses of nitroglycerin (NTG). Ten patients with angina pectoris and angiographically proven...... significant coronary artery disease were included. All patients received a baseline therapy with beta blockers. None of the patients had developed nitrate tolerance at inclusion. NAC/5-ISMN treatment significantly prolonged the total exercise time as compared with placebo/5-ISMN (7.7 +/- 2.1 min vs. 6.8 +/- 1...

  12. Treatment with verapamil and trandolapril in patients with congestive heart failure and angina pectoris or myocardial infarction. The DAVIT Study Group. Danish Verapamil Infarction Trial

    DEFF Research Database (Denmark)

    Hansen, J F; Hagerup, L; Sigurd, B

    1997-01-01

    In a double-blind, randomized trial in a consecutive group of postinfarct patients in treatment with diuretic agents for congestive heart failure, the 3 month rate of cardiac events (i.e., death, repeat infarction, unstable angina pectoris, or repeat admission because of heart failure) was 14......% in patients treated with verapamil and trandolapril and 35% in patients treated with trandolapril (p = 0.01). In another study of patients with angina pectoris and left ventricular ejection fraction less than 40%, trandolapril plus verapamil improved exercise duration and left ventricular ejection fraction...

  13. Pharmacokinetic comparison of the vasorelaxant compound ferulic acid following the administration of Guanxin II to healthy volunteers and patients with angina pectoris.

    Science.gov (United States)

    Li, Yun-Hui; Huang, Xi; Wang, Yang; Fan, Rong; Zhang, Hong-Min; Ren, Ping; Chen, Yao; Zhou, Hong-Hao; Liu, Zhao-Qian; Liang, Yi-Zeng; Lu, Hong-Mei

    2013-11-01

    Coronary heart disease (CHD) is the leading cause of mortality worldwide. The Chinese medicinal formula Guanxin II has been shown to have a favorable effect in the attenuation of angina. The aim of this study was to compare the pharmacokinetics of ferulic acid (FA), which is a vasorelaxant compound present in Guanxin II, in healthy volunteers and patients with angina pectoris following the administration of Guanxin II. Ex vivo experiments were performed in order to investigate the vasorelaxant effect of FA on the human internal mammary artery (IMA) to provide evidence that it is a bioactive component of Guanxin II. Following the oral administration of Guanxin II, the FA levels in the serum were quantified by a simple and rapid high-performance liquid chromatography (HPLC) method. Treatment with FA (10(-8)-10(-3) M) caused a concentration-dependent relaxation of endothelial IMA rings following precontraction with KCl. Statistically significant differences were identified between the pharmaco-kinetic parameters Cmax, t1/2α, t1/2β and t1/2Ka of the healthy volunteers and the patients with angina pectoris following the oral administration of Guanxin II. FA is a bioactive compound absorbed from Guanxin II that attenuates angina pectoris, a condition that may modify the pharmacokinetics of FA. Not only do the pharmacokinetic parameters direct the clinical use of Guanxin II, but they may also be useful for exploring the pathology of angina pectoris.

  14. Incidence and follow-up of Braunwald subgroups in unstable angina pectoris

    NARCIS (Netherlands)

    A.J.M. van Miltenburg-van Zijl (Addy); M.L. Simoons (Maarten); R.J. Veerhoek (Rinus); P.M.M. Bossuyt (Patrick)

    1995-01-01

    textabstractObjectives. This study was performed to establish the prognosis of patients with unstable angina within the subgroups of the Braunwald classification. Background. Among many classifications of unstable angina, the Braunwald classification is frequently used. However, the incidence and

  15. Circulating CD36 and fractalkine levels are associated with vulnerable plaque progression in patients with unstable angina pectoris.

    Science.gov (United States)

    Li, Rui Jian; Yang, Ming; Li, Ji Fu; Xue, Li; Chen, Yu Guo; Chen, Wen Qiang

    2014-11-01

    The chemokine, fractalkine, independently enhances the vulnerability of coronary atherosclerotic plaques. The present study investigated the combined effects of CD36 and fractalkine on coronary plaque progression in patients with unstable angina pectoris. In the present study, 120 unstable angina pectoris patients undergoing coronary angiography and intravascular ultrasound were divided into two groups: an intermediate lesion group (lumen diameter stenosis 50-70%, 80 patients) and a severe lesion group (at least one lesion with lumen diameter stenosis > 70%, 40 patients). The control group consisted of 40 healthy age- and sex-matched subjects. Concentrations of CD36 and fractalkine were measured by enzyme-linked immunosorbent assay. Major adverse cardiovascular events were monitored over a 2-year follow up. Intravascular ultrasound showed that patients with severe lesions had more calcified and mixed plaques, and a larger plaque area and plaque burden than patients with intermediate lesions (P < 0.05-0.01). More patients with severe lesions underwent stent deployment (P < 0.05) than those with intermediate lesions. CD36 and fractalkine concentrations were significantly higher in the severe lesion patients (P < 0.05), and both had significant positive correlations (P < 0.05) with the plaque burden of atherosclerotic lesions. Using the matched nested case-control study, we found that CD36 and fractalkine levels were higher in patients with recurrent major adverse cardiovascular events than controls (P < 0.05). In conclusion, CD36 and fractalkine both promote, and might synergistically enhance, the progression of coronary atherosclerotic plaques.

  16. Effects of XUEZHIKANG on Oxidized Low Density Lipoprotein,C- Reactive Protein, Fibrinogen in Unstable Angina Pectoris Patients

    Institute of Scientific and Technical Information of China (English)

    姚青海; 崔长琮; 王军奎; 姚晓伟

    2003-01-01

    Objectives To study the effects of XUEZHIKANG on lipid modulating and thelevel of oxidized low density lipoprotein (OX - LDL),C -reactive protein(CRP), fibrinogen(FIB) in serum.Methods XUEZHIKANG was given to patientswith unstable angina pectoris and hyperlipidemia at adose of 0.6 gram bid for 2 months and with half-dose for another 2 months. Vitamin E was given tounstable angina pectoris patients with normal lipid atthe dose of 0.1 gram bid for 4 months respectively.Then compared the level of lipid and OX - LDfL, CRP,FIB in serum at beginning, first -month and second -month. Results XUEZHIKANG can reduce theserum level of total cholesterol, low density lipoproteinin 1 month , and gained better effect in 2 months. Itcan also reduce triglyceride and increase high densitylipoprotein in 2 months. Compared with vitamin EXUEZHIKANG can reduce the level of OX- LDL,CRP, FIB significantly after treatment for 2 months.Conclusions XUEZHIKANG has significant effectin lipid modulating , and it can also inhibit the de-velopment of inflammation in coronary plaque.

  17. Plasma α1-antitrypsin: A Neglected Predictor of Angiographic Severity in Patients with Stable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    Hui Zhao; Hong Liu; Lin Chai; Ping Xu; Lu Hua; Xiao-Yuan Guan; Bing Duan

    2015-01-01

    Background:As an acute phase protein,α1-antitrypsin (AAT) has been extensively studied in acute coronary syndrome,but it is unclear whether a relationship exists between AAT and stable angina pectoris (SAP).The purpose of the present study was to investigate the association between AAT plasma levels and SAP.Methods:Overall,103 SAP patients diagnosed by coronary angiography and clinical manifestations and 118 control subjects matched for age and gender were enrolled in this case-control study.Plasma levels of AAT,high-sensitivity C-reactive protein (hsCRP),lipid profiles and other clinical parameters were assayed for all participants.The severity of coronary lesions was evaluated based on the Gensini score (GS) assessed by coronary angiography.Results:Positively correlated with the GS (r =0.564,P < 0.001),the plasma AAT level in the SAP group was significantly higher than that in the control group (142.08 ± 19.61 mg/dl vs.125.50 ± 19.67 mg/dl,P < 0.001).The plasma AAT level was an independent predictor for both SAP (odds ratio [OR] =1.037,95% confidence interval [CO:1.020-1.054,P < 0.001) and a high GS (OR =1.087,95% CI:1.051-1.124,P < 0.001) in a multivariate logistic regression model.In the receiver operating characteristic curve analysis,plasma AAT level was found to have a larger area under the curve (AUC) for predicting a high GS (AUC =0.858,95% CI:0.788-0.929,P < 0.001) than that of hsCRP (AUC =0.665,95% CI:0.557-0.773,P =0.006; Z =2.9363,P < 0.001),with an optimal cut-off value of 137.85 mg/dl (sensitivity:94.3%,specificity:68.2%).Conclusions:Plasma AAT levels correlate with both the presence and severity of coronary stenosis in patients with SAP,suggesting that it could be a potential predictive marker of severe stenosis in SAP patients.

  18. Plasma α1-antitrypsin: A Neglected Predictor of Angiographic Severity in Patients with Stable Angina Pectoris

    Directory of Open Access Journals (Sweden)

    Hui Zhao

    2015-01-01

    Full Text Available Background: As an acute phase protein, α1-antitrypsin (AAT has been extensively studied in acute coronary syndrome, but it is unclear whether a relationship exists between AAT and stable angina pectoris (SAP. The purpose of the present study was to investigate the association between AAT plasma levels and SAP. Methods: Overall, 103 SAP patients diagnosed by coronary angiography and clinical manifestations and 118 control subjects matched for age and gender were enrolled in this case-control study. Plasma levels of AAT, high-sensitivity C-reactive protein (hsCRP, lipid profiles and other clinical parameters were assayed for all participants. The severity of coronary lesions was evaluated based on the Gensini score (GS assessed by coronary angiography. Results: Positively correlated with the GS (r = 0.564, P < 0.001, the plasma AAT level in the SAP group was significantly higher than that in the control group (142.08 ± 19.61 mg/dl vs. 125.50 ± 19.67 mg/dl, P < 0.001. The plasma AAT level was an independent predictor for both SAP (odds ratio [OR] = 1.037, 95% confidence interval [CI]: 1.020-1.054, P < 0.001 and a high GS (OR = 1.087, 95% CI: 1.051-1.124, P < 0.001 in a multivariate logistic regression model. In the receiver operating characteristic curve analysis, plasma AAT level was found to have a larger area under the curve (AUC for predicting a high GS (AUC = 0.858, 95% CI: 0.788-0.929, P < 0.001 than that of hsCRP (AUC = 0.665, 95% CI: 0.557-0.773, P = 0.006; Z = 2.9363, P < 0.001, with an optimal cut-off value of 137.85 mg/dl (sensitivity: 94.3%, specificity: 68.2%. Conclusions: Plasma AAT levels correlate with both the presence and severity of coronary stenosis in patients with SAP, suggesting that it could be a potential predictive marker of severe stenosis in SAP patients.

  19. Relationship between angina pectoris and outcomes in patients with heart failure and reduced ejection fraction : an analysis of the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA)

    NARCIS (Netherlands)

    Badar, Athar A.; Perez-Moreno, Ana Cristina; Jhund, Pardeep S.; Wong, Chih M.; Hawkins, Nathaniel M.; Cleland, John G. F.; van Veldhuisen, Dirk J.; Wikstrand, John; Kjekshus, John; Wedel, Hans; Watkins, Stuart; Gardner, Roy S.; Petrie, Mark C.; McMurray, John J. V.

    2014-01-01

    Aim Angina pectoris is common in patients with heart failure and reduced ejection fraction (HF-REF) but its relationship with outcomes has not been well defined. This relationship was investigated further in a retrospective analysis of the Controlled Rosuvastatin Multinational Trial in Heart Failure

  20. Interindividual and intraindividual variability in plasma fibrinogen, TPA antigen, PAI activity, and CRP in healthy, young volunteers and patients with angina pectoris

    NARCIS (Netherlands)

    Maat, M.P.M. de; Bart, A.C.W. de; Hennis, B.C.; Meijer, P.; Havelaar, A.C.; Mulder, P.G.H.; Kluft, C.

    1996-01-01

    We compared intraindividual and interindividual variability in the plasma levels of fibrinogen, tissue-type plasminogen activator (TPA) antigen, plasminogen activator inhibitor (PAI) activity, and C-reactive protein (CRP) in 20 healthy, young individuals and 26 patients with stable angina pectoris (

  1. Coronary blood flow dynamics during transcutaneous electrical nerve stimulation for stable angina pectoris associated with severe narrowing of one major coronary artery

    NARCIS (Netherlands)

    Jessurun, GAJ; Tio, RA; De Jongste, MJL; Hautvast, RWM; Den Heijer, P; Crijns, HJGM

    1998-01-01

    To study the effect of transcutaneous electrical nerve stimulation (TENS) on coronary vasomotion, patients with New York Heart Association class III angina pectoris and significant single-vessel left coronary artery disease and who were also scheduled for elective percutaneous transluminal coronary

  2. Diagnostic and prognostic value of a careful symptom evaluation and high sensitive troponin in patients with suspected stable angina pectoris without prior cardiovascular disease

    DEFF Research Database (Denmark)

    Madsen, Debbie M; Diederichsen, Axel C P; Hosbond, Susanne E

    2017-01-01

    BACKGROUND AND AIMS: Typical angina pectoris (AP) and high-sensitive troponin I (hs-TnI) are independently associated with coronary artery disease (CAD) and future cardiovascular events (CVE). This study aimed to assess the individual and combined diagnostic and prognostic impact of symptoms and hs...

  3. [Dengzhan Xixin injection as an adjuvant treatment for angina pectoris: a systematic review and Meta-analysis of randomized controlled trials].

    Science.gov (United States)

    Wang, Feng-jiao; Xie, Yan-ming; Liao, Xing; Jia, Min

    2015-08-01

    The paper is to systematically evaluate the efficacy and safety of Deng Zhan Xi Xin injection ( DZXXI) as an adjuvant treatment for patients with angina pectoris. The Cochrane Library, Medline, EMbase, CBM, CNKI, VIP, and Wan fang Data base were searched. Randomized controlled trials (RCTs) of DZXXI combined with western medicine routine treatment versus western medicine routine treatment alone for angina pectoris patients were all included. All trials were assessed according to the Cochrane Reviewer' s Handbook 5.1 for Systematic Reviews of Intervention and Meta analyses were performed by RevMan 5. 2 Software. A total of 30RCTs (3 086 patients including 1 572 patients of treatment group and 1 514 patients of control group) were included. Meta-analysis of treatment group compared with control group showed superior effect over reducing cardiovascular events ( OR = 0.33; 95% CI: [0.16, 0.67], P = 0.002, improving effective rate of DZXXI as adjuvant treatment for angina pectoris patients (OR = 3.97; 95% CI: [3.15, 5.02]; P angina pectoris. But based on the limitations of the study, rigorous design with long follow up clinical trials are necessary for further evidence.

  4. Dietary factor VII activation does not increase plasma concentrations of prothrombin fragment 1+2 in patients with stable angina pectoris and coronary atherosclerosis

    DEFF Research Database (Denmark)

    Bladbjerg, E-M; Münster, A M; Marckmann, P

    2000-01-01

    tissue factor, the cofactor of FVII, to circulating blood; therefore, thrombin formation in response to FVII activation is more likely to occur in such patients. This hypothesis was tested in a randomized crossover study of 30 patients (aged 43 to 70 years) with stable angina pectoris...

  5. 不稳定型心绞痛的临床治疗方法%Clinical Treatment of Unstable Angina Pectoris TIAN Xue-feng

    Institute of Scientific and Technical Information of China (English)

    田学峰

    2013-01-01

    目的:探讨不稳定型心绞痛的内科治疗。方法:选取我院2011年12月~2012年12月收治的100例不稳定型心绞痛患者。对其进行一般治疗及药物治疗。结果:临床治愈效果明显。结论:不稳定型心绞痛患者经一般治疗及药物治疗均好转出院。有研究表明不稳定心绞痛患者在发病最初的几周内心肌梗死的发生率为10%,死亡率为4%。%Objective:To investigate the Department of internal medicine in the treatment of unstable angina pectoris .Methods:Se-lected in our hospital from 2011 December to 2012 December was treated 100 cases of patients with unstable angina pectoris , General treatment and drug therapy .Results:the clinical cure effect .Conclusion:Unstable angina pectoris patients after general treatment and drug treatment were improved and discharged .Studies have shown thatpatients with unstable angina pectoris myocardial incidence in the early week infarction incidence rate was 10%, mortality was 4%.

  6. Addition of felodipine to metoprolol vs replacement of metoprolol by felodipine in patients with angina pectoris despite adequate beta-blockade - Results of the felodipine ER and metoprolol CR in angina (FEMINA) study

    NARCIS (Netherlands)

    Dunselman, P; Liem, AH; Verdel, G; Kragten, H; Bosma, A; Bernink, P

    1997-01-01

    Aims The study aimed to compare the addition of felodipine to metoprolol, and of the replacement of metoprolol by felodipine, with continuation of metoprolol, in patients with angina pectoris despite optimal beta-blockade. Methods and results The study was double-blind, parallel, randomized and cont

  7. Progress on Ivabradine in Treating Stable Angina Pectoris%伊伐布雷定治疗稳定性心绞痛的研究进展

    Institute of Scientific and Technical Information of China (English)

    江明芳; 张家美

    2015-01-01

    Increasing of heart rate is an important risk factor of cardiovascular diseases,also is the main cause of angina pectoris. Ivabradine is one kind of I( f) channel inhibitors,can effectively slow down the heart rate of patients with stable angina pectoris, reduce myocardial oxygen consumption and the attack frequency of angina pectoris, relieve the clinical symptoms. At present,it is not very sure about that whether ivabradine can improve the long-term prognosis or quality of life of patients with stable angina pectoris or not. This paper reviewed the mechanism,related clinical evidences and adverse reactions of ivabradine,to investigate the feasibility of ivabradine in treating stable angina pectoris.%心率增快是心血管疾病的重要危险因素,也是导致心绞痛发作的重要原因。伊伐布雷定是一种I( f)电流通道抑制剂,能有效减慢稳定性心绞痛患者心率,进而减低心肌耗氧量、改善临床症状、减少心绞痛发作次数。但目前关于伊伐布雷定能否改善稳定性心绞痛患者远期预后及提高患者生活质量等方面的研究仍存在争议。本文从伊伐布雷定作用机制、相关临床证据及不良反应等方面进行综述,以探讨伊伐布雷定治疗稳定性心绞痛的可行性。

  8. A comparative study of dalteparin and unfractionated heparin in patients with unstable angina pectoris

    Directory of Open Access Journals (Sweden)

    Hanmant S Amane

    2011-01-01

    Conclusion : Dalteparin is as effective and safe as unfractionated heparin in the treatment of unstable angina. Dalteparin does not require routine laboratory monitoring as with unfractionated heparin.

  9. Inherited chromosomally integrated human herpesvirus 6 as a predisposing risk factor for the development of angina pectoris.

    Science.gov (United States)

    Gravel, Annie; Dubuc, Isabelle; Morissette, Guillaume; Sedlak, Ruth H; Jerome, Keith R; Flamand, Louis

    2015-06-30

    Inherited chromosomally integrated human herpesvirus-6 (iciHHV-6) results in the germ-line transmission of the HHV-6 genome. Every somatic cell of iciHHV-6+ individuals contains the HHV-6 genome integrated in the telomere of chromosomes. Whether having iciHHV-6 predisposes humans to diseases remains undefined. DNA from 19,597 participants between 40 and 69 years of age were analyzed by quantitative PCR (qPCR) for the presence of iciHHV-6. Telomere lengths were determined by qPCR. Medical records, hematological, biochemical, and anthropometric measurements and telomere lengths were compared between iciHHV-6+ and iciHHV-6- subjects. The prevalence of iciHHV-6 was 0.58%. Two-way ANOVA with a Holm-Bonferroni correction was used to determine the effects of iciHHV6, sex, and their interaction on continuous outcomes. Two-way logistic regression with a Holm-Bonferroni correction was used to determine the effects of iciHHV6, sex, and their interaction on disease prevalence. Of 50 diseases monitored, a single one, angina pectoris, is significantly elevated (3.3×) in iciHHV-6+ individuals relative to iciHHV-6- subjects (P = 0.017; 95% CI, 1.73-6.35). When adjusted for potential confounding factors (age, body mass index, percent body fat, and systolic blood pressure), the prevalence of angina remained three times greater in iciHHV-6+ subjects (P = 0.015; 95%CI, 1.23-7.15). Analyses of telomere lengths between iciHHV-6- without angina, iciHHV-6- with angina, and iciHHV-6+ with angina indicate that iciHHV-6+ with angina have shorter telomeres than age-matched iciHHV-6- subjects (P = 0.006). Our study represents, to our knowledge, the first large-scale analysis of disease association with iciHHV-6. Our results are consistent with iciHHV-6 representing a risk factor for the development of angina.

  10. Impact of Clinical Presentation (Stable Angina Pectoris vs Unstable Angina Pectoris or Non-ST-Elevation Myocardial Infarction vs ST-Elevation Myocardial Infarction) on Long-Term Outcomes in Women Undergoing Percutaneous Coronary Intervention With Drug-Eluting Stents.

    Science.gov (United States)

    Giustino, Gennaro; Baber, Usman; Stefanini, Giulio Giuseppe; Aquino, Melissa; Stone, Gregg W; Sartori, Samantha; Steg, Philippe Gabriel; Wijns, William; Smits, Pieter C; Jeger, Raban V; Leon, Martin B; Windecker, Stephan; Serruys, Patrick W; Morice, Marie-Claude; Camenzind, Edoardo; Weisz, Giora; Kandzari, David; Dangas, George D; Mastoris, Ioannis; Von Birgelen, Clemens; Galatius, Soren; Kimura, Takeshi; Mikhail, Ghada; Itchhaporia, Dipti; Mehta, Laxmi; Ortega, Rebecca; Kim, Hyo-Soo; Valgimigli, Marco; Kastrati, Adnan; Chieffo, Alaide; Mehran, Roxana

    2015-09-15

    The long-term risk associated with different coronary artery disease (CAD) presentations in women undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES) is poorly characterized. We pooled patient-level data for women enrolled in 26 randomized clinical trials. Of 11,577 women included in the pooled database, 10,133 with known clinical presentation received a DES. Of them, 5,760 (57%) had stable angina pectoris (SAP), 3,594 (35%) had unstable angina pectoris (UAP) or non-ST-segment-elevation myocardial infarction (NSTEMI), and 779 (8%) had ST-segment-elevation myocardial infarction (STEMI) as clinical presentation. A stepwise increase in 3-year crude cumulative mortality was observed in the transition from SAP to STEMI (4.9% vs 6.1% vs 9.4%; p <0.01). Conversely, no differences in crude mortality rates were observed between 1 and 3 years across clinical presentations. After multivariable adjustment, STEMI was independently associated with greater risk of 3-year mortality (hazard ratio [HR] 3.45; 95% confidence interval [CI] 1.99 to 5.98; p <0.01), whereas no differences were observed between UAP or NSTEMI and SAP (HR 0.99; 95% CI 0.73 to 1.34; p = 0.94). In women with ACS, use of new-generation DES was associated with reduced risk of major adverse cardiac events (HR 0.58; 95% CI 0.34 to 0.98). The magnitude and direction of the effect with new-generation DES was uniform between women with or without ACS (pinteraction = 0.66). In conclusion, in women across the clinical spectrum of CAD, STEMI was associated with a greater risk of long-term mortality. Conversely, the adjusted risk of mortality between UAP or NSTEMI and SAP was similar. New-generation DESs provide improved long-term clinical outcomes irrespective of the clinical presentation in women.

  11. Improving diagnosis and treatment of women with angina pectoris and microvascular disease

    DEFF Research Database (Denmark)

    Prescott, Eva; Abildstrøm, Steen Zabell; Aziz, Ahmed

    2014-01-01

    BACKGROUND: The iPOWER study aims at determining whether routine assessment of coronary microvascular dysfunction (CMD) in women with angina and no obstructive coronary artery disease is feasible and identifies women at risk. METHODS: All women with angina referred to invasive angiographic assess...

  12. Coronary flow reserve evaluated by {sup 201}Tl myocardial perfusion SPECT after coronary artery bypass grafting (CABG) for angina pectoris

    Energy Technology Data Exchange (ETDEWEB)

    Ishino, Yoichi; Nakata, Hajime [Univ. of Occupational and Environmental Health, Kitakyusyu, Fukuoka (Japan)

    2000-11-01

    We compared the flow reserves of the coronary bypass vessels between arterial and venous grafts by {sup 201}Tl myocardial perfusion SPECT on the patients with angina pectoris who had no past history of myocardial infarction or intervention therapy such as PTCA. Thirty two patients had undergone a total of 70 bypass grafts and 66 of them were proved to be patent at postoperative CAG. Reversible defects were observed in 6 of 40 segments (15.0%) covered by patent venous grafts, and in 11 of 26 segments (42.3%) by patent arterial grafts. The rate of postoperative reversible defects was higher in the areas grafted by artery but this had no relation with the severity of coronary artery stenosis before CABG. This reversible defect is most likely to be caused by the character of artery graft itself and this should not be considered to highly suggest the restenosis or occlusion of the graft vessel. (author)

  13. Evaluation of pharmacokinetics and pharmacodynamics relationships for Salvianolic Acid B micro-porous osmotic pump pellets in angina pectoris rabbit

    Directory of Open Access Journals (Sweden)

    Shu-Ling Kan

    2014-06-01

    Full Text Available The work aims to investigate the in vitro release, pharmacokinetics (PK, pharmacodynamics (PD and PK–PD relationships of Salvianolic Acid B micro-porous osmotic pump pellets (SalB-MPOPs in angina pectoris New Zealand White (NZW rabbits, compared with those of SalB immediate-release pellets (SalB-IRPs. The SalB plasma concentrations and Superoxide dismutase levels (PD index were recorded continuously at predetermined time interval after administration, and the related parameters were calculated by using WinNonlin software. The release profile of MPOPs was more sustained than that of IRPs. PK results indicated that the mean Cmax was significantly lower, the SalB plasma concentrations were steadier, both area under concentration-time curve from 0 to 24 h (AUC0–24 h and from 0 to infinity (AUC0–∞ were presented larger, and both the peak concentration time (Tmax and mean residence time (MRT were prolonged for MPOPs, as compared with those of IRPs. PD results suggested that peak drug effect (Emax was lower and the equilibration rate constant (ke0 between the central compartment and the effect compartment was higher of MPOPs vs. those of IRPs. PK–PD relationships demonstrated that the effect-concentration-time (ECT course of MPOPs was clockwise hysteresis loop, and that of IRPs was counter-clockwise hysteresis loop. Collectively, those results demonstrated that MPOPs were potential formulations in treating angina pectoris induced by atherosclerosis.

  14. 催眠针法治疗心绞痛的疗效及血浆ET、NO改变的研究%A Study on Hypnotic Acupuncture Therapy for Angina Pectoris and Its Effects on Plasma ET and NO

    Institute of Scientific and Technical Information of China (English)

    李献; 郑强荪; 宋胜云; 高军军; 尼珍; 袁秀兰; 张录兴

    2002-01-01

    Objective: To evaluate the treatment effects of hypnotic acupuncture therapy on angina pectoris. Methods: 40 cases of angina pectoris treated by hypnotic acupuncture therapy were compared with 31 cases of angina pectoris treated by pure acupuncture. Results: Symptom relief rate and change of ECG were found to be more desirable in the Hypnotic acupuncture therapy group than in the pure acupuncture group (P<0.01,P<0.05). Pre-post treatment comparisons on levels of anxiety, depression, ET and NO also showed that hypnotic acupuncture therapy was superior to the pure acupuncture group (P<0.05).Conclusion:The present study provides strong support for hypnotic acupuncture therapy for angina pectoris, in terms of its treatment effects on both mental and physical improvement.

  15. Structural and Functional Coronary Artery Abnormalities in Patients With Vasospastic Angina Pectoris

    DEFF Research Database (Denmark)

    Ong, Peter; Aziz, Ahmed; Hansen, Henrik Steen

    2015-01-01

    Coronary spasm is involved in many clinical scenarios, such as stable angina, acute coronary syndrome, sudden cardiac death, non-ischemic cardiomyopathy, arrhythmia and syncope. In recent years, imaging tools such as computerized tomographic angiography, intravascular ultrasound or optical cohere...

  16. Manual Thrombus Aspiration and the Improved Survival of Patients With Unstable Angina Pectoris Treated With Percutaneous Coronary Intervention (30 Months Follow-Up).

    Science.gov (United States)

    Yildiz, Bekir S; Bilgin, Murat; Zungur, Mustafa; Alihanoglu, Yusuf I; Kilic, Ismail D; Buber, Ipek; Ergin, Ahmet; Kaftan, Havane A; Evrengul, Harun

    2016-02-01

    The clinical effect of intracoronary thrombus aspiration during percutaneous coronary intervention in patients with unstable angina pectoris is unknown. In this study, we aimed to assess how thrombus aspiration during percutaneous coronary intervention affects in-hospital and 30-month mortality and complications in patients with unstable angina pectoris.We undertook an observational cohort study of 645 consecutive unstable angina pectoris patients who had performed percutaneous coronary intervention from February 2011 to March 2013. Before intervention, 159 patients who had culprit lesion with thrombus were randomly assigned to group 1 (thrombus aspiration group) and group 2 (stand-alone percutaneous coronary intervention group). All patients were followed-up 30 months until August 2015.Thrombus aspiration was performed in 64 patients (46%) whose cardiac markers (ie, creatinine kinase [CK-MB] mass and troponin T) were significantly lower after percutaneous coronary intervention than in those of group 2 (CK-MB mass: 3.80 ± 1.11 vs 4.23 ± 0.89, P = 0.012; troponin T: 0.012 ± 0.014 vs 0.018 ± 0.008, P = 0.002). Left ventricular ejection fraction at 6, 12, and 24 months postintervention was significantly higher in the group 1. During a mean follow-up period of 28.87 ± 6.28 months, mortality rates were 6.3% in the group 1 versus 12.9% in the group 2. Thrombus aspiration was also associated with significantly less long-term mortality in unstable angina pectoris patients (adjusted HR: 4.61, 95% CI: 1.16-18.21, P = 0.029).Thrombus aspiration in the context of unstable angina pectoris is associated with a limited elevation in cardiac enzymes during intervention that minimises microembolization and significantly improves both of epicardial flow and myocardial perfusion, as shown by angiographic TIMI flow grade and frame count. Thrombus aspiration during percutaneous coronary intervention in unstable angina pectoris patients has better

  17. Management policies and prognosis in unstable angina pectoris : use of coronary angiography in different practice settings

    OpenAIRE

    Miltenburg-van Zijl, Addy

    1992-01-01

    textabstractUnstable angina encompasses a wide range of clinical presentations of myocardial ischemia, usually caused by sudden deteriorations of coronary lesions. Sometimes, extracardiac conditions disturbing the oxygen balance, such as severe anaemia, fever or thyrotoxicosis, may cause myocardial ischemia. In this thesis unstable angina is referred to as myocardial ischemia due to obstructive atherosclerotic coronary artery disease. In the literature and in clinical practice a variety of de...

  18. A Clinical Study of Safflower Yellow Injection in Treating Coronary Heart Disease Angina Pectoris with Xin-Blood Stagnation Syndrome

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Objective: To evaluate the clinical effect and safety of Safflower Yellow injection (SYI) in treating coronary heart disease angina pectoris (CHD-AP) with Xin-blood stagnation syndrome (XBSS).Methods: Adopted was the multi-centered, randomized, positive parallel controlled method, 448 patients with CHD-AP-XBSS were enrolled and divided into two groups, 336 in the tested group treated with SYI and112 in the control group treated with Salvia injection by intravenous dripping once a day for 14 days, so as to observe the conditions of angina, electrocardiogram, and therapeutic effect on traditinal Chinese medicine(TCM) symptoms as well as the safety of the treatment. Results: The significantly effective rate and total effective rate in the tested group were 60.06% (194/323) and 91.02% (294/323) respectively; those in improvement of TCM symptoms were 40.18% (129/321) and 75.23% (243/323) respectively, which were better than those in the control group (P<0.01). Conclusion: SYI Injection is effective and safe in treating CHD-AP-XBSS.

  19. Effect of the platelet membrane GP Ⅰ a gene polymorphism in the pathogenesis of unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    Yonghui Zhao; Changcong Cui; Yanni Wang; Jiaqing Zhu

    2005-01-01

    Objective: To investigate the effect of platelet membrane glycoprotein(GP) Ⅰ a gene polymorphism in the pathogenesis of unstable angina pectoris (UAP) in Chinese people. Methods: Collagen type Ⅰ -induced platelet aggregation was measured in 33healthy subjects in vitro. Plasma level of α-granule membrane protein (GMP-140) was measured in both the above 33 healthy subjects during fasting and 35 patients with recent onset effort anina during rest onset within 24 h after hospitalization. Furthermore, the platelet membrane GP Ⅰ a gene 807C/T polymorphism was checked in all subjects with polymerase chain reaction-sequence specific primers(PCR-SSP)technique. Results: The lag time before 30% platelet aggregation was significantly longer in healthy subjects with CC genotype than with TC genotype ( P <0.01). However, there was no significant difference in the maximal platelet aggregation between healthy subjects with the above two genotypes. Plasma level of GMP-140 was significantly higher in TC genotypic patients with recent onset effort angina than in CC genotypic patients with the same type of UAP( P < 0.05) and healthy subjects ( P < 0.01), furthermore, there was also significant difference between the latter two groups( P < 0.05). Conclusion: The rapid initiation of collagen-induced platelet aggregation may be associated with platelet membrane GP Ⅰ a T807 allele, which may play an important role in the pathogenesis of UAP.

  20. 常见心绞痛病因及临床表现对ICD-10编码的影响%The Effect of Different Causes and Clinical Manifestation of Angina Pectoris on ICD-10 Classification

    Institute of Scientific and Technical Information of China (English)

    赵桐

    2011-01-01

    目的 探讨心绞痛的病因,以利于对心绞痛进行分型,作出正确的ICD-10编码.方法 对2009年至2010间各种原因引起的心绞痛资料进行回顾性分析.结果 心绞痛根据不同的病因及临床表现可分为不同类型心绞痛,其对应的ICD-10的编码也不同.结论 了解心绞痛的病因及临床表现,正确细分各型心绞痛,是正确进行ICD-10编码最关键环节.%Objective To discuss the causes of angina pectoris, and classify the angina pectoris correctly by ICD-10.Methods The different causes of angina pectoris from 2009 to 2010 were retrospectively analyzed.Results Angina Pectoris can be classified by different causes and clinical manifestation.Therefore, the code of angina pectoris are different.Conclusion Understanding the different causes and clinical manifestation of angina pectoris,and classifying the disease correctly are the key points of ICD-10 classification.

  1. Stellenwert des sympathischen Nervensystems und positiver Feedback-Mechanismen in der Pathophysiologie der instabilen Angina pectoris

    Directory of Open Access Journals (Sweden)

    Schauenstein K

    1999-01-01

    Full Text Available Die klinischen Begriffe "stabile" und "instabile" Angina beschreiben primär die Vorhersehbarkeit von pektanginösen Beschwerden. Dennoch weisen diese beiden Formen auch objektivierbare pathohistologische und pathophysiologische Unterschiede auf, die in der vorliegenden Einführung diskutiert werden. Besonders betont wird der Stellenwert des sympathischen Nervensystems sowie das Auftreten positiver Feedbackmechanismen im anginösen Anfallsgeschehen, die eine kritische Vertiefung des myokardialen Sauerstoffmangels bewirken können. Andererseits wird auf die Gefahr der häufigen asymptomatischen Koronarinsuffizienz ("stumme Angina" hingewiesen. Aus den skizzierten pathophysiologischen Überlegungen werden die Kriterien für eine effektive Therapie diskutiert.

  2. Transient myocardial ischaemia during ambulatory monitoring out of hospital in patients with chronic stable angina pectoris

    DEFF Research Database (Denmark)

    Egstrup, K

    1988-01-01

    Transient myocardial ischaemia during daily life, detected by ambulatory electrocardiographic monitoring, was investigated in 42 patients with chronic stable angina and documented coronary artery disease. Ambulatory monitoring was initiated for 36 hours after all prophylactic antianginal medication...... had been withdrawn for 5 days. There were 196 episodes of ST-segment depression, 145 (74%) of which were not accompanied by angina. As well, a tendency to more prolonged and greater ST-segment change with symptomatic ischaemic episodes was noted. A diurnal variation in transient ischaemia both...

  3. Evaluation value of real-time three-dimensional adenosine stress echocardiography and coronary angiography for patients with stable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    Ya-Li Wu; Nan-Jue Jiang; Yan Cai

    2016-01-01

    Objective:To study the evaluation value of real-time three-dimensional adenosine stress echocardiography and coronary angiography for patients with stable angina pectoris. Methods:A total of 45 patients diagnosed with stable angina pectoris in our hospital between May 2014 and December 2015 were selected as the stable angina pectoris group (SAP group) of the study and 50 healthy subjects receiving physical examination in our hospital during the same period were selected as control group. Real-time three-dimensional adenosine stress echocardiography was performed to measure coronary flow reserve (CFR), serum was collected to determine lipid metabolism indexes and inflammation indexes, and peripheral blood mononuclear cells were collected to determine the expression levels of inflammatory regulatory molecules.Results:CFR of SAP group was significantly lower than that of control group and the more the number of coronary lesions, the lower the CFR of SAP group; serum Lp(a), LDL-C, ApoB, MIF-1α, ICAM-1, VCAM-1, CD40 and CD40L content as well as the fluorescence intensity of peripheral blood mononuclear cell surface TLR4 and NF-κB of SAP group were significantly higher than those of control group and negatively correlated with CFR level while serum HDL-C and ApoA1 content as well as the fluorescence intensity of peripheral blood mononuclear cell surface TIPE2 and BACH2 were significantly lower than those of control group and positively correlated with CFR level.Conclusion:CFR measured by real-time three-dimensional adenosine stress echocardiography significantly reduces in patients with stable angina pectoris and is correlated with lipid metabolism state and the degree of inflammation.

  4. Serum high-sensitivity C-reaction protein and heart fatty acid binding protein level and cardiac accidents in patients with unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    朱红秋

    2006-01-01

    Objective To investigate the relationship between serum high-sensitivity C-reaction protein (hs-CRP) and heart fatty acid binding protein (h-FABP) on cardiac accidents in patients with unstable angina pectoris (UAP). Methods Serum levels of hs-CRP, h-FABP, cardiac troponin-Ⅰ(cTn-Ⅰ) and creatine kinase MB isoenzyme (CK-MB) were measured and cardiac accidents within 2 weeks after the test were observed in 74 patients (male

  5. Effect of preoperative angina pectoris on cardiac outcomes in patients with previous myocardial infarction undergoing major noncardiac surgery (data from ACS-NSQIP).

    Science.gov (United States)

    Pandey, Ambarish; Sood, Akshay; Sammon, Jesse D; Abdollah, Firas; Gupta, Ena; Golwala, Harsh; Bardia, Amit; Kibel, Adam S; Menon, Mani; Trinh, Quoc-Dien

    2015-04-15

    The impact of preoperative stable angina pectoris on postoperative cardiovascular outcomes in patients with previous myocardial infarction (MI) who underwent major noncardiac surgery is not well studied. We studied patients with previous MI who underwent elective major noncardiac surgeries within the American College of Surgeons-National Surgical Quality Improvement Program (2005 to 2011). Primary outcome was occurrence of an adverse cardiac event (MI and/or cardiac arrest). Multivariable logistic regression models evaluated the impact of stable angina on outcomes. Of 1,568 patients (median age 70 years; 35% women) with previous MI who underwent major noncardiac surgery, 5.5% had postoperative MI and/or cardiac arrest. Patients with history of preoperative angina had significantly greater incidence of primary outcome compared to those without anginal symptoms (8.4% vs 5%, p = 0.035). In secondary outcomes, reintervention rates (22.5% vs 11%, p angina. In multivariable analyses, preoperative angina was a significant predictor for postoperative MI (odds ratio 2.49 [1.20 to 5.58]) and reintervention (odds ratio 2.40 [1.44 to 3.82]). In conclusion, our study indicates that preoperative angina is an independent predictor for adverse outcomes in patients with previous MI who underwent major noncardiac surgery, and cautions against overreliance on predictive tools, for example, the Revised Cardiac Risk Index, in these patients, which does not treat stable angina and previous MI as independent risk factors during risk prognostication.

  6. Effect of PCI on inflammatory factors, cTnI, MMP-9 and NT-pro BNP in patients with unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    Ke-Tong Liu; Xin Wang; Di Zhao

    2016-01-01

    Objective:To investigate the effect of PCI on inflammatory factors, cTnI, MMP-9and NT-pro BNP in patients with unstable angina pectoris.Methods:A total of 80 unstable angina pectoris patients were divided into observation group (40 cases) and control group (40 cases). The observation group was given the therapy of PCI, and the control group was given coronary angiography. To observe the of inflammatory factors, cTnI, MMP-9 and NT-pro BNP were tested and compared before and after operation.Results:At 24 h after operation, CRP and IL-18 levels were increased significantly after treatment inoperation groups, there was no difference on inflammatory factors in control group, and had significant difference on inflammatory factors in two groups; At 24 h after operation, cTnI, MMP-9 and NT-pro BNP levels were increased significantly after treatment inoperation groups, there was no difference on inflammatory factors in control group, and had significant difference on inflammatory factors in two groups.Conclusion: PCI therapy can induce inflammation and myocardial injury in patients with unstable angina pectoris.

  7. 从络病学说论治冠心病心绞痛%Treatment on Coronary Heart Disease and Angina Pectoris form Doctrine of Luo

    Institute of Scientific and Technical Information of China (English)

    吴以岭

    2001-01-01

    As a kind of frequently encountered disease in clinic,coronary heart disease and angina pectoris belongs to the scope of “Qi obstruction in the chest and pericardial pain” in TCM theory. The author of this article made research on the pathogenesis and treatment of coronary heart disease and angina pectoris from Luo theory of TCM and thought that the disease focus should be located in the Luo pulse and its main pathogenesis lies in insufficiency of the heart-qi and stasis of luo pulse,and then designed the treatment method of supplementing qi,promoting blood circulation and relieving pain as well as created Tongxinluo capsules composed of insect herbs and the herbs with the function of supplementing qi,which got marked effect in treating coronary heart disease and angina pectoris.%从中医络病学说探讨冠心病心绞痛的中医病机和治疗,认为冠心病心绞痛病位在心之络脉,主要病机为心气虚乏、络脉瘀阻、绌急而痛,制定了补益心气、活血通络、解痉止痛的治疗大法,并组成益气药和虫类药为主的通心络胶囊,用于治疗冠心病心绞痛疗效显著。

  8. Effect of folic acid adjuvant therapy on Hcy as well as lipid metabolism and endothelial injury in coronary heart disease patients with stable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    Liang Wen; Yi Xie; Xian-Jun Wu; Rui-Feng Wang; Jian Cao

    2016-01-01

    Objective:To analyze the effect of folic acid adjuvant therapy on Hcy as well as lipid metabolism and endothelial injury in coronary heart disease patients with stable angina pectoris. Methods:A total of 98 cases of coronary heart disease patients with stable angina pectoris who received treatment in our hospital from March 2014 to August 2015 were selected as research subjects and randomly divided into observation group 49 cases and control group 49 cases. Control group received conventional clinical treatment, observation group received folic acid adjuvant therapy, and then differences in levels of Hcy, lipid metabolism, endothelial injury and adhesion molecules were compared between two groups after treatment. Results:Hcy, TC, LDL-C and ApoB values of observation group were lower than those of control group while HDL-C and ApoA1/ApoB values were higher than those of control group;Flow-vel and FMD values of observation group after treatment were higher than those of control group;serum E-selectin, ICAM-1, VCAM-1 and sICAM-1 values of observation group after treatment were lower than those of control group. Conclusion:Folic acid adjuvant therapy for coronary heart disease patients with stable angina pectoris can reduce plasma Hcy level and optimize lipid metabolism, further protects vascular endothelium, and has positive clinical significance.

  9. The significance of {sup 123}I-BMIPP myocardial SPECT on the evaluation of angina pectoris

    Energy Technology Data Exchange (ETDEWEB)

    Kurosawa, Kazuhiko; Ohtani, Hiroshi; Saitou, Tomiyoshi; Maruyama, Yukio [Fukushima Medical Coll. (Japan); Katohno, Eiichi; Ohwada, Kenji

    1998-06-01

    Some patients of ischemic heart disease have low uptake in {sup 123}I-labeled beta methyl-iodophenyl pentadecanoic acid (BMIPP) SPECT in spite of normal uptake in thallium-201 (Tl) SPECT. To investigate their clinical significance, we performed both Tl and BMIPP myocardial SPECT in 26 cases with stable angina (n=16) and unstable angina (n=10), and compared with clinical backgrounds electrocardiogram (ECG) and left ventriculography (LVG). In 11 patients of them, the uptake of BMIPP was moderately reduced. We divided 26 cases into two groups according to uptake of BMIPP (normal/reduced). The two groups had no differences in length of angina attack and duration of disease, but they had a significant difference in the abnormality of either ECG or LVG. Three to six months after PTCA, we examined LVG in 18 cases, 12 of 16 cases with the abnormality of LVG showed the improvement of wall motion. We concluded the reduced uptake of BMIPP with normal uptake of Tl was related to more severe ischemia in cases with unstable angina. (author)

  10. 冠心病心绞痛内科治疗临床分析%Clinical analysis of medical treatment of angina pectoris

    Institute of Scientific and Technical Information of China (English)

    郗承莉

    2013-01-01

    目的:研究分析冠心病心绞痛内科治疗中应用不同药物所产生的临床疗效。方法抽取我院60例冠心病心绞痛患者,随机分为观察组与对照组,对照组使用磷酸酯类、阿司匹林、消心痛等进行常规内科治疗,观察组在此基础上加用曲美他嗪进行治疗。结果观察组治疗总有效率明显高于对照组,治疗后心绞痛发作频率、持续时间及硝酸甘油用量均明显少于对照组,差异有统计学意义(P﹤0.05)。结论在对冠心病心绞痛患者的内科治疗中加用曲美他嗪,能够更为有效的减少心绞痛的发作频率及持续时间,明显提高临床治疗效果。%Objective To analyze the clinical effects of different medications in the medical treatment of angina pectoris. Methods Sixty patients with angina pectoris selected from our hospital were randomly divided into observation group and control group. Both groups received conventional medical treatment with phosphate, aspirin, and isosorbide dinitrate, and the observation group received trimetazidine as an addition. Results Compared with the control group , the observation group had a significantly increased overall response rate and significantly decreased frequency and duration of angina pectoris and consumption of nitroglycerin after treatment (P<0.05). Conclusion Additional use of trimetazidine in medical treatment can further decrease the frequency and duration of angina pectoris in patients with angina pectoris, thus significantly improving the treatment outcome.

  11. Norepinephrine, ANP, BNP and {sup 123}I-MIBG scintigraphy in patients with cardiomyopathy or angina pectoris

    Energy Technology Data Exchange (ETDEWEB)

    Ochiai, Yukie; Kodama, Makoto; Aizawa, Yoshifusa [Niigata Univ. (Japan). School of Medicine; Watanabe, Kenichi; Kusano, Yoriko; Miyajima, Seiichi; Nagatomo, Takafumi

    1998-06-01

    The relationship of blood concentration of norepinephrine (NE), A-type (atrial) natriuretic peptide (ANP) and B-type (brain) natriuretic peptide (BNP) and {sup 123}I-metaiodobenzyl guanidine ({sup 123}I-MIBG) scintigraphy was examined in patients with heart failure. The patients were grouped as follows; 13 of dilated cardiomyopathy (DCM) group, 13 of hypertrophic cardiomyopathy (HCM) group and the 8 of stable effort angina. The control group was of 18 cases with normal {sup 201}TlCl (Tl) cardiac scintigraphy and chest pain. The blood was collected before the exercise tolerance by the ergometer, and the concentration of ANP, BNP and NE in blood was measured by the RIA method and the HPLC method, respectively. Patients were intravenously administrated 111Mbq of {sup 123}I-MIBG at rest and early images of the {sup 123}I-MIBG scintigraphy were taken after 15 min and late images after 3 hours. Washout rate (WR) and heart-mediastinal uptake rate (H/M) were obtained from late images. Compared with the control group, the DCM group showed the high levels of ANP and BNP (p<0.01) and the low level of NE (p=0.025). The HCM group showed the high level of BNP (p<0.001) and the low level in H/M. There were no differences in ANP, NE, H/M and WR between angina pectoris and the control. The correlations among BNP and H/M or WT were significant in all cases. BNP may be a remarkable index for sympathetic dysfunction. (K.H.)

  12. Percutaneous transluminal coronary angioplasty in refractory unstable angina pectoris: are new devices useful?

    Science.gov (United States)

    Bertaglia, E; Ramondo, A; Cacciavillani, L; Isabella, G; Reimers, B; Marzari, A; Maddalena, F; Chioin, R

    1996-11-15

    This study was undertaken to assess if the introduction of new angioplasty devices (autoperfusion balloon catheters, stent and atherectomy) could ameliorate early and late results of prompt percutaneous transluminal coronary angioplasty (PTCA) in patients with refractory unstable angina. From January 1993 to June 1995, 59 of 278 patients (14 female, 45 male; mean age: 61 +/- 10 years; range: 38-78) admitted to our Coronary Care Unit with the diagnosis of unstable angina had more than one episode of chest pain at rest with dynamic electrocardiographic ST-T changes and without signs of cardiac necrosis while on medical therapy including oxygen, aspirin, heparin, nitroglycerin and either a beta-blocker or a calcium-antagonist. Coronary angiography was performed within 48 h from the last ischemic attack and a culprilesion technically suitable for PTCA was identified. PTCA was performed in 73 lesions. Elective stent implantation was considered for 16 type B or C lesions in 14 patients. The procedure was initially successful in 52/59 patients (88%), uncomplicated unsuccessful in 4/59 (7%) and complicated in 3/59 (5%). Elective stent insertions were all successful (16/16, 100%). All successfully treated patients were followed up for a mean of 12 +/- 7 months (range: 6-27): 2/52 patients (3.8%) suffered from non-transmural myocardial infarction, 14/52 (26.9%) had a recurrence of angina and 2/52 (3.8%), asymptomatic, had a positive stress test. We conclude that prompt PTCA in refractory unstable angina using 1990s 'state of the art' equipment compares favorably to previous study and that stent delivery might become the elective treatment of complex lesions in this subset of patients.

  13. Diagnosis of coronary vasospasm in patients with clinical presentation of unstable angina pectoris using ergonovine echocardiography.

    Science.gov (United States)

    Song, J K; Park, S W; Kang, D H; Lee, C W; Choi, K J; Hong, M K; Kim, J J; Kim, Y H; Park, S J

    1998-12-15

    Although coronary vasospasm can contribute to the development of unstable angina, the definite diagnostic method has not been established. The purpose of this study was to determine if ergonovine echocardiography (detection of regional wall motion abnormality during bedside ergonovine challenge) after angiographic confirmation of insignificant fixed disease would be useful and safe in detecting coronary vasospasm in patients with unstable angina. After control of chest pain with medications in patients admitted to the coronary care unit under the tentative diagnosis of unstable angina, diagnostic coronary angiography was performed. All patients with normal or insignificant fixed disease underwent ergonovine echocardiography after discontinuation of medications for 4+/-1 days. Among 208 consecutive patients enrolled for this study, 75% (156 of 208) showed significant fixed disease in the angiography. Ergonovine echocardiography was performed in 52 patients with insignificant disease, and coronary vasospasm was documented in 33 (63%, 33 of 52). No serious procedure-related arrhythmia or myocardial infarction occurred. Esophageal motility disorder and hypertrophic cardiomyopathy were diagnosed in 6 and 3 patients, respectively. Chest pain of undetermined etiology was the final diagnosis at discharge in 10 patients (5%, 10 of 208); among them chest pain redeveloped in 2 patients, and repeated ergonovine echocardiography revealed positive results. Our data suggest that among patients with the clinical presentation of unstable angina, coronary vasospasm is the main cause of myocardial ischemia in a considerable number of patients with a normal or near-normal angiogram, and ergonovine echocardiography after confirmation of absence of significant fixed disease is useful and safe for noninvasive diagnosis of coronary vasospasm in this setting.

  14. Effects of nicardipine on coronary blood flow, left ventricular inotropic state and myocardial metabolism in patients with angina pectoris.

    Science.gov (United States)

    Rousseau, M F; Vincent, M F; Cheron, P; van den Berghe, G; Charlier, A A; Pouleur, H

    1985-01-01

    The effects of intravenous nicardipine (2.5 mg) on the left ventricular (LV) inotropic state, LV metabolism, and coronary haemodynamics were analysed in 22 patients with angina pectoris. Measurements were made at fixed heart rate (atrial pacing), under basal state, and during a cold pressor test. After nicardipine, coronary blood flow and oxygen content in the coronary sinus increased significantly. The indices of inotropic state increased slightly, and the rate of isovolumic LV pressure fall improved. Myocardial oxygen consumption was unchanged despite the significant reduction in pressure-rate product, but LV lactate uptake increased, particularly during the cold pressor test. When nicardipine was administered after propranolol, the indices of inotropic state were unaffected. The lack of direct effect of nicardipine on LV inotropic state was further confirmed by intracoronary injection of 0.1 and 0.2 mg in a separate group of 10 patients. It is concluded that the nicardipine-induced coronary dilatation seems to improve perfusion and aerobic metabolism in areas with chronic ischaemia, resulting in reduced lactate production and augmented oxygen consumption.

  15. Effects of nicardipine and nisoldipine on myocardial metabolism, coronary blood flow and oxygen supply in angina pectoris.

    Science.gov (United States)

    Rousseau, M F; Vincent, M F; Van Hoof, F; Van den Berghe, G; Charlier, A A; Pouleur, H

    1984-12-01

    The effects of the calcium antagonists nicardipine and nisoldipine on left ventricular (LV) metabolism were analyzed in 32 patients with angina pectoris. Measurements were made at a fixed heart rate under the basal state and during a cold pressor test (CPT). After administration of the drugs, coronary blood flow increased significantly and the mean aortic pressure decreased by 10% (p less than 0.01) in the basal state and by 11% (p less than 0.01) during CPT. Despite the reduction in pressure-rate product, myocardial oxygen consumption was unchanged in the basal state (18 +/- 4 vs 19 +/- 4 ml/min, difference not significant) and during CPT (21 +/- 5 vs 21 +/- 5 ml/min, difference not significant); this discrepancy between a reduced pressure-rate product and an unchanged oxygen consumption was also noted when nicardipine was given after propranolol (0.1 mg/kg; 12 patients). Both agents also increased LV lactate uptake, particularly during CPT (+13 mumol/min, p less than 0.05 vs control CPT) and reduced LV glutamine production. In 10 patients in whom 14C-lactate was infused, the chemical LV lactate extraction ratio increased more than the 14C-lactate extraction ratio after administration of the drugs, indicating a reduction in LV lactate production. The data are consistent with the hypothesis that nicardipine and nisoldipine improve perfusion and aerobic metabolism in chronically ischemic areas, resulting in an augmented oxygen consumption and in a reduced lactate production.

  16. Diagnostic accuracy of non-invasive 64-slice CT coronary angiography in patients with stable angina pectoris

    Energy Technology Data Exchange (ETDEWEB)

    Pugliese, Francesca; Krestin, Gabriel P. [Erasmus Medical Center, Department of Radiology, Rotterdam (Netherlands); Mollet, Nico R.A.; deFeyter, Pim J. [Erasmus Medical Center, Department of Radiology, Rotterdam (Netherlands); Erasmus Medical Center, Department of Cardiology, Rotterdam (Netherlands); Runza, Giuseppe [University of Palermo, Department of Radiology, Palermo (Italy); Azienda Ospedaliera di Parma, Department of Radiology, Parma (Italy); Mieghem, Carlos van; Meijboom, Willem B.; Baks, Timo [Erasmus Medical Center, Department of Cardiology, Rotterdam (Netherlands); Malagutti, Patrizia [Erasmus Medical Center, Department of Cardiology, Rotterdam (Netherlands); University of Ferrara, Department of Cardiology, Ferrara (Italy); Cademartiri, Filippo [Erasmus Medical Center, Department of Radiology, Rotterdam (Netherlands); Azienda Ospedaliera di Parma, Department of Radiology, Parma (Italy)

    2006-03-15

    Multislice computed tomography (CT) is an emerging technique for the non-invasive detection of coronary stenoses. While the diagnostic accuracy of 4-slice scanners was limited, 16-slice CT imagers showed promising results due to increased temporal and spatial resolution. These technical advances prompted us to evaluate the diagnostic performance of 64-slice CT coronary angiography in the detection of significant stenoses (defined as {>=} 50% luminal diameter reduction) versus invasive quantitative coronary angiography (QCA). Thirty-five patients with stable angina pectoris underwent CT coronary angiography performed with a 64-slice scanner (gantry rotation time 330 ms, individual detector width 0.6 mm) prior to conventional coronary angiography. Patients with heart rates >70 beats/min received 100 mg metoprolol orally. One hundred millilitres of contrast agent with an iodine concentration of 400 mgl/ml were injected at a rate of 5 ml/s into the antecubital vein. The CT scan was triggered with the bolus tracking technique. The sensitivity, specificity and the positive and negative predictive values of 64-slice CT were 99%, 96%, 78% and 99%, respectively, on a per-segment basis. The values obtained on a per-patient basis were 100%, 90%, 96% and 100%, respectively. When referral to catheterisation is questionable, CT coronary angiography may identify subjects with normal angiograms and consistently decrease the number of unnecessary invasive procedures. (orig.)

  17. Prognosis in the thrombolysis in myocardial ischemia III registry according to the Braunwald unstable angina pectoris classification.

    Science.gov (United States)

    Scirica, Benjamin M; Cannon, Christopher P; McCabe, Carolyn H; Murphy, Sabina A; Anderson, H Vernon; Rogers, William J; Stone, Peter H; Braunwald, Eugene

    2002-10-15

    The unstable angina pectoris (UAP) classification proposed by Braunwald in 1989, although often used, has never been validated in a large, prospective multicenter study in which all subgroups of patients were included. Patients with UAP or non-ST-elevation myocardial infarction (NSTEMI) were enrolled in the Thrombolysis In Myocardial Ischemia III Registry and classified according to the Braunwald classification for UAP. Clinical end points were compared at 6 weeks and 1 year. Of 3,318 patients, those with primary UAP had lower rates of recurrent myocardial infarction (MI) or death when compared with patients with secondary UAP and post-MI UAP at 6 weeks (4.1% vs 6.4% vs 13.4%, respectively; p Braunwald classification of UAP predicts prognosis with secondary UAP, post-MI UAP, and patients with pain at rest who have a higher risk for death or recurrent cardiac events. Given their high risk for adverse events, patients with secondary UAP should be treated aggressively.

  18. [Relations of the duration of pre-existing angina pectoris, collateral circulation and left ventricular function after isolated coronary occlusion with or without myocardial infarction].

    Science.gov (United States)

    Juillière, Y; Danchin, N; Grentzinger, A; Suty-Selton, C; Perrin, O; Guenoun, P; Pernot, C; Cherrier, F

    1990-10-01

    The aim of this retrospective study was to determine the relationship between the duration of preceding angina pectoris, collateral circulation and left ventricular function after isolated coronary occlusion with or without myocardial infarction. Coronary angiography of 138 consecutive patients showed isolated and complete occlusions of the left anterior descending (58 patients) or right coronary artery (80 patients). One hundred and four patients had myocardial infarction with (Group A, n = 21) or without (Group B, n = 83) preceding angina pectoris and 34 had angina without myocardial infarction (Group C). The left ventricular ejection fraction was measured by ventriculography in the 30 degrees right anterior oblique projection. The collateral circulation was assessed by coronary angiography and evaluated as follows: no flow or flow limited to collateral branches (subgroup 1) and partial or complete filling of the epicardial arterial segment (subgroup 2). In the global population the left ventricular ejection fraction was higher and the duration of preceding angina pectoris was longer in the subgroups with a well developed collateral circulation. There was no difference in ejection fraction between Groups A and B (presence of myocardial infarction), on the other hand, within each of the groups, a good collateral circulation (subgroup 2) was associated with a significantly higher ejection fraction. Group C (without infarction) patients had better ejection fractions than Groups A or B, especially when the collateral circulation was poorly developed. Within Group C, the quality of the collateral circulation did not seem to affect the ejection fraction. The left ventricular ejection fraction is lower in patients with isolated coronary occlusion and myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS)

  19. Alteration in metabolic signature and lipid metabolism in patients with angina pectoris and myocardial infarction.

    Science.gov (United States)

    Park, Ju Yeon; Lee, Sang-Hak; Shin, Min-Jeong; Hwang, Geum-Sook

    2015-01-01

    Lipid metabolites are indispensable regulators of physiological and pathological processes, including atherosclerosis and coronary artery disease (CAD). However, the complex changes in lipid metabolites and metabolism that occur in patients with these conditions are incompletely understood. We performed lipid profiling to identify alterations in lipid metabolism in patients with angina and myocardial infarction (MI). Global lipid profiling was applied to serum samples from patients with CAD (angina and MI) and age-, sex-, and body mass index-matched healthy subjects using ultra-performance liquid chromatography/quadruple time-of-flight mass spectrometry and multivariate statistical analysis. A multivariate analysis showed a clear separation between the patients with CAD and normal controls. Lysophosphatidylcholine (lysoPC) and lysophosphatidylethanolamine (lysoPE) species containing unsaturated fatty acids and free fatty acids were associated with an increased risk of CAD, whereas species of lysoPC and lyso-alkyl PC containing saturated fatty acids were associated with a decreased risk. Additionally, PC species containing palmitic acid, diacylglycerol, sphingomyelin, and ceramide were associated with an increased risk of MI, whereas PE-plasmalogen and phosphatidylinositol species were associated with a decreased risk. In MI patients, we found strong positive correlation between lipid metabolites related to the sphingolipid pathway, sphingomyelin, and ceramide and acute inflammatory markers (high-sensitivity C-reactive protein). The results of this study demonstrate altered signatures in lipid metabolism in patients with angina or MI. Lipidomic profiling could provide the information to identity the specific lipid metabolites under the presence of disturbed metabolic pathways in patients with CAD.

  20. Unusual case of a large midoesophageal diverticulum mimicking unstable angina pectoris.

    Science.gov (United States)

    Hoffmann, J C; Pistorius, G; Müller, P; Zeitz, M

    2002-04-01

    We describe a 77-year-old lady who presented with progressive retrosternal pain radiating to the left arm and the back. After exclusion of cardiac causes a large midoesophageal diverticulum was found on oesophago-gastro-duodenoscopy. Importantly, the retrosternal pain completely disappeared after endoscopic removal of impacted food from the diverticulum. After the surgical resection the patient became fully asymptomatic. This is the first example of angina-like chest pain which definitively resulted from a midoesophageal diverticulum. Therefore, midoesophageal diverticula should be considered as a rare differential diagnosis of exercise-induced retrosternal pain.

  1. General Situation of Research on the Chinese and Western Medicine in Stable Angina Pectoris of Coronary Heart Disease%冠心病稳定型心绞痛的中西医研究概况

    Institute of Scientific and Technical Information of China (English)

    徐博洋; 王萍

    2015-01-01

    In recent years, angina pectoris of coronary heart diseaseis one of the high death rate disease, chest tightness, chest pain to the main clinical manifestations. From the research of Western medicine research survey, pathogenic factors, treatment of Western medicine and TCM etiology and pathogenesis, treatment of angina pectoris of coronary heart, treatment of angina pectoris of coronary heart diseaaeprogress summary, in order to reduce theincidence of angina pectoris of coronary heart disease, and treatment of angina pectoris of coronary heart disease, in order to improve the quality of life of patients and provide a theoretical basis.%冠心病心绞痛是近些年来高致死率疾病之一,是以胸闷、胸痛为主要的临床表现。现从西医研究概况、致病因素、西医治疗和中医的病因病机、治疗等方面综述冠心病心绞痛的研究进展,为降低冠心病心绞痛发生率和治疗冠心病心绞痛,为提高患者的生活质量提供理论依据。

  2. Frequency of angina pectoris and secondary events in patients with stable coronary heart disease (from the Heart and Soul Study).

    Science.gov (United States)

    Beatty, Alexis L; Spertus, John A; Whooley, Mary A

    2014-10-01

    The extent to which angina pectoris (AP) predicts secondary cardiovascular events beyond independent of measures of disease severity is unknown. We evaluated the association between AP frequency and secondary events in patients with stable coronary heart disease (CHD). We administered the Seattle Angina Questionnaire to 1,023 participants with stable CHD enrolled from September 2000 to December 2002 and followed for a median of 8.9 years. We used Cox proportional hazards to evaluate the association of AP frequency with death and subsequent hospitalization for AP, revascularization, myocardial infarction (MI), or heart failure. At enrollment, 633 (62%) participants reported no AP, 279 (27%) reported monthly AP, and 111 (11%) reported daily or weekly AP. During follow-up, 396 participants died, 204 were hospitalized for AP, 194 for revascularization, 140 for MI, and 188 for heart failure. Compared with participants without AP, participants with daily or weekly AP were more likely to be hospitalized for AP (hazard ratio [HR] 3.3; 95% confidence interval [CI] 2.3 to 4.7; p<0.001), revascularization (HR 2.0; 95% CI 1.3 to 2.9; p=0.001), or heart failure (HR 1.6; 95% CI 1.0 to 2.5; p=0.03) and more likely to die (HR 1.5; 95% CI 1.1 to 2.0; p=0.01). AP was not independently associated with MI (HR 1.3; 95% CI 0.8 to 2.3; p=0.29). After adjusting for demographics, co-morbidities, treadmill exercise capacity, ejection fraction, and inducible ischemia, frequency of AP remained independently associated with hospitalization for AP (HR 2.4; 95% CI 1.6 to 3.6; p<0.001), revascularization (HR 1.7; 95% CI 1.1 to 2.7; p=0.02), and death (HR 1.4; 95% CI 1.0 to 2.0; p=0.045). In conclusion, in outpatients with stable CHD, AP frequency predicts higher rates of secondary cardiovascular events and death, independent of objective measures of disease severity.

  3. Effect of Xinfuning V combined with western medicine therapy on serum blood viscosity, lipid metabolism and plaque stability in patients with coronary heart disease and angina pectoris

    Institute of Scientific and Technical Information of China (English)

    Guo-Feng Ma; Xiang-Yang Wu; Ya-Ning Wang; Jun-De Li

    2016-01-01

    Objective:To analyze the effect of Xinfuning V combined with western medicine therapy on serum blood viscosity, lipid metabolism and plaque stability in patients with coronary heart disease and angina pectoris.Methods: A total of 200 patients with coronary heart disease and angina pectoris were randomly divided into observation group and control group (n=100), control group received routine western medicine therapy, observation group received routine western medicine treatment + adjuvant Xinfuning V treatment, and then the differences in with serum blood viscosity, lipid metabolism, plaque stability parameters, etc were compared between the two groups after treatment.Results: The whole blood viscosity under different shear rate (1/s, 5/s, 30/s and 200/s), plasma viscosity and fibrinogen content in peripheral blood of observation group after 4 weeks of treatment were significantly lower than those of control group; lipid metabolism indexes TC, TG, LDL-C and ApoB content in serum were lower than those of control group while HDL-C content was higher than that of control group; inflammatory factors Lp-PLA2, sICAM-1, NF-κB, hs-CRP and TNF-α content in serum were lower than those of control group; plaque stability parameters AT, TTP, mTT, PI, BI and EI levels were significantly lower than those of control group.Conclusions:Xinfuning V combined with western medicine therapy can optimize the circulating internal environment in patients with coronary heart disease and angina pectoris, and also has a remarkable effect on stabilizing plaque properties.

  4. Effect of salvianolate combined with meglumine adenosine cyclphosphate on blood viscosity, inflammatory factors and NT-proBNP in angina pectoris patients after PCI

    Institute of Scientific and Technical Information of China (English)

    Jing Peng; Li Chen

    2016-01-01

    Objective:To study the effect of salvianolate combined with meglumine adenosine cyclphosphate on blood viscosity, inflammatory factors and NT-proBNP in angina pectoris patients after percutaneous coronary intervention (PCI).Methods:A total of 130 angina pectoris patients who received PCI treatment in our hospital from May 2012 to October 2015 were selected for study, patients' medical records were retrospectively analyzed, they were divided into the experimental group and the control group based on the different medication schemes after PCI, experimental group received routine treatment combined with salvianolate and meglumine adenosine cyclphosphate treatment after operation, and control group received conventional medical treatment after operation. The changes of perioperative blood viscosity, inflammatory factor and NT-proBNP content were compared between two groups.Results:After PCI, the blood viscosity indexes as well as inflammatory factor and NT-proBNP levels of experimental group were significantly lower than those before PCI (P0.05), inflammatory factor and NT-proBNP levels were significantly lower than those before PCI (P<0.05); 7 days after PCI, the high-shear whole blood viscosity, low-shear whole blood viscosity, plasma viscosity and aggregation index as well as TNF-α, sICAM-1, sVCAM-1, LP-PLA2, NT-proBNP, D-dimer and PTEN levels of experimental group were significantly lower than those of control group (P<0.05).Conclusions: Salvianolate combined with meglumine adenosine cyclphosphate can reduce the blood viscosity of patients with angina pectoris after PCI, and can also reduce inflammation and improve heart pump function.

  5. Changes of Lipid Profile and C-Reactive Protein after Withdrawal of Xuezhikang, an Extract of Cholestin, in Patients With Stable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    Hu Chenglin; Xiang Jizhou; Li Yanbo; Zou Yongguang; Liu Jun; Tang Qizhu; Huang Congxin

    2006-01-01

    Objectives In addition to its lipid-lowering properties, statin decreases the level of C-reactive protein (CRP) resulting in reduction of cardiovascular events. However, information about discontinuation of statin therapy in stable cardiac patients is limited. This was a prospective cohort study to explore whether withdrawal of statin treatment could result in rebound of inflammation in patients with stable angina pectoris in a short-term course.Methods and Results 75 patients with stable angina pectoris were randomly divided into three groups: ① Pretreatment with Xuezhikang (XZK, an extract of cholestin) for 6 weeks and then replaced by placebo; ②Treatment with XZK throughout the study; ③ Placebo. Lipid levels, highly sensitive CRP (hs-CRP) and serum cardiac troponin T (cTnT) were assessed before receiving the XZK therapy, 1 day before discontinuation of XZK, and on day 1, 2, 3,7 and 14 after discontinuation of XZK, respectively.At day 14 after discontinuation of XZK therapy,total cholesterol, LDL-C and triglyceride significantly increased, whereas HDL-C level significantly decreased. The median level of hs-CRP increased significantly from the second day after withdrawal of XZK therapy. There was a prominent rebound of hs-CRP concentration 3 days after discontinuation of XZK therapy. 7 to 14 days after discontinuation of XZK therapy, the hs-CRP concentration declined to a similar level as in the placebo group. Elevated cTnT level did not occur throughout the study course in either group. Conclusions Short-term discontinuation of statin therapy could induce a rapid rebound phenomenon of inflammatory response independently of changes of lipid parameters. However, it was not enough to induce myocardial injury in this cohort of patients with stable angina pectoris.

  6. Stable Angina Pectoris Treated with Integrated Therapy of Traditional Chinese and Western Medicine%中西药联用治疗稳定型心绞痛

    Institute of Scientific and Technical Information of China (English)

    李艳娜; 梁秀芬

    2008-01-01

    目的 观察血塞通与常规西药方案联用对稳定犁心绞痛患者的临床疗效.方法 将120例冠心病心绞痛患者随机分为治疗组和对照组各60例,两组均给予静脉输注硝酸酯类药物、心肌营养药物及口服降压药物:治疗组在此基础上,静脉滴注血塞通200 mg/a,10 d为1疗程.结果 1个疗程后,治疗组总有效率97.7%,对照组为80.3%,两组比较有显著性差异(P<0.05).结论 血塞通与常规西药方案联用治疗稳定型心绞痛,临床疗效满意.%Objective To observe the clinical efficacy of combined therapy of Xuesaitong and routine Western Medicine in treating stable angina pectoris. Methods 120 cases of stable angina pectoris were randomly divided into treatment group and control group, with 60 cases in each group. Intravenous Nitrates, cardiac muscle nutrieeufical and antihypertensive medicine were administrated to the both groups. Xuesaitong injection was intravenous dripped to patients in the treatment group with 200 mg/d for 10 days. Results The total effective rate was 97.7% in the treatment group and 80.3%in the control group. There was significant difference between the two groups (P<0.05). Conclusion Integrated therapy of xuesaitong injection and ratine Western Medicine has a great efficacy in treating patients with stable angina pectoris.

  7. Relationship Between Serum Creatine Kinase Isoenzyme MM Subbands and the Gradation of Coronary Stenosis in Patients with Unstable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    Wu Ziqiang; Zhu shanju; Meng Suron; Sun Yueh

    2000-01-01

    Objective To observe the relationship between serum creatine kinase isoenzyme MM sub-bands (CKMM3/MM1 ratio) and the gradation of coronary stenosis and provide a simple, reliable, and economical method for identifying high-risk unstable angina pectoris (UAP). Mehtods Blood samples were drawn at different time after onset of chest pain in 21 patients with UAP and only once in 20 each volunteers for control. CKMM3/MM1 ratio was detected by nonserial buffer agarose gel electrophoresis. CKMB and CK were observed by velocity method. An emergent coronary arteriography was performed as soon as patients were admitted into hospital. Results Patients with UAP were divided into two subgroups:patients with elevated serum enzyme [P( + )] and patients with normal serum enzyme [P( - ) ] according to CKMM3/MM1 ratio < 0.5. Patients with UAP(+)had higher serum CKMM3/MM1 ratios from 0.5 to 12hrs and serum CKMB from 2 to 12 hrs than those with UAP( - ) and control ( P < 0.05) . Serum enzyme concentrations of patients with UAP whose coronary lumen had 90% or more than 90% stenosis were significantly higher than those whose coronary lumen had less than 90% stenosis (P<0.01) . AnyCKMM3/MM1 ratio was less than 1.0 and CK within the normal range in patients with UAP( + ) group. Conclusions CKMM3/MM1 ratios in patients with UAP can reflect severity of myocardial ischemia. Serum CKMM3/MM1 ratio provides a simple, reliable, and economical method for identifying high-risk UAP.

  8. The association of depression and angina pectoris across 47 countries: findings from the 2002 World Health Survey.

    Science.gov (United States)

    Loerbroks, Adrian; Bosch, Jos Antonio; Mommersteeg, Paula Maria Christina; Herr, Raphael Manfred; Angerer, Peter; Li, Jian

    2014-07-01

    Comorbid depression predicts poor health outcomes in patients with angina pectoris (AP). However, epidemiological data on the depression-AP comorbidity is limited and largely restricted to studies from Western countries, making generalizability to other regions uncertain. We aimed to provide additional epidemiological data for non-Western as well as Western countries. The present study used population-based data gathered in 47 countries from four continents (Africa, Asia, South America, and Europe) included in the cross-sectional 2002 WHO World Health Survey. Self-reported indicators of depression included: (a) its diagnosis, (b) its treatment, and (c) seven symptom items to determine presence of a major depressive episode. Similarly, information on AP comprised (a) a self-reported diagnosis, (b) self-reported AP treatment, (c) and a definition according to the WHO Rose questionnaire. In primary analyses, we operationalized depression or AP as positive if any of the respective indicators was present. Associations were estimated by multivariate logistic regression. In the entire sample (n = 213,264), the odds of AP were more than doubled among those with depression [odds ratio (OR) = 2.60, 95% confidence interval = 2.36, 2.87] versus those without depression. These positive associations were replicated across all continents and were observed in both men and women. Likewise, meaningful associations (ORs ≥ 1.5) were observed in virtually all individual countries (46/47). Application of different operationalizations of depression and AP confirmed the above findings, both in the entire sample and in continent-specific analyses. Our study extends the current evidence accrued in Western populations to non-Western populations. The co-occurrence of AP and depression appears to represent a universal phenomenon.

  9. Differences in coronary artery disease by CT angiography between patients developing unstable angina pectoris vs. major adverse cardiac events

    Energy Technology Data Exchange (ETDEWEB)

    Schlett, Christopher L. [Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg (Germany); Nance, John W. Jr. [Heart and Vascular Center, Medical University of South Carolina, Charleston, SC (United States); The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Hospital, Baltimore, MD (United States); Schoepf, U. Joseph, E-mail: schoepf@musc.edu [Heart and Vascular Center, Medical University of South Carolina, Charleston, SC (United States); O’Brien, Terrence X. [Heart and Vascular Center, Medical University of South Carolina, Charleston, SC (United States); The Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC (United States); Ebersberger, Ullrich [Heart and Vascular Center, Medical University of South Carolina, Charleston, SC (United States); Department of Cardiology and Intensive Care Medicine, Heart Centre Munich-Bogenhausen, Munich (Germany); Headden, Gary F. [Heart and Vascular Center, Medical University of South Carolina, Charleston, SC (United States); Hoffmann, Udo [Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Bamberg, Fabian [Cardiac MR PET CT Program, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (United States); Department of Radiology, University of Munich, Grosshadern Campus, and Munich Heart Alliance, Munich (Germany); Department of Radiology, University of Tuebingen (Germany)

    2014-07-15

    Highlights: • Patients developing UAP had overall more atherosclerosis as patients without any events. • Patients developing MACE had only more mixed plaque as those developing UAP. • Different atherosclerotic plaque components by CTA carry different prognostic value. - Abstract: Objective: CT angiography (CTA) has prognostic value in patients. But it is unknown whether differences in atherosclerosis by CTA predict the development of unstable angina pectoris (UAP) vs. major adverse cardiac events (MACE). Methods: We followed patients undergoing CTA as part of their acute chest pain work-up. Primary outcome was the development of UAP or MACE (cardiac death, myocardial infarction, revascularization) during a minimum follow-up of 12-months. CTAs were assessed for extent and composition of coronary plaque and stenosis. Ordinal regression with a 3-level outcome (no events, UAP, MACE) was applied. Results: Among 315 patients, 22 developed UAP and 31 MACE. While UAP patients had higher atherosclerosis burden with respect to all assessed features compared to patients with no events (p ≤ 0.02), only mixed plaque extent was significantly different between UAP and MACE patients (p = 0.02). The odds ratio was 4.55 for being in a higher disease-level comparing patients with low extent to those with no mixed plaque, and 3.02 comparing patients with high to those with low. These findings remained after adjustments for potential confounders. Conclusion: The extent of mixed coronary plaque is different between patients who develop UAP vs. MACE, supporting the hypothesis that it is a more culprit morphology.

  10. Prognostic value of coronary artery calcium score in patients with stable an-gina pectoris after percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    Fang-Fang WANG; Jiang-Li HAN; Rong HE; Xiang-Zhu ZENG; Fu-Chun ZHANG; Li-Jun GUO; Wei GAO

    2014-01-01

    Objectives To evaluate the prognostic value of the coronary artery calcium (CAC) score in patients with stable angina pectoris (SAP) who underwent percutaneous coronary intervention (PCI). Methods A total of 334 consecutive patients with SAP who underwent first PCI following multi-slice computer tomography (MSCT) were enrolled from our institution between January 2007 and June 2012. The CAC score was calculated according to the standard Agatston calcium scoring algorithm. Complex PCI was defined as use of high pressure bal-loon, kissing balloon and/or rotablator. Procedure-related complications included dissection, occlusion, perforation, no/slow flow and emer-gency coronary artery bypass grafting. Main adverse cardiac events (MACE) were defined as a combined end point of death, non-fatal myo-cardial infarction, target lesion revascularization and rehospitalization for cardiac ischemic events. Results Patients with a CAC score>300 (n=145) had significantly higher PCI complexity (13.1%vs. 5.8%, P=0.017) and rate of procedure-related complications (17.2%vs. 7.4%, P=0.005) than patients with a CAC score≤300 (n=189). After a median follow-up of 22.5 months (4-72 months), patients with a CAC score≤300 differ greatly than those patients with CAC score>300 in cumulative non-events survival rates (88.9 vs. 79.0%, Log rank 4.577, P=0.032). After adjusted for other factors, the risk of MACE was significantly higher [hazard ratio (HR):4.3, 95%confidence inter-val (95%CI):2.4-8.2, P=0.038] in patients with a CAC score>300 compared to patients with a lower CAC score. Conclusions The CAC score is an independent predictor for MACE in SAP patients who underwent PCI and indicates complexity of PCI and proce-dure-related complications.

  11. Study of relationship between the levels of serum bilirubin ,uric acid and unstable angina pectoris%不稳定型心绞痛患者血清胆红素及尿酸水平的分析

    Institute of Scientific and Technical Information of China (English)

    梁启权; 曾胜宏

    2009-01-01

    目的 探讨冠心病不稳定型心绞痛与胆红素及尿酸的关系.方法 将入选202例冠心病不稳定型心绞痛患者,采集空腹静脉血测定总胆红素、直接胆红素、间接胆红素及尿酸,比较其心绞痛发作时、3个月、6个月及1年内未再发作时胆红素及尿酸的变化情况.结果 心绞痛发作时胆红素降低,尿酸偏高.结论 胆红素和尿酸水平可间接反映不稳定型心绞痛机体氧化、抗氧化情况,胆红素对评估病情有一定帮助.%Objective To investigate the relationship between the levels of serum bilirubin,uric acid(UA) and coronary heart disease unstable angina pectoris.Methods The leves of total bilirubin (TBIL),direct bilirubin (DBIL),indirect bilirubin(IBIL) and UA in venous blood by limosis were determind in 202 patients with unstable angina pectoris.We determine the different levels of TBIL,DBIL,IBIL and UA when they were suffering from angina pectoris.Then we respectively determine the levels of TBIL,DBIL,IBIL and UA in 3 months,6 months and 12 months after they had been suffered from angina pectoris.Results The levels of serum bilirubin were lower and UA were higher,when the patients were suffering from angina pectoris.Conclusion We can indirectly assess the oxidative and antioxidative activities by testing bilirubin and UA in unstable angina pectoris.

  12. Compliance, clinical outcome, and quality of life of patients with stable angina pectoris receiving once-daily betaxolol versus twice daily metoprolol: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Przemyslaw Kardas

    2007-05-01

    Full Text Available Przemyslaw KardasThe First Department of Family Medicine, Medical University of LodzBackground: A randomized, controlled trial was conducted in an outpatient setting to examine the effect of beta-blocker dosing frequency on patient compliance, clinical outcome, and health-related quality of life in patients with stable angina pectoris.Methods: One hundred and twelve beta-blockers-naive outpatients with stable angina pectoris were randomized to receive betaxolol, 20 mg once daily or metoprolol tartrate, 50 mg twice daily for 8 weeks. The principal outcome measure was overall compliance measured electronically, whereas secondary outcome measures were drug effectiveness and health-related quality of life.Results: The overall compliance was 86.5 ± 21.3% in the betaxolol group versus 76.1 ± 26.3% in the metoprolol group (p < 0.01, and the correct number of doses was taken on 84.4 ± 21.6% and 64.0 ± 31.7% of treatment days, respectively (p < 0.0001. The percentage of missed doses was 14.5 ± 21.5% in the once-daily group and 24.8 ± 26.4% in the twice-daily group (p < 0.01. The percentage of doses taken in the correct time window (58.6% vs 42.0%, p = 0.01, correct interdose intervals (77.4% v 53.1%, p < 0.0001, and therapeutic coverage (85.6% vs 73.7%, p < 0.001 were significantly higher in the once-daily group. Both studied drugs had similar antianginal effectiveness. Health-related quality of life improved in both groups, but this increase was more pronounced in the betaxolol arm in some dimensions.Conclusions: The study demonstrates that patient compliance with once-daily betaxolol is significantly better than with twice daily metoprolol. Similarly, this treatment provides better quality of life. These results demonstrate possible therapeutic advantages of once-daily over twice-daily beta-blockers in the treatment of stable angina pectoris.Keywords: patient compliance, quality of life, stable angina pectoris, randomized controlled trial

  13. Predictive value of the corrected TIMI frame count in patients with suspected angina pectoris but no obstructive coronary artery disease at angiography

    DEFF Research Database (Denmark)

    Jespersen, Lasse; Abildstrøm, Steen Z; Peña, Adam

    2014-01-01

    AIMS: To evaluate whether the corrected thrombolysis in myocardial infarction frame count (CTFC), an index of resting coronary blood flow, is associated with the risk of major adverse cardiovascular events (MACE) in patients with suspected stable angina pectoris (SAP) but no obstructive coronary...... artery disease (CAD) at angiography. METHODS AND RESULTS: In this case-control study, CTFC at baseline in 127 patients (50 % women) who subsequently experienced a myocardial infarction, non-hemorrhagic stroke or cardiovascular death during 2001-2011 was compared with CTFC in 254 event-free matched...

  14. Kinetics of blood lipoprotein spectrum indices in patients with angina pectoris during and after low-intensity laser therapy as a paraclinical criterion for treatment efficiency

    Science.gov (United States)

    Babushkina, G. V.; Kartelishev, A. V.

    2001-04-01

    An investigation was made of applying (lambda) equals 0.63 micrometers laser radiation in treating 403 patients affected by angina pectoris. The patients were administered a course of combined laser therapy consisting of the intravenous laser irradiation of blood combined with laser acupuncture. Apart from that, the patients took the maintenance doses of antianginal preparations and therapeutic doses of vitamins A and E. The blood lipoprotein spectrum revealed that this combined laser therapy was capable of producing an antiatherogenic effect. It was also found that the most effective exposure time of laser radiation was in the range of 10 to 15 min.

  15. Rest delayed images on {sup 99m}Tc-MIBI myocardial SPECT as a noninvasive screen for the diagnosis of vasospastic angina pectoris

    Energy Technology Data Exchange (ETDEWEB)

    Ono, Soichi; Yamaguchi, Hiroyuki; Takayama, Shin [Yamagata Prefectural Shinjo Hospital (Japan); Kurabe, Atsushi; Heito, Takayuki [Yamagata Prefectural Nihonkai Hospital, Sakata (Japan)

    2002-05-01

    Diagnostic usefulness of {sup 99m}Tc-hexakis-2-methoxy isobutyl isonitrile (MIBI) myocardial SPECT at rest was examined in 39 cases of coronary vasospastic angina pectoris who were diagnosed by a positive reaction to ergonovine provocation. SPECT was performed 45 minutes (early image) and 3 hours (delayed image) after the intravenous injection of approximately 600 MBq of MIBI. Decrease in accumulation was ranked by four defect scores (0: normal; 1: slight decrease; 2: moderate decrease; 3: severe decrease) and the total defect score was evaluated semiquantitatively. The washout rate between the normal area and the spasm area was also evaluated quantitatively using bull's eye. As a result, 15 cases (15/39; 38.4%) showed decreased accumulation in the early image and 27 cases (27/39; 69.2%) showed decreased accumulation in the delayed image. All of the cases which showed decreased accumulation in the early image had decreased accumulation in the delayed image as well. In 6 cases (6/34; 17.6%) showed ST wave changes during exercise ECG and 16 cases (16/34: 47%) showed decreased accumulation in the exercise myocardial SPECT. The washout rate of MIBI in the decreased accumulation area was significantly higher than that of the normal area. Of 32 ergonovine induced vasospastic area, 23 areas (72%) exhibited decreased accumulation in the delayed image for the same area. Decreased accumulation in the delayed image in MIBI was due to the enhanced washout, which, in turn, indicated declined retention of MIBI by mitochondrial membrane. In coronary vasospastic angina pectoris, spasm induced ischemia was thought to have an effect on the mitochondria. This study suggested that even with a normal exercise ECG and exercise myocardial SPECT, there's a strong possibility of coronary vasospastic angina pectoris if a decreased accumulation was found in the delayed image in the MIBI myocardial SPECT at rest. Hence, in diagnosing coronary vasospastic angina pectoris, the delayed

  16. Analysis of thrombelastography in type 2 diabetes patients complicated with angina pectoris of coronary heart disease and its correlation with disease severity

    Institute of Scientific and Technical Information of China (English)

    Hong-Hong Liu; Zhao-Chuan Liu; Hong-Tao Liu; Yu-Ji Zhang; Qing-Ling Fu; Jun-Ling Wang

    2016-01-01

    Objective:To analyze the thrombelastography parameters in type 2 diabetes patients complicated with angina pectoris of coronary heart disease and their correlation with disease severity.Methods:30 cases of healthy volunteers, 30 cases of patients with simple angina pectoris of coronary heart disease (CHD) and 30 cases of type 2 diabetes patients complicated with angina pectoris of coronary heart disease were selected for study. Thrombelastography parameters R value, K value, αangle and MA value as well as inflammation-associated molecules YKL-40 and NK-kB expression were detected.Results:R values and K values of simple CHD group and diabetes complicated with CHD group were lower than those of control group, and αangle and MA values were higher than those of control group; R values and K values of diabetes complicated with CHD group were lower than those of simple CHD group, and αangle and MA values were higher than those of simple CHD group; R values and K values of 2 branch lesions group and 3 branch lesions group were lower than those of 1 branch lesion group, and αangle and MA values as well as YKL-40 and NK-kB contents were higher than those of 1 branch lesion group; R values and K values of 3 branch lesions group were lower than those of 2 branch lesions group, and αangle and MA values as well as YKL-40 and NK-kB contents were higher than those of 2 branch lesions group; R value and K value were negatively correlated with YKL-40 and NK-kB contents, and αangle and MA value were positively correlated with YKL-40 and NK-kB contents.Conclusions: Thrombelastography parameters in type 2 diabetes patients complicated with angina pectoris of coronary heart disease are significantly abnormal, and R value, K value, αangle and MA value can reflect disease severity and inflammation degree.

  17. Efficacy of controlled-release isosorbide-5-mononitrate as adjunctive treatment to beta-blocking agents in patients with stable angina pectoris

    DEFF Research Database (Denmark)

    Svendsen, Jesper Hastrup; Aldershvile, J; Abildgaard, U

    1989-01-01

    to a beta blocker. In bicycle ergometer exercise tests performed 4 h after study drug intake, total exercise time and time until 1-mm ST-depression increased significantly during both regimens as compared with placebo (p less than 0.05). However, only the 60-mg once-daily regimen was significantly better...... than placebo with regard to time until angina pectoris. The results indicate that ISMN-CR 60 mg once daily is effective as adjunctive to beta-blocker treatment, and nitrate tolerance appeared to develop during the twice-daily regimen. In 10 of the patients, the effect of additional sublingual...

  18. Three Vessel Coronary Cameral Fistulae Associated with New Onset Atrial Fibrillation and Angina Pectoris

    Directory of Open Access Journals (Sweden)

    Murat Yuksel

    2014-01-01

    Full Text Available Coronary cameral fistulas are abnormal communications between a coronary artery and a heart chamber or a great vessel which are reported in less than 0.1% of patients undergoing diagnostic coronary angiography. All three major coronary arteries are even less frequently involved in fistula formation as it is the case in our patient. A 68-year-old woman was admitted to cardiology clinic with complaints of exertional dyspnea and angina for two years and a new onset palpitation. Standard 12-lead electrocardiogram revealed atrial fibrillation (AF with a ventricular rate of 114 beat/minute and accompanying T wave abnormalities and minimal ST-depression on lateral derivations. Transthoracic echocardiographic examination was normal except for diastolic dysfunction, minimally mitral regurgitation, and mild to moderate enlargement of the left atrium. Sinus rhythm was achieved by medical cardioversion with amiodarone infusion. Coronary angiography revealed diffuse and multiple coronary-left ventricle fistulas originating from the distal segments of both left and right coronary arterial systems without any stenosis in epicardial coronary arteries. The patient’s symptoms resolved almost completely with medical therapy. High volume shunts via coronary artery to left ventricular microfistulas may lead to increased volume overload and subsequent increase in end-diastolic pressure of the left ventricle and may cause left atrial enlargement.

  19. Alternative complement pathway activation during invasive coronary procedures in acute myocardial infarction and stable angina pectoris.

    Science.gov (United States)

    Horváth, Zsófia; Csuka, Dorottya; Vargova, Katarina; Kovács, Andrea; Leé, Sarolta; Varga, Lilian; Préda, István; Tóth Zsámboki, Emese; Prohászka, Zoltán; Kiss, Róbert Gábor

    2016-12-01

    The effect of invasive percutaneous coronary procedures on complement activation has not been elucidated. We enrolled stable angina patients with elective percutaneous coronary intervention (SA-PCI, n=24), diagnostic coronary angiography (CA, n=52) and 23 patients with ST segment elevation myocardial infarction and primary PCI (STEMI-PCI). Complement activation products (C1rC1sC1inh, C3bBbP and SC5b-9) were measured on admission, 6 and 24h after coronary procedures. The alternative pathway product, C3bBbP significantly and reversibly increased 6h after elective PCI (baseline: 7.81AU/ml, 6h: 16.09AU/ml, 24h: 4.27AU/ml, p<0.01, n=23) and diagnostic angiography (baseline: 6.13AU/ml, 6h: 12.08AU/ml, 24h: 5.4AU/ml, p<0.01, n=52). Six hour C3bBbP values correlated with post-procedural CK, creatinine level and the applied contrast material volume (r=0.41, r=0.4, r=0.3, p<0.05, respectively). In STEMI-PCI, baseline C3bBbP level was higher, compared to SA-PCI or CA patients (11.33AU/ml vs. 7.81AU/ml or 6.13AU/ml, p<0.001). Similarly, the terminal complex (SC5b-9) level was already elevated at baseline compared to SA-PCI group (3.49AU/ml vs. 1.87AU/ml, p=0.011). Complement pathway products did not increase further after primary PCI. Elective coronary procedures induced transient alternative complement pathway activation, influenced by the applied contrast volume. In STEMI, the alternative complement pathway is promptly activated during the atherothrombotic event and PCI itself had no further detectable effect.

  20. Early and six-month outcome in patients with angina pectoris early after acute myocardial infarction (the GISSI-3 APPI [angina precoce post-infarto] study).

    Science.gov (United States)

    1996-12-01

    There is conflicting evidence whether or not early postinfarction angina implies an unfavorable prognosis. This prospective study assessed the significance and natural history of early angina in a broad population of patients conservatively managed after acute myocardial infarction (AMI) and enrolled in the third Gruppo Italiano per lo Studio della Sopravvivenza nel Infarto Miocardico (GISSI-3) trial. Out of 2,363 consecutive patients (age 63 +/- 11; first AMI in 86%; thrombolysis in 74%) admitted in 31 centers lacking on-site revascularization facilities, early angina associated with transient electrocardiographic (ECG) changes was documented in 332 (14%). At multivariate analysis, preinfarction angina, age > or = 70 years, female gender, and history of infarct were significant predictors of early angina. Though the in-hospital course was free from major cardiac events in 78% of patients after the first anginal episode, reinfarction was more common after early angina (7% vs 2% in patients without, RR 3.1, 95% confidence interval [CI] 1.9 to 5.6; p <0.001), and death occurred in 7% of patients with early angina (vs 5% of patients without, RR 1.4, CI 0.9 to 2.4, p = NS). No demographic or clinical characteristics identified patients who suffered nonfatal reinfarction after angina, and neither the ECG location (infarct zone or remote) nor patterns of ECG changes during angina proved significant predictors of in-hospital reinfarction or death. Early angina emerged as the sole independent predictor of 6-month cumulative reinfarction (12% vs 5% of patients without, RR 2.9, CI 2.0 to 4.4; p <0.0001) and an independent predictor of death (13% vs 7% of patients without early angina, RR 2.3, CI 1.6 to 3.3; p <0.0001). Early postinfarction angina is a powerful prognostic marker. Patients with early postinfarction angina had an unfavourable in-hospital outcome, but the prospective identification of patients at greater risk of major events after angina remains elusive

  1. Observation the Effect of Felpdipine on Curing 86 Cases of Angina Pectoris%非洛地平治疗心绞痛 86例临床观察

    Institute of Scientific and Technical Information of China (English)

    沙敏

    2001-01-01

    Objective:Evaluating the clinical effect of Felpdipine on curing angina pectoris of coronary heart disease.Methods:86 cases of angina pectoris were treated with 5mg of Felodipine once per day for two weeks and taking the cases as the self- contrast.Results:The total clinical effective rate on curing angina pectoris was 81.2% .The ECG improving rate was 72.5% . At the same time,it had obvious effect on decreasing high blood pressure(P<0.01) and little side effect.Conclusion:Felodipine is a safe and effective medicine for curing angina pectoris of coronary heart disease.%目的:评价非洛地平治疗冠心病心绞痛的临床疗效。方法:采用自身对照,对 86例冠心病心绞痛进行治疗,每 d1次 5mg,连续 2w。结果:治疗心绞痛临床总有效率 81.2%,心电图改善总有效率 72.5%,同时有显著降压作用 (P<0.01),副作用小。结论:非洛地平是一种安全、有效的治疗冠心病心绞痛的药物。

  2. 益气活血法治疗胸痹心痛临床观察%Clinical Study of Treatment with Yiqi Huoxue Chinese Medicine for Coronary Heart Disease Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    宋红莉; 赵东东

    2011-01-01

    目的:观察益气活血法治疗胸痹心痛的疗效.方法:采用保元汤合桃红四物汤治疗胸痹心痛50例,与西药治疗50例作对照观察.结果:治疗组总有效率为94%,对照组总有效率为82%,两组比较具有可比性.结论:保元汤合桃红四物汤治疗胸痹心痛的疗效确切.%Objective: To observe the therapeutic effects of Yiqi Huoxue Chinese medicine on coronary heart disease ( CHD ) angina pectoris.Methods: One hundred patients with CHD angina pectoris were randomized into treatment group ( 50 cases ) and control group ( 50 cases ).The treatment group was treated with Chinese medicine of Baoyuan Tang and Taohongsiwu Tang combined with conventional western medicine, and the control group was treated with conventional western medicine only.Result: The clinical symptoms of angina pectoris and electrocardiogram were obviously improved.The treatment group was better than the control group ( P<0.05 ).Conclusion: Yiqi Huoxue Decoction has good effect on coronary heart disease angina pectoris.

  3. Resolution of Angina Pectoris and Improvement of the Coronary Flow Reserve after Ranolazine Treatment in a Woman with Isolated Impaired Coronary Microcirculation

    Directory of Open Access Journals (Sweden)

    Alessandro Santoro

    2013-01-01

    Full Text Available In a 61-year-old woman with well controlled arterial hypertension, hypercholesterolemia, and smoke and suffering from recurrent angina pectoris despite angiographically normal epicardial coronary vessels and maximal therapy, the replacement of nitrates with novel antiangina drug ranolazine, after 6-month therapy, induced a complete relief of angina and a relevant rising of the transthoracic Doppler-derived coronary flow reserve (CFR. The present clinical case underlines therefore how in patients with chronic ischemic heart disease without epicardial coronary stenosis ranolazine can induce an improvement till the complete solution of the angina symptoms and a substantial increase of CFR as expression of the enhancement of the microvascular coronary function. The improvement of both symptoms and coronary microvascular function is strictly linked to the mechanism of action of the drug. Ranolazine induces in fact a reduction of the intracellular late sodium current that leads to a reduction of the intracellular calcium concentration thus producing a better myocardial diastolic relaxation process which in its turns enhances the myocardial perfusion. The ranolazine acts therefore as a lusitropic drug that improves the diastolic dysfunction and the segmental ischemia thus affecting one of the first steps of the ischemic cascade.

  4. Clinical Observation of Shexiang Baoxin Pill in the Treatment of Refractory Angina Pectoris%麝香保心丸辅助治疗顽固性心绞痛的临床观察

    Institute of Scientific and Technical Information of China (English)

    杨生平; 黄华; 吴斌

    2013-01-01

    OBJECTIVE: To explore therapeutic efficacy of Shexiang baoxin pills in the treatment of refractory angina pectoris. METHODS: 86 cases of refractory angina pectoris during Oct. 2010 -Dec. 2011 were randomized into treatment group and control group. Control group received conventional treatment of anti-angina; treatment group was given Shexiang baoxin pills orally, 3 pills each time, tid. on the basis of control group. The angina pectoris attacks, angina pectoris stable state and treatment satisfaction were observed in 2 groups after 2 weeks according to Seattle angina questionnaire (SAQ); Limitation of body activity and improvement of the understanding of disease were also observed. RESULTS: Angina pectoris attack (79.3 ± 9.5), angina pectoris stable state (83 ±7.9), satisfaction degree (90.2 ±7.5), limitation of physical activity (71.2 ± 13.2) and understanding of disease (77.4 ± 8.2) in treatment group were obviously improved, compared to angina pectoris attack (88.3 ± 11.4) , angina pectoris stable state (63 ± 11.5), satisfaction degree (78.2 ± 9.4), limitation of physical activity (89.2 ± 7.8) and understanding of disease (71.2 ± 13.7) of control group. There was no significant serious ADR found in both groups. There was statistical difference in therapeutic efficacy of 2 groups (P<0.05). CONCLUSION: Patients with refractory angina pectoris treated with Shexiang baoxin pills obtain sound curative effect, and there are rare adverse drug reactions.%目的:观察麝香保心丸辅助治疗顽固性心绞痛的疗效和安全性.方法:将2010年10月-2011年12月住院治疗的顽固性心绞痛患者86例,随机均分为治疗组与对照组.对照组给予常规抗心绞痛治疗;治疗组在对照组治疗基础上口服麝香保心丸治疗,3粒/次,tid.2周后根据西雅图心绞痛量表观察两组患者的心绞痛发作情况、稳定状态及对患者治疗的满意程度,并观察患者躯体活动受限程度以及对疾病认识程度.结

  5. 氯吡格雷在治疗冠心病不稳定型心绞痛的临床分析%Analysis of Curative Effectiveness of Clopidogrel on Unstable Angina Pectoris in Coronary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    刘磊磊

    2013-01-01

      目的研究氯吡格雷治疗冠心病不稳定型心绞痛的临床疗效。方法120例疗病毒性心肌炎患者分为Ⅰ、Ⅱ,Ⅰ组60人,采用氯吡格雷和阿司匹林联合治疗;Ⅱ组为60人,作为对照,单用阿司匹林治疗。结果经治疗后,Ⅰ组、Ⅱ组两组治疗方法都有着一定的功效,与治疗前相比,都有着一定的改善,两组相比较来看,Ⅰ组的治疗疗效明显优于对照组Ⅱ组(P<0.05)。结论氯吡格雷治疗冠心病不稳定型心绞痛有着较好的医疗效果,值得在临床上推广研究。%  Objective To study the efficacy of clopidogrel therapy for unstable angina pectoris in coronary heart disease. Methods 120 cases of unstable angina pectoris in coronary heart disease patients were divided into two groupsⅠandⅡ, groupⅠ60, treated with(clopidogrel+aspirin);groupⅡ60, treated with (aspirin). Results We found both groups had effect on unstable angina pectoris in coronary heart disease. Compared with before treatment, both groups had better effect on unstable angina pectoris in coronary heart disease. Compared the two groups, The therapy of groupⅠhad better efficacy than groupⅡ(P<0.05). Conclusion Clopidogrel for patients with unstable angina pectoris in coronary heart disease had a certain effect, we should spread it in clinical research.

  6. Unstable Angina Pectoris Patients Serum hs-CRP Levels in Clinical Research%不稳定心绞痛患者血清hs-CRP水平临床研究

    Institute of Scientific and Technical Information of China (English)

    易慧芳

    2014-01-01

    Objective Investigate al ergic hs CRP determination in patients with unstable angina pectoris diagnosis value of serum. Methods Choose 60 cases of unstable angina pectoris patients as observation group, In the treatment of day 1, day 15 test hs-CRP concentration in serum, select 60 outpatient patients with stable angina pectoris patients as control group. Results Group of patients with unstable angina pectoris patients serum hs- CRP concentration significantly increased, compared with the control group with very significant dif erence( P<0.05 ) ,Observation group in the treatment of before and after comparison, hs-CRP concentration in serum increased obviously, there are significant dif erences(P<0.05). Conclusion The hs-CRP significantly higher in patients with unstable angina pectoris, has a high diagnostic value.%目的:探讨超敏C反应蛋白( High sensitivity C Reactive Protein,hs-CRP )测定在不稳定心绞痛患者血清中的诊断价值。方法选取60例不稳定心绞痛患者作为观察组,在入院第1d、第15d检测血清中hs-CRP浓度,选取门诊稳定心绞痛患者60例作为对照组。结果不稳定心绞痛患者患者组血清中hs-CRP浓度明显增高,与对照组比较有非常显著性差异(P<0.05),观察组在治疗前、后比较,血清中hs-CRP浓度明显增高,有显著性差异(P<0.05)。结论 hs-CRP在不稳定心绞痛患者中显著增高,有很高的诊断价值。

  7. Correlation of angina pectoris and perfusion decrease by collateral circulation in single-vessel coronary chronic total occlusion using myocardial perfusion single-photon emssion computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Sang Geon; Park, Ki Seong; Kang, Sae Ryung [Chonnam National University Hospital, Gwangju (Korea, Republic of); and others

    2016-03-15

    To evaluate the perfusion decrease in donor myocardium by collateral circulation and its correlation with angina pectoris in patients with chronic total occlusion (CTO) using myocardial perfusion single-photon emission computed tomography (MPS). Thirty-six patients with single-vessel CTO without any other stenosis were included. All patients underwent MPS and coronary angiography (CAG) within 2 months. Total 72 donor arteries were evaluated for the grades of collaterals to the CTO artery using the Rentrop grading system on CAG. Perfusion defects and perfusion scores in donor and CTO territories were analyzed on MPS. Myocardial perfusion of donor and CTO territories were evaluated according to the presence of angina pectoris and the grades of collateral circulation. When the CTO territory was ischemic, symptomatic patients showed higher summed difference scores in the CTO territory compared to asymptomatic patients (3.5 ± 2.4 vs. 1.5 ± 0.8 for symptomatic and asymptomatic groups respectively; p = 0.034). However, when the CTO territory was nonischemic, symptomatic patients showed higher summed stress scores (SSS, 4.3 ± 2.9 vs. 1.6 ± 1.2; p = 0.032) and summed rest scores (SRS, 4.2 ± 2.5 vs. 1.5 ± 1.1; p = 0.003) in the donor territories. On the per-vessel analysis, perfusion defects in donor territories were more frequent (0 % vs. 53 % vs. 86 % for Rentrop 0, Rentrop 1–2 and Rentrop 3, respectively; p < 0.001) and showed higher SSS (0.0 ± 0.0, 1.3 ± 1.6 and 2.1 ± 1.1 for Rentrop 0, Rentrop 1–2 and Rentrop 3, respectively; p = 0.001) and SRS (0.0 ± 0.0, 1.0 ± 1.4 and 1.7 ± 1.2; p = 0.003) at higher Rentrop grades, but their patterns were variable. Angina pectoris was related to either ischemia of the myocardium beyond CTO or a perfusion decrease in the donor myocardium. The perfusion decrease in donor myocardium positively correlated with the collateral grades.

  8. Clinical Significance of MALB and hs-CRP in Patients with Unstable Angina Pectoris%不稳定型心绞痛患者测定UAER、hs-CRP的临床意义

    Institute of Scientific and Technical Information of China (English)

    赵有翼; 田东霞

    2012-01-01

    Objective To study the significance of urinary albumin excretion rate(UAER) and high sensitivity C-reactive protein (hs-CRP) in patients with unstable angina pectoris. Methods All 178 patients with unstable angina pectoris were divided into four groups. Initial onset angina pectoris group consisted of 46 patients, progressive angina pectoris group consisted of SO patients,spontaneous angina group consisted of 54 patients,and post-infarction angina pectoris group consisted of 28 patients. The level of UAER and hs-CRP were tested and the data were compared to that of 40 healthy controls. Results The levels of UAER and hs-CRP were higher both in initial onset angina pectoris group and progressive angina pectoris group than those of health con-trols(P <0.01). The UAER in post-infarction angina pectoris group was higher either( P < 0.05). Conclusion The level of UAER and hs-CRP in early periods of patients with unstable angina pectoris should be tested so as to get the best curing effect. Combining with myocardial zymogram and electrocardiogram examination,the proper therapy can prevent myocardial infarction.%目的 探讨尿微量白蛋白排泄率(UAER)与超敏C-反应蛋白(hs-CRP)在不稳定型心绞痛诊断中的临床意义.方法 将178例临床诊断为不稳定型心绞痛患者分为初发劳力型心绞痛组46例,恶化劳力型心绞痛组50例,自发型心绞痛组54例及梗死后心绞痛组28例;同期正常体检者40例作为对照组,分别应用免疫金标法测定尿微量白蛋白排泄率,免疫比浊法测定超敏C-反应蛋白水平,并进行比较.结果 初发型心绞痛组和恶化型心绞痛组的UAER及hs-CRP均有很大程度的增高,二者显著高于对照组(P<0.01);梗死后心绞痛组UAER明显高于对照组(P<0.05),hs-CRP在正常范围;自发型心绞痛组两项测定指标均在正常范围.结论 在心绞痛的早期应该注意监测UAER和hs-CRP的变化,以其尽早干预心绞痛的病程进展,对于

  9. [Off-pump coronary artery bypass grafting for unstable angina pectoris combined with hypothyroidism and chronic renal failure; report of a case].

    Science.gov (United States)

    Hirano, Y; Matsumoto, Y; Endoh, M; Kasashima, F; Abe, Y; Sasaki, H

    2002-08-01

    Coronary artery bypass grafting for patients with ischemic heart disease and hypothyroidism contains many controversies, and chronic renal failure causes perioperative water-electrolyte balance disorders. We experienced a case of unstable angina pectoris combined with hypothyroidism and chronic renal failure successfully treated by off-pump coronary artery bypass grafting (OPCAB). A 68-year-old man with a history of hypothyroidism and chronic renal failure was hospitalized with chest pain. Cardiac catheterisation revealed a 90% stenosis of segment 3, 11 and right ventricular (RV) branch, 75% stenosis of segment 6 and 50% stenosis of segment 5. His thyroid function was normal with orally administered levothyroxine. OPCAB was performed safely with hemodialysis until a day before operation and hemofiltration from a day after operation, and postoperative course was uneventful.

  10. Sixty-one Cases of Angina Pectoris due to Coronary Heart Disease Treated by External Use of the Paste of Nitrum and Realgar Powder on Zhiyang (GV 9)

    Institute of Scientific and Technical Information of China (English)

    刘新; 马鸿斌; 李朝平; 崔庆荣; 郭月季; 汪龙德; 李培杰; 骆力

    2002-01-01

    In order to inquire into the therapeutic effects of Xiao Shi Xiong Huang San (硝石雄黄散the Nitrum and Realgar Powder), one of the Dunhuang Prescription, on angina pectoris due to coronary heart disease (APCHD), the authors have treated 61 cases of APCHD by externally applying paste of the powder on Zhiyang (GV 9), with another 30 cases of APCHD treated with the nitroglycerin paste on Zhiyang as the controls. The results showed that the total effective rate was 82% and markedly effective rate 31.2% in the treatment group (the Paste of Nitrum and Realgar Powder), and the total effective rate was 46.6% and markedly effective rate 23.2% in the control group (the nitroglycerin paste). The difference in therapeutic effects between the two groups was very significant (P<0.01), indicating that the therapeutic effect of the former was significantly superior to that of the latter.

  11. A Meta analysis for the relation of heart rate and postinfarction angina pectoris in Chinese population%心率影响梗死后心绞痛发生率的国内Meta分析

    Institute of Scientific and Technical Information of China (English)

    李婧; 陈汉想; 李伟

    2014-01-01

    By Meta analysis ,we determined the influence of heart rate on postinfarction angina pectoris incidence in Chinese population with acute myocardial infarction .A comprehensive collection of an epidemiological study pub-lished domestically on the relationship between resting heart rate and postinfarction angina pectoris in AMI patients , was carried out , for making the Meta analysis by using RevMan software with fixed effects model and random effects model.We calculated the relative risk (RR) of postinfarction angina pectoris risk of AMI patients in slow heart rate group relative to quick heart rate group ,and evaluated the influence of heart rate level with AMI on occurrence of postinfarction angina pectoris , and analyzed the publication bias by funnel plot .The 7 articles were included .The total sample size was 1888 cases.There were 1030 cases in the heart rate slow group ,and postinfarction angina pec-toris appeared in 128 cases.The heart rate quick group was 858 cases, 247 cases combined with postinfarction angi-na pectoris;RR=0 .46 ,95%confidence interval was ( 0 .38-0 .55 ) .Funnel plot analysis showed no presence of publication bias .There is a correlation between heart rate level and postinfarction angina pectoris occurrence in AMI patients .Postinfarction angina pectoris is increased in heart rate quick patients .Slowing down the heart rate may re-duce the risk of postinfarction angina pectoris .%采用Meta分析( Meta analysis )的方法确定我国人群心率对急性心肌梗死( Acute myo-cardia infarction ,AMI)患者梗死后心绞痛发生的影响。全面收集国内发表的有关AMI患者静息心率与梗死后心绞痛关系的文献,对符合条件的所有研究结果利用RevMan软件进行固定效应模型的Meta分析。计算AMI患者心率慢组相对心率快组发生梗死后心绞痛的危险( rel-ative risk,RR),评价心率快慢对AMI患者梗死后心绞痛发生的影响,并用漏斗图分析发表性

  12. Literature Analysis of Acupoint Application for Angina Pectoris%心绞痛穴位敷贴治疗特点的文献分析

    Institute of Scientific and Technical Information of China (English)

    张洁; 赵凌; 冷俊艳; 张玲霖; 李德华; 梁繁荣

    2015-01-01

    Objective:To explore the characteristics of the treatment of acupoint application for angina pectoris. Methods:Search the literatures related to angina pectoris treated by acupoint application in CNKI, VIP, CBM, PUBMED,and then summarize the clinical characteristics of syndrome differentiation, acupuncture points selec-tion method, Chinese medicine rules, acupuncture frequency, course of treatment and treatment effect on angi-na pectoris by acupoint application.Results:In the collected 64 articles, 49 articles selected the points by dif-ferentiation of disease;there were 9 points with the frequency of usage above 5 times,and the highest frequen-cies were Xinyu and Danzhong, and the secondary was Neiguan; combined points often used were Neiguan, Danzhong and Xinyu.There were 22 herbs with the frequency of usage above 5 times,and Chuanxiong, Bingpi-an, Xixin, Danshen had the higher frequency of use;medicines for invigorating blood circulation and elimina-ting stasis and medicines for inducing resuscitation were in common use.In clinical practice for treating angina pectoris by acupoint application, once a day, fourteen or fifteen times as one treatment course without interval days was regular and was widely used.The short-term effect was well and the side effect was mostly itchy skin.Conclusion:For treating angina pectoris by acupoint application, acupuncture points selection by disease differentiation is the common method.The Shu-acupoints and Mu-acupoints are commonly used acupoints and combinations.Medicines for invigorating blood circulation and eliminating stasis and medicines for inducing resuscitation are also in common use.In addition, the acupoint application for treating angina pectoris is worthy of recommending its clinical use because of good short-term effects and no evident toxic effects, but its long-term follow-up result requires the further clinical studies to authenticate it.%目的:探讨穴位敷贴治疗心绞痛的治疗特点。方法:电

  13. Transient myocardial ischemia during daily life in rest and exertional angina pectoris and comparison of effectiveness of metoprolol versus nifedipine

    DEFF Research Database (Denmark)

    Ardissino, D; Savonitto, S; Egstrup, K

    1991-01-01

    The clinical characteristics of 65 patients with mixed angina were classified by means of (1) a questionnaire investigating the proportion of symptoms occurring at rest and on effort, (2) an exercise stress test, (3) 24-hour ambulatory Holter monitoring, and (4) coronary arteriography. According...... life (p less than 0.05) irrespective of the patients' clinical characteristics. Nifedipine was ineffective, particularly in patients with angina predominantly on effort and with a moderate to severe reduction in exercise tolerance. It is concluded that in patients with mixed angina, ischemic episodes...

  14. Use of myocardial perfusion imaging to predict the effectiveness of coronary revascularisation in patients with stable angina pectoris

    Energy Technology Data Exchange (ETDEWEB)

    Johansen, Allan [Odense University Hospital, Department of Clinical Physiology and Nuclear Medicine, Odense (Denmark); Odense University Hospital, Department of Nuclear Medicine, Odense (Denmark); Hoeilund-Carlsen, Poul Flemming; Moeldrup, Mette [Odense University Hospital, Department of Clinical Physiology and Nuclear Medicine, Odense (Denmark); Christensen, Henrik Wulff [Nordic Institute of Chiropractic and Clinical Biomechanics, Odense (Denmark); Vach, Werner [University of Southern Denmark, Department of Statistics, Odense (Denmark); Haghfelt, Torben [Odense University Hospital, Department of Cardiology, Odense (Denmark)

    2005-12-01

    Coronary revascularisation is the treatment of choice in patients with stable angina who have significant stenoses. From a pathophysiological point of view, however, mitigation of angina is to be expected only in the presence of reversible ischaemia. Therefore it was the aim of this study to examine the effect of revascularisation on stable angina in relation to the myocardial perfusion imaging (MPI) pattern prior to intervention. Three hundred and eighty-four patients (58.0{+-}8.8 years) referred for angiography underwent MPI. Prior to MPI and at 2-year follow-up, patients were classified as having typical angina, atypical angina, non-cardiac chest pain or no pain, and the severity of chest pain was graded according to the Canadian Cardiovascular Society (CCS) criteria. The patients themselves estimated their pain on a visual analogue scale. Management was based on symptoms and angiographic findings, since the results of MPI were not communicated. Among the 240 patients who were not revascularised, 79% had typical or atypical angina at study entrance versus 40% at follow-up. In comparison, 93% of the 144 revascularised patients had typical or atypical angina before intervention versus only 36% at follow-up. This additional advantage of invasive therapy was present only in patients with reversible defects; revascularisation had no additional effect in patients with normal perfusion or irreversible defects. Similarly, additional, significant reductions in CCS class and visual analogue score were observed exclusively in patients with reversible defects. In patients referred for coronary angiography owing to known or suspected stable angina, revascularisation was significantly more effective than medical treatment exclusively in patients with reversible ischaemia. (orig.)

  15. Clinical usefulness of delayed exercise images on {sup 99m}Tc-tetrofosmin myocardial SPECT in the diagnosis of vasospastic angina pectoris

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Kazuki; Zen, Kan; Hikosaka, Takatou; Adachi, Yoshihiko; Yoneyama, Satoshi; Katoh, Shuuji [Asahi Univ., Gifu (Japan). Murakami Memorial Hospital; Sugihara, Hiroki; Nakamura, Tomoki; Azuma, Akihiro

    2000-05-01

    This study was designed to evaluate the clinical usefulness of delayed exercise images in {sup 99m}Tc-tetrofosmin (TF) myocardial SPECT in the diagnosis of vasospastic angina pectoris. We studied 30 patients with vasospastic angina, 10 of 30 patients (group A) had both effort and rest angina, 20 of 30 patients (group B) had rest angina. A 370 MBq of TF was intravenously injected at peak exercise, and initial (EX-I) and delayed exercise (EX-D) images were obtained at 30 min and 180 min after the injection. An additional 740 MBq of TF was intravenously reinjected after EX-D image acquisition, and rest images were obtained 30 min after the reinjection. The left ventricular wall was divided into 9 segments. Regional myocardial uptakes of TF were scored by 4-point defect score (0=normal, 1=mildly reduced, 2=moderately reduced, and 3=severely reduced). Total defect score (TDS) was calculated from the sum of defect scores in 9 segments. Reverse redistribution (RR) was defined as increase of more than 2 in TDS on EX-D images. In group A, 4 of 10 cases (40%) showed decreased uptake on EX-I images, 6 of 10 cases (60%) revealed RR on EX-D images, and none of the patients showed decreased uptake on rest images. In group B, no one showed decreased uptake on EX-I and rest images, 11 of 20 cases (55%) revealed RR on EX-D images. The mean{+-}SD of TDS were 2.9{+-}3.4, 5.1{+-}4.5, 0.5{+-}0.5 on EX-I, EX-D, rest images in group A, and serially 0.4{+-}0.5, 3.3{+-}3.6, 0.4{+-}0.5 in group B. Regional wall motion abnormality was reduced in regions with RR. RR on EX-D images may reflect ischemic damaged but viable myocardium in vasospastic angina. The clinical usefulness of exercise-rest TF imaging in detection of organic coronary artery disease has been well established. Therefore, exercise-rest TF imaging with additional delayed exercise image could evaluate not only organic coronary artery disease but also coronary artery vasospasm. (author)

  16. Effect of Xin'anning Nasal Drop ( 心安宁滴鼻剂 ) in Treating Coronary Heart Disease with Unstable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To observe the clinical efficacy of Xin'anning Nasal Drop (XAND, 心安宁滴鼻剂 )in treating coronary heart disease with unstable angina pectoris (CHD-UAP). Methods: Sixty patients with CHD-UAP were assigned, according to the randomizing number table, to two groups, the control group treated with conventional Western medicine, and the treated group treated with conventional Western medicine plus XAND. The clinical efficacy and the changes of S-T segment in resting EKG and total ischemia burden (TIB) in 24-h dynamic EKG were observed. Results: The clinical efficacy, including the effect of angina alleviation, its initiation, and the effect of TCM syndrome score reduction, were significantly superior in the treated group to those in the control group ( P<0.05 or P<0.01 ). The degree and extent of myocardial ischemia were significantly improved in both groups ( P<0.01 ), but the improvement in the treated group was better than that in the control group ( P<0.05). Moreover, it was worth mentioning that the immediate effect in the treated group was better than that in the control group, and the reduction of TIB, the improvement in heart rate and myocardial oxygen consumption (immediately after the first administration or by the end of the therapeutic course), and systolic blood pressure after treatment in the former were all superior to those in the latter, showing significant difference ( P<0.05 or P<0. 01 ). Conclusion: XAND has a quick effect in alleviating angina in patients with CHD-UAP, and it is worthy of further studies and spreading in clinical practice.

  17. Xuesaitong Soft Capsule (Chinese Patent Medicine for the Treatment of Unstable Angina Pectoris: A Meta-Analysis and Systematic Review

    Directory of Open Access Journals (Sweden)

    Xiaochen Yang

    2013-01-01

    Full Text Available Objective. To provide a systematic review to evaluate the effectiveness and safety of Xuesaitong soft capsule (XST in treating unstable angina (UA. Methods. An extensive search of 6 medical databases was performed up to August 2013. Randomized controlled trials (RCTs involving XST alone or combined with conventional drugs versus conventional drugs were included. A meta-analysis of reduction of angina symptoms and electrocardiogram (ECG improvement was performed to evaluate the effects of XST on UA. Results. After researching, a total of 6 RCTs with 716 participants were included. Our review showed that XST combined with conventional drugs had significant effect on relieving angina symptoms (RR: 1.14 [1.07,1.22]; P=0.0001 and improving ECG (RR: 1.26 [1.12,1.42]; P=0.0001 compared with conventional drugs alone. Conclusions. XST appears to have beneficial effects on improvement of ECG, reduction of angina symptoms, and decreasing the frequency and duration of angina attack in participants with UA. However, the findings should be interpreted with caution due to the poor methodological quality of the included trials.

  18. 异舒吉治疗不稳定型心绞痛的临床疗效观察%Observation on Clinical Efficacy of Isoket Treating Unstable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    彭国顺; 林晓红

    2003-01-01

    Objective To compare the efficacy of intravenous Isoket with Nitroglycerine in patients with unstable angina pectoris.Methods 70 patients were enrolled and split into treatment group(Isoket group)and control group (Nitroglycerine group) randomly and double-blindedly.There were 36 cases in treatment group who were treated with intravenous Isoket 20~30mg per day for 10 consecutive days;whereas 34 cases in control group who were treated with intravenous Nitroglycerine 10~20mg per day for 10 days.Results 18 cases were significantly effective and 14 patients were effective with total effective rate 88.9% in treatment group compared with 8 cases,11 cases and 55.7% in control group respectively.The treatment group is significantly better than the control group.Conclusion It is effective and safe to treat the patients with unstable angina pectoris with intravenous Isoket.

  19. Advances on clinical research of blood stasis coronary heart disease angina pectoris treated with Chinese medicine%中医药治疗心血瘀阻型冠心病心绞痛的临床研究进展

    Institute of Scientific and Technical Information of China (English)

    崔番瑜; 杨少琴

    2014-01-01

    Coronary heart disease (CHD) angina pectoris is a common clinical disease with high rates of incidence, morbidity and mortality, which has a serious inlfuence on human health, especially on the mental workers aged more than 40-year-old who are in high risk. Many Chinese medical scholars were committed to the research of prevention and treatment for CHD angina pectoris all along, and they developed a number of new Chinese medicine. In this paper, the clinical research data of blood stasis CHD angina pectoris were selected, and it emphatically summarized the clinical drug efifcacy of blood stasis type of angina pectoris syndrome in recent years, as well as the research and development (R&D) status of new Chinese medicine.%冠心病心绞痛是临床常见病,其发病率、致残率和病死率均较高,严重影响着人类的健康,尤其是40岁以上的脑力劳动者更是高危人群。一直以来,很多中医学者都致力于冠心病心绞痛的预防和治疗研究,并研制出了众多新型中成药。选取心血瘀阻型冠心病心绞痛的临床研究资料,着重综述了近几年来对于冠心病心绞痛心血瘀阻证的临床用药疗效以及新型中成药的研发现状。

  20. 中药治疗冠心病心绞痛的临床分析%Clinical Analysis of Traditional Chinese Medicine in the Treatment of Angina Pectoris of Coronary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    石志坚

    2016-01-01

    Objective To investigate the clinical effect of traditional Chinese medicine in the treatment of angina pectoris of coronary heart disease.Methods260 cases of coronary heart disease patients with angina pectoris in accordance with the different treatment measures were divided into groups, A group (traditional Chinese medicine + western medicine) treatment mode 130 cases, B group of 130 cases of conventional western medicine treatment.Results The effective rate of A group was higher than that of B group, and the adverse reaction rate was lower than that of B group (P<0.05).Conclusion The application of traditional Chinese medicine in patients with angina pectoris of coronary heart disease, the treatment effect is more obvious.%目的:探讨中药治疗冠心病心绞痛的临床效果。方法260例冠心病心绞痛患者依照不同治疗措施进行分组,A组实施(中药+西药)治疗模式130例,B组实施常规西药治疗模式130例。结果 A组患者治疗有效率高于B组,不良反应率低于B组(P<0.05)。结论中药应用于冠心病心绞痛患者,治疗成效更为明显。

  1. Clinical Experience of Using of Acupoint Sticking Therapy to Treat Labor Type Angina Pectoris%运用穴位贴敷疗法治疗劳力型心绞痛临床经验

    Institute of Scientific and Technical Information of China (English)

    朱玉婕; 张培影

    2011-01-01

    目的:探讨中药穴位贴敷治疗劳力型心绞痛的临床经验.方法:针对阳虚血瘀型心绞痛的病因、病机,运用自选穴位贴敷治疗,贴于膻中、心俞、膈俞、至阳等腧穴,2 d更换1次,14 d为1个疗程.结果与结论:穴位贴敷治疗劳力型心绞痛有一定疗效,且使用简便,无毒副作用.%Objective:To discuss the clinical experience of using acupoint sticking therapy to treat labor type angina pectoris. Methods:Based on the etiology,pathogenesis of angina pectoris of yang deficiency and blood stasis, celected acupoint sticking therapy was applied in Shanzhou, Xinshu, Geshu, Zhiyang etc ,which were neplaced every two days with 14 days as a course of treatment. Results and Conclusion:Acupoint sticking therapy for angina pectoris has certain effect, and easy to use, without toxic side effects.

  2. 复方丹参滴丸治疗冠心病心绞痛的疗效观察%Observation on Curative Effects of Composite Dan Shen Guttate Pill on Angina Pectoris in Coronary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    郑达; 陈长华

    2001-01-01

    Purpose: To observe the definite curative effects of Composite Dan shen Guttate Pill on angina pectoris in coronary heart disease. Methods: 52 cases of angina pectoris were treated with this pill, while 25 cases in the control group with isosorbide dinitrate. The changes in symptoms and ECG were observed.Results:The total effective rate in the observation group reached 94.2% with the effective rate of improvement on ECG being 65.5% .Conclusion: Composite Danshen Guttate Pill has significant effects on treating angina pectoris in coronary heart disease.%目的:观察复方丹参滴丸治疗冠心病心绞痛的确切疗效。方法:用该药治疗冠心病心绞痛52例,并与消心痛组25例进行对照,观察症状、心电图的变化。结果:观察组对症状疗效总有效率942%,对心电图改善情况总有效率655%。结论:复方丹参滴丸具有治疗冠心病心绞痛的作用。

  3. To Investigate the Clinical Characteristics and Treatment Strategies of Elderly Patients with Angina Pectoris and Myocardial Infarction%探讨老年人心绞痛、心肌梗死的临床特征及治疗对策

    Institute of Scientific and Technical Information of China (English)

    陈金等

    2016-01-01

    目的:研究老年人心绞痛、心肌梗死患者的临床特点以及治疗对策。方法选择2014年8月-2015年11月之间在我院接受治疗的心绞痛患者70例、心肌梗死患者66例,将其分为心绞痛组和心肌梗死组,分析老年心绞痛、心肌梗死的临床特征及治疗方法。结果心绞痛组、心肌梗死组患者中分别有65.71%、68.18%的患者因劳累过度而诱发。临床表现不典型,心肌梗死组有56.06%的患者表现为不典型心绞痛,30.30%的患者表现为典型的心绞痛,13.64%表现为非心绞痛性疼痛;心绞痛组有47.14%的患者表现为不典型心绞痛,35.71%的患者表现为典型心绞痛,17.15%的患者表现为非心绞痛性疼痛。发病24h后,心肌梗死组的心肌酶谱明显升高,而心绞痛组均在正常范围。心绞痛患者发作时含服硝酸甘油,缓解期静脉滴注硝酸酯类可取得较好的治疗效果,治疗有效率高达92.86%。心肌梗死患者采用介入治疗或溶栓治疗,治疗有效率高达87.88%,但临床治疗过程中均有部分患者出现并发症。结论大部分心绞痛、心肌梗死的老年患者均存在一些基础疾病,多种因素可以诱发,硝酸酯类可以显著缓解心绞痛,而心肌梗死患者则应尽早进行介入治疗或溶栓治疗。%ABSTRACR: Objective To study the clinical characteristics and treatment of elderly patients with angina pectoris and myocardial infarction. Methods between August 2014 2015 November in our hospital accepted treatment of 70 cases of patients with angina pectoris and myocardial infarction patients 66 cases, the angina pectoris and myocardial infarction group. Analysis of the clinical features and treatment of senile angina pectoris and myocardial infarction.Results the angina group, myocardial infarction group patients were 65.71% and 68.18% of patients induced by overwork. Atypical clinical manifestations, myocardial infarction group, 56

  4. Regional myocardial perfusion in patients with atherosclerotic coronary artery disease, at rest and during angina pectoris induced by tachycardia

    Energy Technology Data Exchange (ETDEWEB)

    Maseri, A.; L' Abbate, A.; Pesola, A.; Michelassi, C.; Marzilli, M.; De Nes, M.

    1977-03-01

    We studied regional myocardial perfusion by scintigraphic computer-assisted analysis of initial distribution, washout rates, and residual activity of /sup 133/Xe injected into the left coronary artery of four patients with normal arteriograms and 14 patients with coronary stenosis. At rest, residual activity in poststenotic regions was always greater than in control regions, but initial washout rates were not slower. During angina, following xenon injections, the amount of indicator distributed to the poststenotic regions was markedly reduced; the increase of the initial washout rates was smaller than in control regions relative to rest, and residual activity was higher. Initial washout rates did not differ as much as from those of normal myocardium because in severe ischemia too little indicator is deposited initially in these regions to produce a change of any magnitude. Indeed, when angina was induced immediately after the xenon injection, poststenotic washout rates became much slower during angina than at rest, a finding that implicates functional factors in impairing poststenotic myocardial perfusion during angina.

  5. EFFICACY OF SPINAL-CORD STIMULATION AS ADJUVANT THERAPY FOR INTRACTABLE ANGINA-PECTORIS - A PROSPECTIVE, RANDOMIZED CLINICAL-STUDY

    NARCIS (Netherlands)

    DEJONGSTE, MJL; HAUTVAST, RWM; HILLEGE, HL; LIE, KI

    1994-01-01

    Objectives. In a prospective, randomized study with an 8-week follow-up period, we evaluated the efficacy of spinal cord stimulation an exercise capacity and quality of life in patients with intractable angina. Background. Despite important achievements in therapy for ischemic heart disease, there r

  6. Meta-analysis of Salvianolate on Unstable Angina Pectoris%丹参多酚酸盐治疗不稳定型心绞痛的Meta分析

    Institute of Scientific and Technical Information of China (English)

    姚冲; 姚金; 杨水新; 张书伟

    2013-01-01

    目的:从循证医学的角度系统评价丹参多酚酸盐治疗不稳定型心绞痛的疗效和安全性.方法:通过全面检索与丹参多酚酸盐相关的随机对照研究文献,进行质量评价,纳入合格文献进行Meta分析.结果:9个随机对照实验纳入系统评价,均为Jadad评分小于等于3分的低质量研究.Meta分析结果显示丹参多酚酸盐联合常规治疗在整体临床症状、心电图的改善和舒缩血管因子水平改善方面均优于单纯使用常规治疗.整体临床疗效比较OR值为4.37,95%可信区间为2.71 ~7.03;心电图改善情况比较OR值为3.56,95%可信区间为2.22 ~5.69.改善血清NO和ET水平分别为[WMD=16.78,95%CI(14.62,18.93),P<0.00001]和[WMD=24.76,95% CI(19.08,30.44),P<0.00001].结论:丹参多酚酸盐联合常规治疗用于冠心病不稳定型心绞痛可能取得较单一常规治疗更好的效果,且安全性良好.但由于纳入的研究方法学质量低,尚需更多设计合理的高质量临床试验加以验证.%Objective:To systematically appraise the effect and the safety of salvianolate on unstable angina pectoris.Methods:Comprehensively search the reports about randomized controlled trials of salvianolate,and evaluate the researching quality.Then the Meta-analysis would be carried out for those reports satisfying some criteria.Results:9 randomized controlled trials,with equal or lesser than 3 Jadad scores,were included for the systematic review.A Meta-analysis showed that the combination of salvianolate and conventional treatment had better efficacy on both overall clinical manifestations and ECG than the conventional monotherapy.The odds ratio (OR) and 95% confidence interval (95% CI) from the comparison of the improvement on overall clinical manifestations were 4.37 and 2.71-7.03 respectively.The OR and 95% CI of comparison of the improvement of ECG were 3.56 and 2.22-5.69 respectively.The results of improving levels of serum NO and ET were

  7. Clinical Effect of Xueshuantong Injection in Adjuvant Treatment of Coronary Disease and Angina Pectoris%血栓通注射液辅助治疗冠心病心绞痛的疗效分析

    Institute of Scientific and Technical Information of China (English)

    刘峰

    2014-01-01

    Objective To investigate the clinical effect of Xueshuantong injection in the adjuvant treatment of coro-nary disease and angina pectoris. Methods A total of 80 patients with coronary disease and angina pectoris were selected in our hospital from March 2013 to May 2014,and they were randomly divided into control group and treatment group,40 cases in each group. both groups given conventional treatment,while treatment group given extra Xueshuantong injection. ECG effect and angina pectoris effect between two groups were compared. Results The total effective rate of ECG of treatment group (95. 0% )was higher than that of control group(72. 5% ),the difference was statistically significantly different(P 〈 0. 05). The total effective rate of angina pectoris of treatment group(92. 5% ) was higher than that of control group(70% ),the difference was statistically significantly different(P 〈 0. 05). Conclusion Xueshuantong injection has certain effect in adju-vant treatment of coronary disease and angina pectoris.%目的:探讨血栓通注射液治疗冠心病心绞痛的临床疗效。方法选取我院2013年3月—2014年5月收治的冠心病心绞痛患者80例,随机分为对照组和治疗组,每组40例。两组患者均给予常规治疗,治疗组在常规治疗基础上给予血栓通注射液静脉滴注,比较两组患者心电图及心绞痛疗效。结果治疗组心电图总有效率(95.0%)高于对照组(72.5%),差异有统计学意义(P 〈0.05)。治疗组心绞痛总有效率(92.5%)高于对照组(70.0%),差异有统计学意义(P 〈0.05)。结论血栓通注射液治疗冠心病心绞痛疗效显著。

  8. Analysis of the Application of Angina Pectoris of Coronary Heart Disease in TCM Diagnosis and Treatment Scheme%冠心病心绞痛中医诊疗方案的应用分析

    Institute of Scientific and Technical Information of China (English)

    毕明昌

    2015-01-01

    目的:探讨冠心病心绞痛的中医诊疗方法。方法根据2011年~2013年我院接收的80例冠心病心绞痛患者来进行研究分析,采取辩证论治的方式,对其临床疗效进行分析。结果冠心病心绞痛中医诊疗方法对于患者的临床症状改善非常明显,患者的胸痛、胸闷等症状有所患者,临床总有效率是88.7%,根据观察来看,患者症状发作频率减缓,心电图有效率80%,P<0.05。结论冠心病心绞痛患者接受中医诊疗方法的效果比较好,临床症状改善明显,因此推荐为患者提供中医诊疗的方法来进行冠心病心绞痛治疗。%Objective To investigate the methods of diagnosis and treatment of angina pectoris of coronary heart disease in tcm. Methods according to the 80 cases of angina pectoris of coronary heart disease patients in our hospital received to carry on the research analysis, the clinical efficacy analysis. Results angina pectoris of coronary heart disease in TCM diagnosis and treatment methods for the clinical symptoms of the patients improved obviously, chest pain, chest distress and other symptoms to patients, the clinical total effective rate was 88.7%, the effective rate of ECG in 80%, P<0.05. Conclusion the method of TCM in patients undergoing coronary heart disease and angina pectoris effect is better, the clinical symptoms improved significantly, therefore compared recommended TCM treatment methods for the patients for treatment of angina pectoris of coronary heart disease, this study also provides some reference for this kind of treatment method.

  9. The Time Profile of Pentraxin 3 in Patients with Acute ST-Elevation Myocardial Infarction and Stable Angina Pectoris Undergoing Percutaneous Coronary Intervention

    Directory of Open Access Journals (Sweden)

    Ragnhild Helseth

    2014-01-01

    Full Text Available Background. High levels of Pentraxin 3 (PTX3 are reported in acute myocardial infarction (AMI. Aim. To investigate circulating levels and gene expression of PTX3 in patients with AMI and stable angina pectoris (AP undergoing PCI. Methods. Ten patients with AP and 20 patients with AMI were included. Blood samples were drawn before PCI in the AP group and after 3 and 12 hours and days 1, 3, 5, 7, and 14 in both groups. Results. Circulating PTX3 levels were higher in AMI compared to AP at 3 and 12 hours (P<0.001 and P=0.003. Within the AMI group, reduction from 3 hours to all later time points was observed (all P≤0.001. Within the AP group, increase from baseline to 3 hours (P=0.022, followed by reductions thereafter (all P<0.05, was observed. PTX3 mRNA increased in the AMI group from 3 hours to days 7 and 14 in a relative manner of 62% and 73%, while a relative reduction from baseline to 3 and 12 hours of 29% and 37% was seen in the AP group. Conclusion. High circulating PTX3 levels shortly after PCI in AMI indicate that AMI itself influences PTX3 levels. PTX3 mRNA might be in response to fluctuations in circulating levels.

  10. Alterations in luminol-enhanced chemiluminescence from nondiluted whole blood in the course of low-level laser therapy of angina pectoris patients

    Science.gov (United States)

    Voeikov, Vladimir L.; Novikov, Cyril N.; Siuch, Natalia I.

    1997-05-01

    Addition of Luminol to nondiluted blood of healthy donors results in a short and weak increase of chemiluminescence (CL) from it. Contrary to that in 25 cases of stable angina pectoris the intensity of CL from blood of patients sharply increased upon addition of luminol exceeding that form healthy donors' blood 10-100-fold. 24 hours after the 3D intravenous low-level treatment CL burst in patients' blood in the presence of Luminol was in general significantly lower than before the beginning of the treatment. After the 7th treatment the pattern of CL kinetics was in most cases similar to that of healthy donors' blood. However, after the 10th treatment intensity of Luminol-enhanced CL usually increased and for blood of some patients even exceeded its values obtained before the treatment. Some correlation CL from nondiluted blood with neutrophil activity studied by NTB-test and plasma viscosity of same blood was noted. Using highly sensitive single photon counters it is possible to reveal abnormal levels of CL from no more than 0.1-0.2 ml of blood within 3-5 min.

  11. Effect of Chinese Herbs for Activating Blood Circulation,Removing Stasis and Supplementing Qi on the Circulating Endothelial Cells in Patients with Unstable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    马丽红; 阮英茆; 焦增绵; 李晓惠

    2004-01-01

    Objective: To observe the effect and clinical significance of circulating endothelial cells (CEC) in the pathogenesis of coronary heart disease with unstable angina pectoris (CHD-UAP), and to explore the protective effect of Chinese herbs for activating blood circulation, removing stasis and supplementing Qi (CH) on CHD-UAP patient's CEC. Methods: Sixty patients with diagnosis of CHD-UAP confirmed and differentiated to be Qi-deficiency and blood stasis by TCM were randomly divided into two groups and treatime, with 1 month as one therapeutic course. The number of CEC in patients' blood circulation was counted before and after treatment. Besides, the number of CEC in 30 healthy persons was also counted for control.Results: The number of CEC in CHD-UAP patients was significantly higher than that in the healthy persons (P<0.01). After the patients were treated with CH, either TXL or HXTM, it significantly decreased (P<0.01)with insignificant difference between the two treated groups. Conclusion: CEC in CHD-UAP patients is severely damaged and endothelial function in disorder, Chinese herbs have protective effect on patients' CEC.

  12. Comparison of the safety and efficacy of ivabradine and nebivolol mono- and combination therapies in the treatment of stable angina pectoris patients with left ventricular dysfunction

    Directory of Open Access Journals (Sweden)

    Rasim Kutlu

    2013-08-01

    Full Text Available We aimed to investigate the pharmacoeconomic efficacy of ivabradine and nebivolol in treatment of stable angina pectoris patients with left ventricular dysfunction prospectively. Pharmacoeconomic analysis was performed by using cost minimization analysis, and cost effectiveness analysis. After 6 months’ treatment LVEF for the nebivolol group (17 patients, 50% improved by (38 ± 6.5 to (41 ± 3.2, (p>0.05 and for the ivabradine group (17 patients, 50% (37 ± 5.4 to (41 ± 2.3, (p>0.05, mean MET value in the nebivolol group increased from (3.7 ± 1.2 to (5.5 ± 1.6, (p>0.05, versus from (3.6 ± 1.5 to (5.5 ± 1.4, (p>0.05 in the ivabradine group, cost minimization analysis results showed a difference in the total cost of treatment was US$ 5288.7 in favor of nebivolol. The findings suggest that nebivolol is more cost-effective than ivabradine in the treatment of patients with left ventricular dysfunction.

  13. Limitations of spontaneous reperfusion and conventional medical therapy to afford myocardial protection through antecedent angina pectoris in acute myocardial infarction

    Energy Technology Data Exchange (ETDEWEB)

    Hashimoto, Akiyoshi; Nakata, Tomoaki; Wakabayashi, Takeru; Yuda, Satoshi; Eguchi, Mariko; Sasao, Hisataka; Tsuchihashi, Kazufumi; Shimamoto, Kazuaki [Sapporo Medical Univ. (Japan)

    1999-10-01

    Despite the cardioprotective effect of rapid coronary reperfusion, the effects of spontaneous recanalization on myocardial viability and metabolism are unknown. We studied whether preinfarction angina affords cardioprotection when spontaneous coronary reperfusion occurred in acute infarct patients. Myocardial tomographies with thallium and I-123-labeled-{beta}-methyl-p-iodophenyl penta-decanoic acid (BMIPP) were performed in 27 acute myocardial infarct patients treated medically: 15 patients had preexisting angina before infarction (group A) and 12 did not (group B). Thallium and BMIPP abnormalities and regional function were quantified by a polar map and contrast ventriculography, respectively. There was no significant difference between thallium and BMIPP in the severity index in groups A and B (89{+-}97 vs. 85{+-}68, 97{+-}28 vs. 95{+-}27, respectively), and no significant difference between the groups in the thallium or BMIPP severity index. The ratio of the thallium severity index to that of BMIPP and the regional wall-motion abnormality index were identical in groups A and B. Both patient groups were divided into 2 subgroups based on the presence or absence of spontaneous coronary reperfusion: subgroups A1 and A2, and subgroups B1 and B2, respectively. There were no significant differences among the 4 subgroups in severity indexes for both tracers, the thallium/BMIPP ratio, or the asynergy score. The BMIPP severity index correlated significantly with that of thallium in all subgroups, but no significant difference between the regression lines was found. It is therefore unlikely that spontaneous coronary recanalization affords beneficial effects through preservation of myocardial viability in an ischemia-related zone, suggesting that the cardioprotective effect of preinfarction angina is a limited phenomenon in patients undergoing rapid coronary reperfusion. (author)

  14. A literature review to evaluate the economic value of ranolazine for the symptomatic treatment of chronic angina pectoris.

    Science.gov (United States)

    Vellopoulou, Katerina; Kourlaba, Georgia; Maniadakis, Nikos; Vardas, Panagiotis

    2016-05-15

    To conduct a systematic review of the evidence regarding the economic value of ranolazine relative to standard-of-care (SOC) for the treatment of symptomatic chronic stable angina (CSA). Electronic databases were searched using relevant keywords. The identified studies were independently reviewed by two investigators against pre-determined inclusion and exclusion criteria. Their data were extracted using a relevant form and consequently were synthesized. Studies were also evaluated using the Quality of Health Economic Studies scale. The main outcomes considered were the cost and effectiveness for each comparator and the incremental cost per quality-adjusted-life year (QALY) gained. Six studies were included in the review. Five of these assessed the cost-utility of ranolazine added to SOC, compared to SOC alone, using decision trees or Markov models whereas one was a retrospective cost evaluation study. The analysis was conducted from a payer perspective in five studies and from a societal perspective in one study with the time horizon varying between six months and a year. The incremental cost-effectiveness ratio (ICER), ranged from €4000 to €15,000 per QALY gained. Ranolazine appears to be dominant or cost-effective, mainly due to its ability to decrease angina-related hospitalizations and also due to a marginal improvement in quality of life. The acquisition cost of ranolazine was the variable with the greatest impact upon the ICER. The existing evidence, although limited, indicates that ranolazine may be a dominant or cost-effective therapy option, for the treatment of patients with symptomatic CSA. Further research is required to evaluate the cost-effectiveness of ranolazine.

  15. Influence of Nursing Intervention on Incidence of Angina Pectoris of Coronary Heart Disease%护理干预对冠心病心绞痛发生率的影响探讨

    Institute of Scientific and Technical Information of China (English)

    袁琳

    2016-01-01

    目的:探究护理干预对冠心病心绞痛发生率的影响。方法选择2015年1月~2016年1月来我院就诊的冠心病心绞痛患者152例为研究对象,将其分成两组,对照组行常规优质护理,以此为基础观察组患者行个性化护理,治疗后,观察两组患者的治疗期间心绞痛发生次数和住院时长。结果和对照组相比,观察组患者在心绞痛发生次数和住院时长方面结果较好,组间数据差异有统计学意义,P <0.05。结论对于冠心病心绞痛患者,使用个性化护理干预,能够在极大程度上降低患者心绞痛发生次数和住院时长,降低医疗成本。%Objective To explore the influence of nursing intervention on the incidence of coronary heart disease angina pectoris. Methods 152 cases of patients with coronary heart disease angina were chosen as the research object from January 2015 to January 2016 in our hospital, it is divided into two groups, control group routine quality care, observation group of patients based on personalized care, after the treatment, observe two groups during the treatment of patients with angina frequency and duration in hospital. Results Compared with control group, the observation group of patients hospitalized in angina frequency and duration, significantly better, data statistical differences between groups, P<0.05. Conclusion For the coronary heart disease angina pectoris, the use of personalized nursing intervention, to reduce the number of patients with angina pectoris occurred on the great degree and the hospitalization time, reduce the medical cost.

  16. Simvastatin Combined With Low Molecular Heparin in the Treatment of Coronary Heart Disease Angina Pectoris%辛伐他汀联合低分子肝素钠治疗冠心病心绞痛效果探讨

    Institute of Scientific and Technical Information of China (English)

    李海男

    2015-01-01

    Objective To study the effect of simvastatin combined with low molecular heparin for treatment of coronary heart disease angina pectoris. Methods Using digital random method to divided 156 cases into control group and observation group,78 cases in each group. Control group patients were given anti angina pectoris drugs for regular treatment,observation group patients were given simvastatin combined with low molecular heparin,compared two groups of therapeutic effect. Results In observation group,total effective rate was significantly higher than control group,the difference was statistical y significant(P<0.05). Conclusion Simvastatin combined with low molecular heparin sodium have exact curative effect on coronary heart disease angina pectoris.%目的:研究分析辛伐他汀联合低分子肝素钠治疗冠心病心绞痛的临床效果。方法将156例患者按照数字随机法均分为对照组和观察组,每组各78例。对照组患者给予抗心绞痛药物进行常规治疗,观察组患者在对照组的基础上给予辛伐他汀联合低分子肝素钠进行治疗,比较两组治疗效果。结果观察组治疗总有效率高于对照组的高,差异具有统计学意义(P<0.05)。结论辛伐他汀联合低分子肝素钠治疗冠心病心绞痛疗效更加确切,而且安全性高,有效改善患者的病情,提高生活质量。

  17. 音乐疗法对类心绞痛患者抑郁焦虑状态的干预%Music therapy on patients with angina pectoris class depression anxiety state intervention

    Institute of Scientific and Technical Information of China (English)

    姚倩; 李莉; 彭顺蓉

    2013-01-01

    Objective To study music therapy on patients with angina pectoris class depression anxiety state intervention effect.Methods From June 2009 to August 2012 will depression self rating scale (SDS) and anxiety self-assessment scale (SAS) score 50 points at the same time > 110 cases of the kind of angina pectoris patients were randomly divided into use music therapy in nursing intervention group and control group,evaluate and compare two groups of SDS and SAS box score index signs.Results Music therapy intervention to 3 ~ 4w,the patients with SDS box SAS scores have significantly reduced (P < 0.05),systolic blood pressure have decreased obviously (P < 0.01).Conclusion Music therapy for classes angina pectoris patients depressive state improvement and signs control have a positive effect.%目的 探讨音乐疗法对类心绞痛患者抑郁焦虑状态的干预效果.方法 于2009年6月~2012年8月将抑郁自评量表(SDS)和焦虑自评量表(SAS)评分同时>50分的110例类心绞痛患者随机分为用音乐疗法进行护理干预组和对照组,评定并比较两组SDS和SAS得分及体征指标.结果 音乐疗法干预到第3~4周时,患者的SDS和SAS评分有明显的降低(P<0.05),收缩压也有明显下降(P<0.01).结论 音乐疗法对于类心绞痛患者抑郁状态的改善和体征的控制有积极的作用.

  18. Higher risk of orofacial clefts in children born to mothers with angina pectoris: a population-based case-control study.

    Science.gov (United States)

    Czeizel, Andrew E; Vereczkey, Attila; Bánhidy, Ferenc

    2015-02-01

    Previously an unexpected association of maternal angina pectoris (MAP) during pregnancy with a higher risk of orofacial clefts in their children was found. There were three objectives of this study: (i) to evaluate the validity of MAP-diagnoses in the previous study and the recent history of mothers with MAP in a follow-up study; (ii) to estimate the prevalence of other congenital abnormalities in the offspring of mothers with MAP; and (iii) to analyze the possible effect of confounders for the risk of orofacial clefts. The large dataset of population-based Hungarian Case-Control Surveillance System of Congenital Abnormalities, 1980-1996 was evaluated including 22 843 cases with congenital abnormalities and 38 151 controls without any defect. Twenty-two cases (0.10%) and 12 controls (0.03%) were born to mothers with medically recorded MAP (odds ratio [OR] with 95% confidence interval [CI]: 3.7, 1.8-7.3). Of 22 cases, six had isolated cleft lip ± palate (OR with 95% CI: 13.3, 4.9-35.9) and two were affected with isolated cleft palate (OR with 95% CI: 10.5, 2.3-47.6). The diagnosis of MAP was confirmed in seven women visited at home in 2009-2010, two had recent myocardial infarction and five were smokers. There was no higher risk for other congenital abnormalities. In conclusion the higher risk of orofacial clefts was confirmed in the children of mothers with MAP and smoking may trigger the genetic predisposition of both MAP and orofacial clefts. However, the number of cases was limited and therefore further studies are needed to confirm or reject this theoretically and practically important observation.

  19. Myocardial infarction determined by technetium-99m pyrophosphate single-photon tomography complicating elective coronary artery bypass grafting for angina pectoris

    Energy Technology Data Exchange (ETDEWEB)

    Burns, R.J.; Gladstone, P.J.; Tremblay, P.C.; Feindel, C.M.; Salter, D.R.; Lipton, I.H.; Ogilvie, R.R.; David, T.E.

    1989-06-15

    The incidence of acute myocardial infarction (AMI) complicating coronary artery bypass grafting (CABG) has previously been based on concordance of electrocardiographic, enzymatic and scintigraphic criteria. Technetium-99m pyrophosphate (Tc-PPi) single-photon emission computed tomography now enables detection of AMI with high sensitivity and specificity. Using this technique, perioperative AMI was detected in 12 of 58 patients (21%) undergoing successful elective CABG for stable angina pectoris. Stepwise multivariate logistic regression analysis was performed to compare the predictive value of preoperative (New York Heart Association class, left ventricular ejection fraction and use of beta blockers) and intraoperative (number of grafts constructed, use of internal mammary anastomoses, use of sequential saphenous vein grafts, smallest grafted distal vessel lumen caliber and aortic cross-clamp time) variables. Preoperative New York Association class (p = 0.04) and smallest grafted distal vessel lumen caliber (p = 0.03) were significant multivariate predictors of perioperative AMI. Only 1 perioperative patient with AMI (and 1 pyrophosphate-negative patient) developed new Q waves. Serum creatine kinase-MB was higher in patients with AMI by repeated measures analysis of variance (p = 0.0003). Five AMIs occurred in myocardial segments revascularized using sequential saphenous vein grafts, and 7 in segments perfused by significantly stenosed epicardial vessels with distal lumen diameter and perfusion territory considered too small to warrant CABG. At 6-month follow-up, the mean left ventricular ejection fraction increased from 0.61 to 0.65 in Tc-PPI-negative patients (p = 0.01), but not in perioperative patients with AMI.

  20. Alterations in myocardial metabolism and function at rest in stable angina pectoris: relations with the amount of exercise-induced thallium-201 perfusion defect

    Energy Technology Data Exchange (ETDEWEB)

    De Kock, M.; Melin, J.A.; Pouleur, H.; Rousseau, M.F.

    1986-01-01

    The relation between the amount of exercise-induced ischemia and alterations in left ventricular (LV) function and metabolism at rest was studied in 18 coronary patients with stable angina pectoris. An ischemic defect area score was computed from quantitative exercise thallium-201 (Tl-201) scintigraphy; this estimation of the amount of ischemic myocardium was used to classify the patients in group I (n = 8; score less than 15%, mean 6.7 +/- 2.5%) and II (n = 10; score greater than 15%; mean 27.2 +/- 8.9%). Hemodynamics and metabolism were studied in basal state. No patient had anginal pain during the study, and the extent of angiographic coronary artery disease (CAD) was comparable in the two groups. Heart rate, aortic pressure, coronary blood flow, and myocardial oxygen uptake were also similar in both groups. However, ejection fraction was reduced in group II (51 +/- 13 vs 63 +/- 5%; p less than 0.01) and LV relaxation was impaired as shown by the increase in time-constant of isovolumic pressure fall (55 +/- 16 vs 44 +/- 6 ms in group I; p less than 0.05); the LV end-diastolic pressure was also increased in group II (19 +/- 8 vs 10 +/- 4 mmHg in group l; p less than 0.05). Furthermore, in group II, myocardial lactate uptake was reduced (4 +/- 19 vs 30 +/- 29 mumole/min in group I; p less than 0.01) and the productions of alanine and glutamine were augmented (-7.5 +/- 4.4 vs -4.6 +/- 1.6 mumole/min in group I; p less than 0.05).

  1. Effects of Ginkgo Leaf Extract on Function of Dendritic Cells and Th1/Th2 Cytokines in Patients with Unstable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    LI Da-zhu; SHARMA Ranjit; ZENG Qiu-tang

    2005-01-01

    Objective: To investigate the effects of Ginkgo leaf extract (GLE) on function of dendritic cells (DC) and Th1/Th2 cytokines in patients with unstable angina pectoris(UAP). Methods: Fifty-four patients with UAP were equally assigned into two groups, the treated group and the control group, both treated with conventional Western medicine, but with GLE given additionally to the treated group. Blood of all patients was taken before and 4 weeks after treatment to prepare the peripheral mononuclear cells, then which were incubated in the completed medium containing granulocyte-macrophage colony stimulatory factor (GMCSF) and interleukin-4 (IL-4) to induce mature DC. The expression of co-stimulating factor CD86 (B7-2) on the surface of DC was detected by flow cytometry, and the stimulating capacity of DC was determined by mixed lymphocyte reaction (MLR). The blood levels of cytokines, interferon-γ (IFN-γ), and IL-4, were analyzed by ELISA, and blood C-reactive protein (CRP) level by turbidimetry. Moreover, the direct effect of Ginkgolide B on CD86 expression on DC were also tested in vitro. Results: After treatment, CD86 expression on DC, the stimulating capacity of DC as well as levels of IFN-γ and CRP were lowered in both groups ( P<0.05 or P<0.01), but the changes were much more significant in the treated group than those in the control group. Ginkgolide B showed a direct inhibitory effect on the CD86 expression on DC. Conclusion: The inhibition of GLE on DC and thereby the suppression on inflammatory reaction may be one of the mechanisms of GLE in treating patients with UAP.

  2. Gambaran Angiografi Koroner Pasien Angina Pektoris Tidak stabil Berjenis Kelamin Wanita di RSUP H. Malik Medan

    OpenAIRE

    Hutagalung, Adit Muhammad Prasetya

    2016-01-01

    Unstable angina pectoris are commonly diagnosis in women who have a heart attack with non spesific symptoms. Angina pectoris in women commonly show chest pain symptom but normal coronary arteries imaging. This study aims to determine the characteristics of the location of the blockage of the coronary arteries in patients with unstable angina pectoris in women and to determine the severity of coronary artery blockages in patients with unstable angina pectoris in women in RSUP. H...

  3. 参松养心胶囊联合硝酸酯类治疗心绞痛疗效观察%Observation of Effect of Shensong Yangxin Capsule Combined with Nitrateesters in Treatment of Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    肖勇

    2010-01-01

    @@ 心绞痛(Angina Pectoris)是冠状动脉供血不足,心肌急剧的、暂时缺血与缺氧所引起的以发作性胸痛或胸部不适为主要表现的临床综合征.笔者2008-03-2009-12采用参松养心胶囊联合硝酸酯类治疗心绞痛患者84例,疗效确切,报告如下.

  4. Comparison of the efficacy and tolerability of ivabradine and ranolazine in patients of chronic stable angina pectoris

    Directory of Open Access Journals (Sweden)

    Aditi Chaturvedi

    2013-01-01

    Full Text Available Introduction: To compare the efficacy and tolerability of Ivabradine (IVA and Ranolazine (RAN in chronic angina patients. Materials and Methods: This was a follow-on, open-label trial conducted in a tertiary care hospital of Uttarakhand. Thirty patients each taking IVA 5 mg twice daily or RAN 500 mg twice daily were distributed to the respective groups. Patients were asked to fill a pretested questionnaire on frequency of anginal attacks and adverse reactions before and 2, 4 and 8 weeks after taking the respective medicines. Their blood pressure, heart rate and routine hematological and biochemical estimations were performed at baseline and after intervention. Results were statistically analyzed using different statistical tests, with P < 0.05 considered as significant. Results: There was no significant difference in the frequency of anginal attacks per week between the groups. The adverse drug reactions (ADRs reported in the IVA group were dizziness (30%, headache (16.6%, backache (16.6%, vertigo (13.3%, blurred vision (13.3%, muscle cramps (10%, arthralgia (10%, cough and dyspnea (6.6%, hypersensitivity rash (6.6%, fever (3.3% and nausea (3.3%. The ADRs in the RAN group were nausea (26.6%, dizziness (23.3%, vomiting (3.3%, constipation (3.3% and vertigo (3.3%. The blood pressure, heart rate and routine hematological and biochemical evaluations did not show any significant difference in the pre-post values. IVA significantly decreased the resting heart rate after eight weeks of intervention. Conclusions: Both antianginal agents appeared equiactive. However, RAN had a better safety and tolerability profile than IVA. Serum sickness-like reaction was an adverse event noticed with IVA, which needs causality establishment.

  5. 冠心爽合剂治疗不稳定性心绞痛的疗效及作用机制%Effect of Guanxinshuang Mixture on Unstable Angina Pectoris and Its Mechanism

    Institute of Scientific and Technical Information of China (English)

    周小明; 刘如秀; 李敏; 阚杰

    2011-01-01

    目的:观察冠心爽合剂治疗不稳定性心绞痛的疗效并探讨其作用机制.方法:将56例患者随机分为对照组和治疗组各28例.对照组给予阿司匹林肠溶片、单硝酸异山梨酯片和低分子量肝素钙注射液治疗,治疗组在上述治疗基础上加服冠心爽合剂.两组疗程均为1个月.观察两组患者单项症状、心绞痛及西雅图心绞痛量表(SAQ)评分并检测血清生物标记物.结果:治疗组可明显改善患者胸痛、胸闷、气短、腰膝酸软、头晕耳鸣症状,缩短心绞痛持续时间,减少硝酸甘油用量,增加SAQ评分(P<0.05或P<0.01).治疗后,两组血清超敏C反应蛋白(hs-CRP)均有显著降低,但治疗组降低幅度更大(P<0.05);对照组基质金属蛋白酶9(MMP-9)、金属蛋白酶组织抑制剂1(TIMP-1)均无明显变化,治疗组MMP-9明显降低(P<0.05),而TIMP-1无明显变化.结论:冠心爽合剂是治疗不稳定性心绞痛的有效中药复方,抗炎、稳定动脉斑块可能是其作用机制.%Objective To observe the effect of Guanxinshuang Mixture (herbal mixture for coronary heart disease) on unstable angina pectoris and to explore its possible mechanism.Methods Fifty-six unstable angina pectoris patients were randomized into control group and treatment group, 28 in each.The control group was given aspirin enteric-coated tablets, isosorbide mononitrate tablets and low molecular heparin, based on which, the treatment group was given Guanxinshuang Mixture as well.The treatment course was one month.Single symptom, angina pectoris and score of Seattle Angina Questionare were observed and the serum bioindicator was determined.Results The treatment group was significantly improved in relieving chest pain, chest fullness, shortness of breath, weakness and soreness in waist and knee, dizziness, and tinnitus; shortening the duration of angina pectoris, reducing the dose of nitroglycerin, and increasing SAQ score (P<0.05 or P<0.01).After treatment, the

  6. Clinical analysis of the 76 cases of coronary heart disease with stable angina pectoris and unstable angina%冠心病稳定型心绞痛与不稳定型心绞痛76例临床分析

    Institute of Scientific and Technical Information of China (English)

    朱国安

    2015-01-01

    目的:分析和探究稳定性心绞痛与不稳定型心绞痛的发病规律、诱因、临床表现、差异性和治疗措施。方法:回顾性分析76例心绞痛患者的临床特点和治疗措施,实验室及其他检查,研究稳定型心绞痛与不稳定型心绞痛的临床表现和治疗方法。结果:冠心病心绞痛常见的症状为发作性胸痛,疼痛部位主要在胸骨体中段或上段之后,稳定型心绞痛表现为阵发性的前胸压榨性疼痛,主要治疗以休息和舌下含服硝酸酯制剂。不稳定型心绞痛表现为原有劳力性心绞痛恶化,出现静息心绞痛及梗死后心绞痛,治疗以止痛、抗栓、抗凝、急诊冠状动脉介入治疗。结论:稳定型心绞痛根据临床表现以控制和减轻症状为主。不稳定型心绞痛以抗凝、防止心肌梗死为主。%Objective:To analyze and explore pathogenesis regularity,inducement,clinical manifestations,difference and treatment measures of stable angina and unstable angina.Methods:A retrospective analysis of 76 cases of angina patients clinical features and treatment measures,laboratory and other tests,studying the clinical manifestations and treatment with stable angina unstable angina.Results:Common symptoms of angina pectoris is chest pain episodes,pain in the middle part of the main body of the sternum or after the previous paragraph,stable angina showed paroxysmal crushing chest pain,the main treatment is rest and sublingual nitrates.Unstable angina is characterized by the deterioration of the existing angina pectoris,appear resting and post-infarction angina pectoris,treatment of pain,antithrombotic,anticoagulant,percutaneous coronary intervention.Conclusion:According to the clinical manifestations of stable angina in order to control and alleviate symptoms.Unstable angina with anticoagulation,prevention of myocardial infarction based.

  7. Impact of high lipoprotein(a) levels on in-stent restenosis and long-term clinical outcomes of angina pectoris patients undergoing percutaneous coronary intervention with drug-eluting stents in Asian population.

    Science.gov (United States)

    Park, Sang-Ho; Rha, Seung-Woon; Choi, Byoung-Geol; Park, Ji-Young; Jeon, Ung; Seo, Hong-Seog; Kim, Eung-Ju; Na, Jin-Oh; Choi, Cheol-Ung; Kim, Jin-Won; Lim, Hong-Euy; Park, Chang-Gyu; Oh, Dong-Joo

    2015-06-01

    Lipoprotein(a) (Lp(a)) is known to be associated with cardiovascular complications and atherothrombotic properties in general populations. However, it has not been examined whether Lp(a) levels are able to predict adverse cardiovascular outcomes in patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES). A total of 595 consecutive patients with angina pectoris who underwent elective PCI with DES were enrolled from 2004 to 2010. The patients were divided into two groups according to the levels of Lp(a): Lp(a) 50 mg/dL was significantly associated with the 3-year adverse clinical outcomes including any myocardial infarction, revascularization (target lesion revascularization (TLR) and target vessel revascularization (TVR)), TLR-major adverse cardiac events (MACEs), TVR-MACE, and All-MACEs. In our study, high Lp(a) level ≥ 50 mg/dL in angina pectoris patients undergoing elective PCI with DES was significantly associated with binary restenosis and 3-year adverse clinical outcomes in an Asian population.

  8. Systematic Review of Associated Prescriptions of Gualou and Xiebai on Unstable Angina Pectoris%《金匮要略》瓜蒌薤白类方治疗不稳定型心绞痛的系统评价

    Institute of Scientific and Technical Information of China (English)

    庄严

    2014-01-01

    Objective:To systematically assess the efficacy of the associated prescriptions of Gualou and Xiebai on unstable angina pectoris. Methods:Randomized controlled trials of associated prescriptions of Gualou and Xiebai on unstable angina pectoris were retrieved from the Cochrane library,PubMed,CNKI, Wanfang database and CBM. The risk of bias of included studies was assessed according to the criteria recommended by the Cochrane Handbook for Systematic Reviews of interventions. Such statistical analyses as heterogeneity analysis,meta-analysis,sensitivity analysis and funnel plot analysis were performed using the Review Manager 5.2.6 software. Results:Fourteen qualified trials were included. The risk of bias was generally high and clinical heterogeneity exists among them. Meta-analysis shows that the associated pre scriptions of Gualou and Xiebai can improve angina pectoris(RR=1.24,95%CI[1.18,1.31]) and ECG manifestations(RR=1.29,95%CI[1.19,1.39]),funnel plot is asymmetry. Conclusion:Current evidence indicates that treating un-stable angina pectoris with the associated prescriptions of Gualou and Xiebai can improve the efficacy on unstable angina pectoris. Due to the low quality of included studies ,clinical trials with adequate samples , rational design and strict execution should be carried out to provide more reliable evidence.%目的:系统评价《金匮要略》瓜蒌薤白类方治疗不稳定型心绞痛的临床疗效。方法:检索中国学术文献总库(CNKI)、万方数据库、中国生物医学文献数据库(CBM)、The Cochrane Library、PubMed等数据库,搜集瓜蒌薤白类方治疗不稳定型心绞痛的随机对照试验,按照Cochrane协作网推荐的方法评估纳入研究的偏倚风险,运用RevMan 5.2.6软件完成异质性检验、Meta-分析、敏感性分析、倒漏斗图分析等相关统计分析。结果:共纳入14项合格研究,均存在较高的方法学偏倚风险,Meta-分析显示瓜蒌薤白类方在

  9. Smoking, alcohol consumption, physical activity, and family history and the risks of acute myocardial infarction and unstable angina pectoris: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Gorgels Anton PM

    2011-03-01

    Full Text Available Abstract Background Few studies investigated the association between smoking, alcohol consumption, or physical activity and the risk of unstable angina pectoris (UAP, while the strength of these associations may differ compared to other coronary diseases such as acute myocardial infarction (AMI. Therefore, we investigated whether the associations of these lifestyle factors with UAP differed from those with AMI. Additionally, we investigated whether these effects differed between subjects with and without a family history of myocardial infarction (MI. Methods The CAREMA study consists of 21,148 persons, aged 20-59 years at baseline and randomly sampled from the Maastricht region in 1987-1997. At baseline, all participants completed a self-administered questionnaire. After follow-up of maximally 16.9 years, 420 AMI and 274 UAP incident cases were registered. Incidence rate ratios (RRs were estimated using Cox proportional hazards models. Results For both diseases, smoking increased the risk while alcohol consumption was associated with a protective effect. Associations with both risk factors were stronger for AMI than UAP, although this difference was only statistically significant for smoking. In men, an inverse association was found with physical activity during leisure time which seemed to be stronger for the risk of UAP than of AMI. On the contrary, physical activity during leisure time was associated with an increased risk of both AMI and UAP in women which seemed to be weaker for UAP than for AMI. Except for occupational physical activity in women, no significant interactions on a multiplicative scale were found between the lifestyle factors and family history of MI. Nevertheless, the highest risks were found in subjects with both a positive family history and the most unfavorable level of the lifestyle factors. Conclusions The strength of the associations with the lifestyle factors did not differ between AMI and UAP, except for smoking

  10. Burden of hospital admission and repeat angiography in angina pectoris patients with and without coronary artery disease: a registry-based cohort study.

    Directory of Open Access Journals (Sweden)

    Lasse Jespersen

    Full Text Available AIMS: To evaluate risk of hospitalization due to cardiovascular disease (CVD and repeat coronary angiography (CAG in stable angina pectoris (SAP with no obstructive coronary artery disease (CAD versus obstructive CAD, and asymptomatic reference individuals. METHODS AND RESULTS: We followed 11,223 patients with no prior CVD having a first-time CAG in 1998-2009 due to SAP symptoms and 5,695 asymptomatic reference individuals from the Copenhagen City Heart Study through registry linkage for 7.8 years (median. In recurrent event survival analysis, patients with SAP had 3-4-fold higher risk of hospitalization for CVD irrespective of CAG findings and cardiovascular comorbidity. Multivariable adjusted hazard ratios(95%CI for patients with angiographically normal coronary arteries was 3.0(2.5-3.5, for angiographically diffuse non-obstructive CAD 3.9(3.3-4.6 and for 1-3-vessel disease 3.6-4.1(range(all P<0.001. Mean accumulated hospitalization time was 3.5(3.0-4.0(days/10 years follow-up in reference individuals and 4.5(3.8-5.2/7.0(5.4-8.6/6.7(5.2-8.1/6.1(5.2-7.4/8.6(6.6-10.7 in patients with angiographically normal coronary arteries/angiographically diffuse non-obstructive CAD/1-, 2-, and 3-vessel disease, respectively (all P<0.05, age-adjusted. SAP symptoms predicted repeat CAG with multivariable adjusted hazard ratios for patients with angiographically normal coronary arteries being 2.3(1.9-2.9, for angiographically diffuse non-obstructive CAD 5.5(4.4-6.8 and for obstructive CAD 6.6-9.4(range(all P<0.001. CONCLUSIONS: Patients with SAP symptoms and angiographically normal coronary arteries or angiographically diffuse non-obstructive CAD suffer from considerably greater CVD burdens in terms of hospitalization for CVD and repeat CAG compared with asymptomatic reference individuals even after adjustment for cardiac risk factors and exclusion of cardiovascular comorbidity as cause. Contrary to common perception, excluding obstructive CAD by CAG in such

  11. 穴位埋线联合中药治疗不稳定型心绞痛临床观察%Clinical Observation on Treatment of Unstable Angina Pectoris with Catgut Embedding at Acupoints and Herbs

    Institute of Scientific and Technical Information of China (English)

    范宗鹏; 吴玉姣

    2013-01-01

    目的:观察穴位埋线联合中药治疗不稳定型心绞痛临床疗效及副作用.方法:将临床确诊为不稳定型心绞痛患者348 例随机分为2 组,治疗组采用穴位埋线联合中药加常规西药治疗,对照组单纯应用常规西药治疗.2 组进行临床症状,心电图疗效及副作用对比分析.结果:治疗后在胸痛发作次数、持续时间及硝酸甘油耗量治疗组均明显低于对照组(P<0.01),治疗组治疗后心电图总ST 段,总T 波压低程度低于对照组(P<0.05).结论:穴位埋线联合中药加常规西药治疗不稳型心绞痛疗效满意,副作用少.%Objective: To observe clinical effects and adverse reactions of catgut embedding at acupoints and herbs in treating unstable angina pectoris. Method: All 348 patients proved with coronary heart disease and unstable angina pectoris were randomized into two groups. The treatment group received catgut embedding at acupoints, herbs and routine western medicine, the control group were applied with routine western medicine. Curative effects, EEG and side effects were compared and analyzed. Result: The treatment group was lower than the control group significantly in the attack times of chest pain, duration and consumption of glyceryl trinitrate after treating (P<0.05), the treatment group was lower than the control group after treating in depressed degrees of total ST segment and total T segment of ECG (P<0.05). Conclusion: Catgut embedding at acupoints, herbs and routine western medicine could obtain satisfactory effects in treating unstable angina pectoris with minor side-effects.

  12. Meta-analysis of Guanxinning Injection as Adjunctive Therapy for Unstable Angina Pectoris%冠心宁注射液辅助治疗不稳定型心绞痛的Meta分析

    Institute of Scientific and Technical Information of China (English)

    王建民

    2011-01-01

    OBJECTIVE: To evaluate the clinical efficacy of Guanxinning injection as adjunctive therapy for unstable angina pectoris (UAP).METHODS: Randomized controlled trials (RCT) of Guanxinning injection as adjunctive therapy for UAP were gathered from Medline, EMBase, Cochrane Library, CBM, VIP, CNKI and Wanfang databases.The quality of included studies was evaluated and meta-analysis was carried out.RESULTS: 9 RCTs were included, all were graded C.Meta-analysis indicated that the excellence rate of symptom improvement of angina pectoris had significant difference(RR= 1.48, 95%CI[1.24, 1.76]).The excellence rate of electrocardiogram improvement had no significant difference (RR= 1.39, 95% CI[0.97, 1.99]).CONCLUSION:Guanxinning injection combined with conventional treatment for UAP could improve angina pectoris symptom and excellence rate of electrocardiogram improvement.%目的:评价冠心宁注射液辅助治疗不稳定型心绞痛(UAP)的临床疗效.方法:计算机检索Medline、EMBase、Cochrane图书馆、CBM、VIP、CNKI、万方数据库,纳入冠心宁注射液治疗UAP的随机对照试验(RCT),对纳入研究进行质量评价,并对研究数据进行Meta分析.结果:纳入9个RCT,均为C级.Meta分析结果显示,心绞痛症状改善显效率差异有统计学意义[RR=1.48,95%CI(1.24,1.76)]、心电图改善显效率差异无统计学意义[RR=1.39,95%CI(0.97,1.99)].结论:在常规治疗基础上加用冠心宁注射液治疗UAP能够提高心绞痛症状和心电图改善的显效率.

  13. Effect of behavioral therapy on quality of life in patients with coronary heart disease angina pectoris%行为干预对冠心病心绞痛患者生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    兰洁; 廖光荣; 方向红; 张秀芳; 杨雨竹

    2012-01-01

    目的:探讨行为干预对冠心痛心绞痛患者生活质量的影响.方法:将110例冠心病心绞痛患者随机分为研究组和对照组各55例,对照组按心内科常规护理,研究组在此基础上增加行为干预包括戒烟限酒、低脂低盐饮食、规律睡眠、有氧运动、放松训练、听轻音乐、减少孤独焦虑抑郁等.采用Zung焦虑自评量表(SAS)、抑郁自评量表(SDS)、体重指数(BMI)及生活质量指数评定量表(QOL),于入院后3个月对两组患者进行评估.结果:研究组健康行为改善优于对照组(P<0.01),焦虑、抑郁程度和体重指数(BMI)低于对照组(P<0.05),生活质量各维度评分均高于对照组(P<0.05).结论:常规护理加针对性行为干预可减轻冠心病心绞痛患者的焦虑、抑郁等负性情绪,改善健康行为,从而提高患者的生活质量.%Objective:To evaluate the effect of behavioral intervention on quality of life in patients with coronary heart disease angina pectoris. Methods: 110 Cases of patients with coronary heart disease angina pectoris were randomly divided into the study group (55) cases and the control group ( 55 ) cases. The control group was treated with routine cardiology nursing care. The study group received behavioral therapy including alcohol restriction and smoking giving up,low fat and salt diet,regular sleep,aerobic exercise,relaxation training,light music enjoyment,less loneliness,anxiety or depression on the basis of routine cardiology nursing. Zung Self-rating Anxiety Scale (SAS) ,Self- rating Depression Scale (SDS) ,Body Mass Index (BMI) and Quality of life Index (QOL) were taken to evaluate the two groups of patients respectively 3 months before and after the admission of patients. Results: Compared with the control group, the health behavior of patients with coronary heart disease angina pectoris in the study group was improved significantly. The SAS, SDS and BMI levels of the study group were relieved. The scoring

  14. 两种他汀类药物辅助治疗冠心病心绞痛临床对比研究%Clinical comparative study of two kinds of statins dryg in the treatment of coronary heart disease with angina pectoris

    Institute of Scientific and Technical Information of China (English)

    胡立涛

    2016-01-01

    Objective:To investigate the clinical effects difference of simvastatin and atorvastatin of statins dryg in the treatment of coronary heart disease with angina pectoris.Methods:140 patients with coronary heart disease with angina pectoris were chosen and randomly divided into two groups including A group (70 patients) with simvastatin and B group (70 patients) with atorvastatin on the basis of conventional systematic treatment; and the clinical effect of angina pectoris and ECG, the frequency of angina pectoris, duration of angina pectoris and blood lipid index before and after treatment of both groups were compared.Results:There was no significant difference in the clinical effects between 2 groups(P>0.05).There was no significant difference in the frequency of angina pectoris, duration of angina pectoris and blood lipid index after treatment between 2 groups(P>0.05).Conclusion:simvastatin and atorvastatin of statins dryg in the treatment of coronary heart disease with angina pectoris possess the same clinical effects and can efficiently relieve the symptoms and signs, improve the condition of angina pectoris and blood lipid level.%目的:探讨辛伐他汀与阿托伐他汀辅助治疗冠心病心绞痛临床疗效差异。方法:选取冠心病心绞痛患者共140例,以随机数字表法分为A组(70例)和B组(70例),分别在常规对症干预基础上加用辛伐他汀和阿托伐他汀辅助治疗;比较两组患者心绞痛和心电图疗效,治疗前后心绞痛发作频率、心绞痛持续时间及血脂指标水平等。结果:两组患者临床疗效比较差异无统计学意义(P>0.05);两组患者治疗后心绞痛发作频率、持续时间及血脂指标水平组间比较差异无统计学意义(P>0.05)。结论:辛伐他汀与阿托伐他汀辅助治疗冠心病心绞痛临床疗效接近,均可显著缓解症状体征,改善心绞痛病情和血脂水平。

  15. Observation of the Therapeutic Effect of Ferulic Acid Sodium Treating Unstable Angina Pectoris in 86 Cases%阿魏酸钠治疗不稳定型心绞痛86例疗效观察

    Institute of Scientific and Technical Information of China (English)

    裘健

    2011-01-01

    目的 观察阿魏酸钠治疗不稳定型心绞痛(UAP)的疗效及安全性.方法 164例UAP患者随机分为两组:阿魏酸钠组(治疗组)和丹参组(对照组),观察两组患者的临床症状疗效、心电图改善情况,治疗前后高敏C反应蛋白(hs-CRP)变化及不良反应发生情况.结果 治疗组临床症状及心电图改善情况均显著优于对照组(P<0.05);两组患者治疗前后hs-CRP均无显著变化(P>0.05);两组患者在治疗过程中均未出现明显不良反应.结论 阿魏酸钠治疗UAP疗效明显,安全性佳,值得临床推广应用.%Objective To observe the clinical effect and safety of ferulic acid sodium for patients with unstable angina pectoris( UAP ). Methods 164 UAP patients were randomly divided into ferulic acid sodi-um group( treatment group )and the salvia miltiorrhiza group( control group ). Clinical symptoms, electrocardi-ogram,high sensitive C-reactive protein( hs-CRP)and adverse effect were observed. Results Clinical symp-toms and electrocardiogram,amelioration in treatment group were better than control group( P 0.05 ); there was no obvious adverse effects during the treatment course in bothgroups. Conclusion Ferulic acid sodium is an efficient and safe therapeutic tool for unstable angina pectoris, worthy of clinical applica-tion.

  16. 探讨血管内皮损伤致冠心病心绞痛的发生机理%Studying the Mechanism of Damage of Vascular Endotheliocyte Result in Angina Pectoris of Coronary Heart Disease

    Institute of Scientific and Technical Information of China (English)

    韩学杰; 沈绍功

    2001-01-01

    Hyperlipidemia syndrome (Phlegm accumulates with stagnant blood syndrome) is easily to cause disorder or damage of vascular endotheliocyte,which in turn induce angina pectoris of coronary heart disease under stimulation of many kinds of pathogenic factors. According to the theory of Traditional Chinese Medicine,the occurrence of “Xiong Bi” is due to the phlegm and blood stasis which blocks heart meridian. One hypothesis of the mechanisms of phlegm accumulates with stagnant blood are increase of lipoid peroxide,oxygen free radical,attachment of lipoid to vascular endothelia cell,and injury of vascular system. which provides theory basis for study the pathogenesis of angina pectoris of coronary heart disease.%高脂血症(痰瘀互结证)易致血管内皮功能紊乱或损伤,在各种致病因素的刺激下诱发冠心病心绞痛的发作。中医认为“胸痹”的发生是由于“痰瘀互结,阻塞心脉”。痰瘀互结证的物质基础可能是脂质过氧化、氧自由基增多,脂性物质附着在血管内皮上,逐渐损伤血管内皮的病理过程。此假设为研究冠心病心绞痛的发病机制提供理论基础。

  17. 穴位按压联合艾灸治疗稳定型心绞痛33例临床观察%Clinical observation of stable angina pectoris treated by combination of acupressure and moxibustion

    Institute of Scientific and Technical Information of China (English)

    王秋云; 王玉梅; 郭雅丽

    2012-01-01

    Objective To investigate clinical effect of stable angina pectoris treated by combination of acupressure and moxibustion. Methods 66 cases of stable angina patients were randomly divided into 2 groups. 33 cases in control group received the conventional Western treatment for five weeks; 33 cases in treatment group received combination of acupressure and moxibustion on the basis of the control group 6 times a week for 5 consecutive weeks. The effect of angina, electrocardiogram and traditional Chinese medicine syndrome (chest pain, chest tightness, heart palpitations and shortness of breath) were recorded. Results The total efficiency of angina pectoris, chest pain, chest tightness, heart palpitations and shortness of breath in treatment group were 96. 97% , 96. 97% , 100% , 96.97%, 96.97%. Those of control group were 72.72% , 75.76%, 81.82%, 75.76%, 75.76%. Markedly effective rate of ECG in treatment group (63.63%) was superior to that in control group (39.39%, P<0.05). Conclusion Acupressure combined moxibustion was safe, convenient and effective on treatment of stable angina pectoris.%目的 观察定位按压联合艾灸治疗稳定型心绞痛的临床疗效.方法 将66例稳定型心绞痛患者随机分为2组,对照组33例予西医常规治疗,连续5周;治疗组33例在对照组治疗基础上加穴位按压联合艾灸,每周6次,连续5周.统计2组心绞痛、心电图及中医证候(胸痛、胸闷、心悸及气短)疗效.结果 治疗组心绞痛、胸痛、胸闷、心悸及气短总有效率分别为96.97%、96.97%、100%、96.97%、96.97%,对照组分别为72.72%、75.76%、81.82%、75.76%、75.76%,治疗组均优于对照组(P<0.05).治疗组心电图显效率63.63%,对照组显效率39.39%,2组显效率比较差异有统计学意义(P<0.05),治疗组优于对照组.结论 穴位按压联合艾灸治疗稳定型心绞痛安全方便,疗效确切.

  18. Gender difference of clinical characteristics in Chinese patients with spontaneous variant angina

    Institute of Scientific and Technical Information of China (English)

    ZHU Cheng-gang; GUO Yuan-lin; GAO Zhan; ZHENG Xin; LI Jian-jun; XU Yan-lu; YUAN Jin-qing; QIN Xue-wen; YANG Yue-jin; QIAO Shu-bin; CHEN Ji-lin; CHEN Zai-jia

    2010-01-01

    Background Spontaneous attack of variant angina (VA) is a unique component of coronary artery disease (CAD), and associated with severe cardiac events. However, no data are available regarding sex differences in Chinese patients with spontaneous attacks of VA. Accordingly, the present retrospective study was initiated to evaluate the Clinical characteristics of Chinese female patients with spontaneous attacks of VA.Methods From January 2003 to January 2008, a total of 209 patients were diagnosed to have had a spontaneous attack of VA at Fu Wai Hospital. Of them, 27 were female, and their clinical findings were collected and compared with male patients for aspects of risk factors, clinical features and angiographical findings.Results Spontaneous attacks of VA was relatively uncommon in female (12.9%) compared with male patients. The female patients were less likely to have a history of smoking (14.8% vs. 79.7%, P <0.001), more likely to have a family history of CAD (33.3% vs. 11.0%, P<0.01), and to have had a greater incidence of ventricular fibrillation during attack (11.1% vs. 2.2%, P<0.05). There were no significant differences in other characteristics between the two groups.Conclusion Chinese female patients who experienced a spontaneous attack of VA had the characteristics of less smoking history, more family history of CAD and higher occurrence of ventricular fibrillation than male patients.

  19. 益气活血通络法对38例冠心病心绞痛治疗的疗效分析%Yiqi huoxue t2dm method for the treatment of 38 cases of coronary heart disease angina pectoris curative effect analysis

    Institute of Scientific and Technical Information of China (English)

    徐兴培

    2014-01-01

    目的:正确了解益气活血通络法对冠心病心绞痛的治疗疗效。方法:随机抽取76例冠心病心绞痛患者,并利用数字法随机分成两组,每组38例患者。分别采用益气活血通络法(实验组)西医治疗的方法(对照组)对每组冠心病心绞痛患者进行治疗,并对其疗效及心电图进行分析。结果:益气活血通络法治疗的38例冠心病心绞痛患者治愈率及心电图有效率分别为90%、85%均高于西医治疗74%、65%。结论:益气活血通络法对冠心病心绞痛有治疗效果,在临床上治疗冠心病心绞痛可靠有效。%objective: to correctly understand the yiqi huoxue t2dm method for the treatment of coronary heart disease angina pectoris curative effect. Methods: randomly selected 76 cases of coronary heart disease angina pectoris patients, and USES the method of digital randomly divided into two groups, each group of 38 patients. Yiqi huoxue t2dm method (experimental group) were used respectively to the treatment of western medicine (control group) treatment of coronary heart disease angina pectoris patients in each group, and to analyze the curative effect and electrocardiogram (ecg). Results: the yiqi huoxue t2dm method of 38 patients with coronary heart disease angina pectoris cure rate and ecg effective rate were 90%, 85%, 74%, 65% higher than that of western medicine treatment. Conclusion: yiqi huoxue method of t2dm has therapeutic effect on coronary heart disease angina pectoris, reliable in clinical treatment of coronary heart disease angina pectoris effectively.

  20. Symptoms of angina pectoris increase the probability of disability pension and premature exit from the workforce even in the absence of obstructive coronary artery disease

    DEFF Research Database (Denmark)

    Jespersen, Lasse; Abildstrøm, Steen Z; Hvelplund, Anders

    2013-01-01

    To evaluate probabilities of disability pension (DP) and premature exit from the workforce (PEW) in patients with stable angina symptoms and no obstructive coronary artery disease (CAD) at angiography compared with obstructive CAD and asymptomatic reference individuals.......To evaluate probabilities of disability pension (DP) and premature exit from the workforce (PEW) in patients with stable angina symptoms and no obstructive coronary artery disease (CAD) at angiography compared with obstructive CAD and asymptomatic reference individuals....

  1. The efficacy of new agents for unstable angina pectoris and preliminary exploration on design of clinical trial of these agents%不稳定型心绞痛药物疗效及设计方案初探

    Institute of Scientific and Technical Information of China (English)

    奚悦文; 范维琥

    2001-01-01

    不稳定型心绞痛是冠心病中常见的类型,是介于稳定型心绞痛与急性心肌梗死和猝死之间的临床状况。本文总结了抗不稳定型心绞痛药物的疗效评价,其主药为抗凝血药物及抗血小板药物;并针对不稳定型心绞痛特殊的临床过程,对如何进行临床试验设计作了初步探讨。%Unstable angina pectoris(UAP) is a common coronary heart disease with a clinical symptom situated between stable angina pectoria and acute myocardial infarction.The evaluation studies on efficacy of agents for UAP,including antiplatelets and anticoagulants,were reviewed,and preliminary exploration on how to design clinical trials of these agents was also provided in this paper.

  2. Meta-analysis of Dengzhanshengmai capsule in the treatment of angina pectoris%灯盏生脉胶囊治疗冠心病心绞痛的Meta分析

    Institute of Scientific and Technical Information of China (English)

    雷玉华; 唐其柱

    2015-01-01

    目的评价灯盏生脉胶囊治疗冠心病心绞痛的临床效果。方法计算机检索中国生物医学文献数据库(网络版)、CNKI数据库、万方数据库、维普中文科技期刊全文数据库、PubMed中有关灯盏生脉胶囊治疗冠心病心绞痛疗效的随机对照试验(RCT),检索时限为建库至2013年12月。对文献质量进行严格评价后,采用Review Manager 5.1软件对纳入的研究结果进行Meta分析。结果共纳入10篇RCT文献,3项疗效指标比较差异均有显著性。心绞痛临床症状疗效评价结果显示,OR=3.55,95%CI:2.40~5.24;心电图变化疗效评价结果显示,OR=2.43,95%CI:1.68~3.51;心血管事件结果评价显示,OR=0.34,95%CI:0.20~0.58。结论冠心病心绞痛患者在常规治疗基础上加用灯盏生脉胶囊可明显改善心绞痛症状,有效控制心绞痛发作。%Objective To evaluate the efifcacy and safety of Dengzhanshengmai capsule in the treatment of angina pectoris. Method The data based on PubMed, CNKI, CBM, Wanfang and VIP Data were retrieved for collecting the randomized controlled trials (RCT) about Dengzhanshengmai capsule treated with angina pectoris from the date of establishment of the databases to December 2013. After the critical evaluation on the quality of literature, the extracted data were analyzed by Review Manager 5.1 software. Result A total 10 pieces of RCT were discovered. Meta-analysis showed that there was statistical difference between 3 effect index in evaluating the symptoms of angina efifcacy, OR = 3.55, 95%CI:2.40 ~ 5.24, the ECG efifcacy, OR=2.43, 95%CI:1.68~3.51, and the incidence of adverse cardiac events, OR=0.34, 95%CI:0.20~0.58. Conclusion Dengzhanshengmai capsule can significantly improve the clinical condition of patients with angina pectoris, and decrease the incidence of adverse cardiac events.

  3. Clinical analysis of diltiazem hydrochloride combined with nitroglycerin in the treatment of unstable angina pectoris%盐酸地尔硫和硝酸甘油联合治疗不稳定型心绞痛的效果

    Institute of Scientific and Technical Information of China (English)

    柳青; 李慧芳; 刘丽凤; 董瓅瑾

    2012-01-01

    Objective To observe the efficacy of injection of diltiazem hydrochloride combined with nitroglycerin in the treatment of unstable angina pectoris. Methods 101 patients with unstable angina pectoris in our hospital were randomly divided into test group (re =51) and control group (re = 50) . The test group was administered with diltiazem hydrochloride in combination with nitroglycerin while the control group was given nitroglycerin alone. After 48 hours, the two groups of patients were observed and compared in terms of anginal attacks, heart rate, Prt, Qrto, 01 interval time, blood pressure, myocardial oxygen consumption index, blood routine, blood biochemical index. JvesultS Ihere was no death, no complications or significant arrhythmias and hemodynamic changes. After treatment, the heart rate and myocardial oxygen consumption index of the test group decreased more significantly ( P < 0. 05 ) than in the control group. PR interval and QT interval of the test group were slightly longer than those of the control group, but without significant difference. Conclusion Injection of diltiazem hydrochloride combined with nitroglycerin in the treatment of unstable angina pectoris patients induces no serious adverse rectons and can effectively relieve angina,significantly reduce myocardial oxygen con- sumption and provide better myocardial protection.%目的 观察注射用盐酸地尔硫和硝酸甘油联合治疗不稳定型心绞痛的临床疗效.方法 选择我院住院的101例不稳定型心绞痛患者,随机分为实验组(n=51) 和对照组( n=50),对照组单用硝酸甘油,实验组应用硝酸甘油和盐酸地尔硫联合治疗.观察并比较两组患者用药48 h对心绞痛发作次数、心率、PR间期、QRS时限、QT间期、血压、心肌耗氧指标、血常规、血生化等指标.结果 两组均无并发症,无死亡,并且血流动力学的改变及心律失常的发生率差别均无统计学意义.实验组治疗后心率

  4. 耳穴压豆在冠心病急性心绞痛患者中的应用%Application of acupressure therapy with Wangbuliuxing at auricular point in CHD patients with acute angina pectoris

    Institute of Scientific and Technical Information of China (English)

    王洪燕

    2016-01-01

    Objective:To investigate the application of acupressure therapy with Wangbuliuxing at auricular point in patients with acute angina pectoris resulting from coronary heart disease(CHD). Methods:80 patients with acute angina pectoris were randomly divided into the observation group and the control group(40 cases in each group). The conventional treatment and nursing care were given to the pa-tients in the control group;the acupressure therapy with Wangbuliuxing at auricular point was additionally adopted in the observation group. The heart rate and systolic blood pressure of the patients,clinical curative effect,angina attack frequency and duration were com-pared between the two groups. Results:The heart rate and systolic blood pressure of the patients was lower in the observation group than the control group after the acupressure therapy for 10,20 and 30 minutes respectively(P < 0. 05);there were statistically significant differences between the two groups in the comparison of the total effective rate,angina attack frequency and duration of the patients during hospitaliza-tion(P < 0. 05). Conclusion:The acupressure therapy with Wangbuliuxing at auricular point has has the two - way adjustment function and it can quickly relieve symptoms,reduce angina attack frequency and shorten the duration.%目的:探讨耳穴压豆在冠心病急性心绞痛患者中的应用。方法:将80例冠心病急性心绞痛患者随机分为观察组和对照组各40例,对照组给予常规治疗和护理,观察组在此基础上给予耳穴压豆治疗,比较两组心率、收缩压、临床疗效、心绞痛发作次数及持续时间。结果:观察组按压10、20、30 min 时心率和收缩压均低于对照组(P <0.05),两组总有效率、住院期间心绞痛发作次数及持续时间比较差异均有统计学意义(P <0.05)。结果:耳穴压豆治疗对冠心病急性心绞痛患者的心率和血压有双向调节作用,能够迅速缓解患

  5. 心绞痛患者血清hsCRP、MIF及IL-1O水平与临床分型研究%Detection of high-sensitivity C-reactive protein, macrophage migration inhibitory factor and interleukin-10 in patients with angina pectoris

    Institute of Scientific and Technical Information of China (English)

    徐向明; 黄运林; 钟巧媚; 黄瑞香; 何坚

    2012-01-01

    Objective To explore the relationship between angina pectoris clinical subtype and biomarkers by detecting the level of serum high-sensitivity C-reactive protein (hsCRP),macrophage migration inhibitory factor (MlF)and interleukin-10 (IL-10) in patients with stable angina pectoris and unstable angina pectoris. Methods 43 cases of stable angina pectoris patients and 50 cases of unstable angina pectoris patients were enrolled into the study. 40 cases of healthy volunteers were enrolled into the controlled group.The serum level of hsCRP,MIF and IL-10 was detected by ELISA. The data were then analyzed by One-way ANOVA. Results The serum level of hsCRP (12.53±2.89)mg/L in unstable angina pectoris patients was significantly higher than the controlled group (3.46±1.02)mg/L and stable angina pectoris paiients (4.51±0.98)mg/L (P<0.05). The serum level of MIF (30.94±5.85)μg/L in unstable angina pectoris patients was significantly higher than the controlled group (8.31±1.38)μg/L and stable angina pectoris patients(9.85±1.44)μg/L(P<0.05). There was no significant difference in the level of hsCRP and MIF between the stable angina pectoris and controlled group. The serum level of IL-10 in the unstable and stable angina pectoris group was (19.44±2.11)ng/L and(20.19±2.04) ng/L, respectively. The value was significantly higher than the controlled group (14.89±2.49) ng/L (P<0.05). Conclusion A distinct pattern of inflammatory and anti-inflammatory biomarkers in patients with stable and unstable angina pectoris was observed. The balance of inflammatory and anti-inflammatory response may be associated with the disease progress.%目的 检测稳定型心绞痛患者及不稳定型心绞痛患者外周血血清高敏C反应蛋白(hsCRP)、巨噬细胞移动抑制因子(MIF)、白介素10(IL-10)水平,了解其变化与患者临床分型之间的关系.方法 共收入43例稳定型心绞痛患者和50例不稳定型心绞痛患者,同时收入40例健康志愿者作为对照

  6. 曲美他嗪对冠心病稳定性劳力型心绞痛患者心肌缺血的影响%Effect of trimetazidine on myocardial ischemia in patients with stable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    吴奇志

    2010-01-01

    目的 探讨曲美他嗪对冠心病(CHD)稳定性劳力型心绞痛患者心肌缺血的影响.方法 选择在1周内经2次运动试验,结果为阳性且运动持续时间变异低于10%的CHD稳定性劳力型心绞痛患者40例,在原有治疗不变的情况下,加用曲美他唪20 mg,3次/d,治疗12周.治疗前后均行平板运动试验,观察用药前后下述指标的变化:①用药前后每周心绞痛发作的次数;②每周硝酸甘油片的用量;③心率及心率与收缩压的乘积;④运动诱发心绞痛发作所需的时间;⑤运动后ST段下降1 mm所需的时间;⑥运动持续时间;⑦总工作量.结果 曲美他嗪应用12周后,患者每周心绞痛发作次数及硝酸甘油片的用量明显下降(P<0.05),而对心率及心率与收缩压的乘积的影响无统计学意义(P>0.05).与试验前相比,运动耐量和总工作量显著提高(P<0.01),至心绞痛发作的时间及ST段下降1 mm所需的时间均明显延长(P<0.01).不良反应较少.结论 曲美他嗪能增加CHD稳定性劳力型心绞痛患者的运动耐量,改善运动诱发心绞痛的心肌缺血,且安全有效,易于耐受.%Objective To evaluate the efficacy of trimetazidine on myocardial ischemia in patients with stable angina pectors. Methods 40 stable exertional angina patients with two positive exercise tests within one week and the difference of duration of exercise between two tests ≤ 10% were included, with routine treatment were given trimetazidine 20 mg, tid for 12 weeks. Treadmill exercise testing was adopted and the following inde xes were invesgated before and after therapy: ①times of angina petoris attack every week; ② consumption of ni troglycerin every week;③heart rate systolic pressure and their product;④time for inducing angina pectoris by exercise; ⑤time for inducing 1 mm ST segment depression by exercise; ⑥the total exercise time; ⑦total work load. Results After 12 weeks therapy of trimetazidine angina petoris

  7. Markers of fibrinolytic potency and clotting activation in stable angina pectoris : Role of urokinase, assessment of atrioventricular differences and correlation with coronary patency

    NARCIS (Netherlands)

    Páramo, U.A.; Panizo, C.; Montes, R.; Orbe, J.; Alegría, E.; Martínez-Caro, D.; Dooijewaard, G.

    1999-01-01

    To characterize the extent of activation of the hemostatic system and to detect local alterations which may favour thrombus formation we obtained samples from the right atrium (RA) and left ventricle (LV) of 60 stable angina patients (mean age 59 years, M/F: 49/11) during the cardiac catheterization

  8. 冠心病心绞痛经皮冠状动脉介入治疗术的临床观察%Clinical observation of percutaneous coronary intervention on the patients with angina pectoris

    Institute of Scientific and Technical Information of China (English)

    崔年芳; 郭杰

    2011-01-01

    Aim To observe the efficacy of PCI(percutaneous coronary intervention) in patients with stable angina pectoris or acute coronary syndrome according to the disease process. Methods 34 inpatients with angina pectoris were collected from June to July in 2009 and divided into two groups, stable angina and unstable angina, by chest pain. The characteristics of the patients ,their medical history, age and the attacking situation were analyzed. The efficacy of the stent, and disease related risk factors were compared between the two groups ,as well as the relevant laboratory examinations,such as troponin T(cTnTl) ,Chest X-ray,ECG,the stenosis and extent of the lesion of related arteries tested by CAG. Results Among the 34 patients,23 patients were hospitalized as acute coronary syndrome(ACS) and 14 patients(4 patients with stable angina and 10 patients with unstable angina) were for hospital in emergency during 12 hours given the treatment of CAG and PCI. The other 20 patients were treated with non-emergency PCI. One case was relieved by giving conservative medical treatment for the opening and proximal part of LAD without suitable catheter. 8 patients,with three diffuse diseased arteries and without any indication for stent interventional treatment,were transferred for surgery. 2 patients with myocardial bridge were transferred to another hospital. Conclusion Acute coronary syndrome is the most common emergency case in the cardiovascular department,as well as stable angina. The patients with those indications should be cured with CAG and PCI as soon as possible to rehabilitate the myocardial necrosis and improve the prognosis. The increase of blood-sugar and fibrin in unstable angina group is significantly higher than stable angina group. But there is no significant difference in blood-lipid,creatase and development of hypertensive disease between two groups.%目的 观察稳定型心绞痛、急性冠脉综合征患者经皮冠状动脉介入治疗(PCI)临床疗效与

  9. Clinical Analysis of Patients with Type 2 Diabetes Combined with Unstable Angina Pectoris%2型糖尿病合并不稳定型心绞痛患者的临床分析

    Institute of Scientific and Technical Information of China (English)

    王隽书; 林珊珊; 佘其美; 董亚苒

    2013-01-01

      目的探讨合并与不合并2型糖尿病的不稳定型心绞痛患者临床特点。方法选取合并与不合并2型糖尿病的患者各100例,对两组患者的临床特点进行分析比较。结果2型糖尿病合并不稳定型心绞痛组患者高血压史、高血脂史、空腹血糖、甘油三酯、低密度脂蛋白、纤维蛋白原高于对照组患者,高密度脂蛋白低于对照组;冠状动脉病变程度大于对照组( P<0.05)。结论2型糖尿病组患者冠状动脉病变复杂严重,应积极采取有效措施控制患者血压、血糖、血脂及纤维蛋白原。%Objective To discuss the clinical features of unstable angina pectoris and unstable angina pectoris with type 2 diabetes . Methods Type 2 diabetic group(n=100 cases) and control group(n=100 cases) were chosen ,the clinical characteristics of the two groups of patients were analyzed and compared .Results The history of hypertension ,history of high cholesterol ,fasting glucose , triglycerides ,low density lipoprotein ,fibrinogen of Type 2 diabetic group were more than control patients ;the high-density lipopro-tein was less than control group .From coronary artery disease ,Type 2 diabetic group was higher than control group ( P<0 .05) . Conclusion Patients with Type 2 diabetic suffer from complex and serious coronary lesions ,and effect measures should be applied to actively control the blood pressure ,the blood sugar ,the blood lipids and the fibrinogen .

  10. Influence of Comprehensive Nursing on Life Quality of Senile Patients with Coronary Heart Disease Angina Pectoris%综合护理对老年冠心病心绞痛患者生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    张红丽; 刘海荣; 王媛; 刘文莉

    2014-01-01

    目的:探讨综合护理对老年冠心病心绞痛患者生活质量的影响。方法:将106例老年冠心病心绞痛患者随机分为观察组及对照组各53例,观察组采用综合护理干预措施,对照组采用一般常规护理干预,对比2组的生活质量。结果:对于疾病的认知程度评分及疼痛、精力、睡眠、情绪反应、社交隔离、躯体活动、总指数等生活质量评分2组干预后均明显升高(P<0.05),观察组升高更明显(P<0.05)。结论:综合护理可有效改善老年冠心病心绞痛患者的生活质量。%Objective:To explore the effects of comprehensive nursing on life quality of senile patients with coronary heart disease angina pectoris. Methods:All 106 patients were randomized into the observation group and the control group, the observation group were given with intervention measures of comprehensive nursing and the control group routine care, life quality of both groups were compared. Results:The scales of disease cognition and life quality scales containing pain, energy, sleep, emotional response, social isolation, physical activity, total indexes and others were raised significantly after the intervention (P<0.05), the improvement of the observation group was more notable (P<0.05). Conclusion:Comprehensive nursing could effectively improve life quality of senile patients with coronary heart disease angina pectoris.

  11. Clinical Research about Different Antiplatelet Scheme forTreatment of Unstable Angina Pectoris%不同抗血小板方案治疗不稳定性心绞痛疗效临床研究

    Institute of Scientific and Technical Information of China (English)

    邓应忠; 曹晨; 郑兴萍

    2011-01-01

    Objective:To compare unstable angina pectoris curative effect of single,double, double dual antiplatelet therapy.Methods:325 cases of unstable angina patients were divided into dual antiplatelet group of 120 patients,single-agent antiplatelet group 114 cases,the first two group therapy invalid cases into double dual antiplatelet therapy.Observe clinical treatment effect of unstable angina pectoris.Results:Dual antiplatelet therapy was significantly effective in 71 cases(59.17%),effective in 23 cases(19.17%)and invalid in 26 cases(21.67%).Single-agent antiplatelet therapy was significantly effective in 56 cases (49.12%),effective in 19 cases(16.67%)and invalid in 39 cases (34.12%).P<0.05,the difference was statistically significant.Double dual antiplatelet therapy was significantly effective in 21 cases(65.63%),effective in 5 cases(15.63%)and invalid in 6 cases(28.6%).Conclusions:Dual antiplatelet therapy is more effective than single-agent antiplatelet therapy in treatment of unstable angina,double dual antiplatelet therapy can further enhance the curative effect.%目的:比较单重、双重、加倍双重抗血小板治疗不稳定性心绞痛(UAP)的疗效,探讨UAP更好的治疗方案.方法:234例不稳定型心绞痛患者分为双重抗血小板组120例、单重抗血小板组114例,前两组治疗无效病例进入加倍双重抗血小板治疗组32例.观察UAP临床治疗效果.结果:双重抗血小板治疗组显效71例(59.17%),有效23例(19.17%),无效26例(21.67%).单重抗血小板治疗组:显效56例(49.12%),有效19例(16.67%),无效39例(34.21%);差异有统计学意义(P<0.05).加倍双重抗血小板治疗组:显效21例(65.63%),有效5例(15.63%),无效6例(28.6%).结论:双重抗血小板治疗较单重抗血小板治疗有UAP治疗更好的疗效,加倍双重抗血小板治疗可以进一步提高疗效.

  12. Application Effect of Overall Nursing Intervention in Patients With Coronary Heart Disease Combined With Angina Pectoris%冠心病合并心绞痛患者行整体护理干预的应用效果探析

    Institute of Scientific and Technical Information of China (English)

    贾玲

    2015-01-01

    目的:探讨冠心病合并心绞痛患者行整体护理干预的临床应用效果。方法随机将我院2014年3月~2015年3月收治的130例冠心病合并心绞痛患者分为两组,每组65例。对照组采用常规护理,观察组在对照组基础上实施整体护理干预,观察两组血压、心绞痛发作次数及护理满意度等指标。结果观察组血压、心绞痛发作次数、护理满意度等指标均优于对照组,差异具有统计学意义(P<0.05)。结论冠心病合并心绞痛患者行整体护理干预临床效果理想,患者护理满意度高。%Objective To investigate the clinical application of overal nursing intervention effect in the coronary heart disease and angina pectoris patients. MethodsWe divided 130 patients with coronary heart disease and angina pectoris from March 2014 to March 2015 into two groups randomly,65 cases in each group. Control group using conventional nursing,the observation group was implemented overal nursing intervention on the basis of control group,observed two groups of blood pressure,attack frequency of angina pectoris and nursing satisfaction index.Results The observation group blood pressure,attack frequency of angina pectoris,nursing satisfaction index were significantly better than the control group,difference had statistical significance(P< 0.05).Conclusion The effect of overal nursing intervention effect in the coronary heart disease and angina pectoris patients is significant,improving nursing satisfaction.

  13. Clinical Non-inferiority Trial on Treatment of Coronary Heart Disease Angina Pectoris of Xin-blood Stasis Syndrome Type with Lyophilized Salvia Salt of Lithospermic Acid Powder for Injection

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To evaluate the effectiveness and safety of lyophilized Salvia salt of lithospermic acid powder for injection (SSLA) in treating coronary heart diseases angina pectoris (CHD-AP) of Xin-blood positive control. Methods: An non-inferiority clinical layered, segmented, randomized, and blinded trial on three parallel and multiple centered groups was conducted in 480 patients with stable effort angina grade Ⅰ ,Ⅱ and Ⅲ, who had two or more times of attack every week. The 240 patients in test group A were treated with SSLA 200 mg added in 250 ml of 5% glucose solution for intravenous dripping every day; the 120 patients in test group B were treated with SSLA but the dosage doubled; and the 120 patients in the control group were treated with DSI 20 ml daily in the same method as SSLA was given. The clinical effectiveness and safety were evaluated after the patients were treated for 14 days. Results: The results showed that the markedly effective rate in test groups A, B and control group was 37.45 %, 36.75 % and 30.09 % respectively, while the total effective rate in them was 88.09%, 89.74% and 67.26% respectively. Statistical significance was shown in comparisons of the therapeutic effect between control group with test group A and test group B, with that in the two test groups superior to that in the control group, and non-inferiority trial showed eligibility (P<0.01). Adverse reaction appeared in 8 patients in the test groups and 2 in the control group.Conclusion: SSLA has definite therapeutic effect in treating patients with CHD-AP, with its effect not inferior to that of DSl, and no evident toxic-adverse reaction.

  14. Relationship between coronary artery remodeling and cumulative incidence of coronary angiographic lesions with vulnerable characteristics in patients with stable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    SUN Ling; L(U) Shu-zheng; JIN Ze-ning; SONG Xian-tao

    2010-01-01

    ackground Development of vulnerable lesions is not limited to the target lesions, but a pan-coronary process. Such lesions are identified by positive remodeling (intravascular ultrasound (IVUS) and complex lesions (angiography)). The prevalence of lesions with vulnerable characteristics in patients with stable angina was not well known. The purpose of the present study was to evaluate the relationship between coronary artery remodeling and incidence of angiographic complex lesions and its calcification in stable angina patients.Methods One hundred and sixty-one stable angina patients (95 males, aged (68±11) years) with 161 de novo target lesions were studied using pre-interventional IVUS. Remodeling index was defined as the lesion divided by reference vessel area; positive remodeling was defined as remodeling index >1.05. Besides the 161 target lesions, there were 613 angiographic lesions with >30% diameter stenoses, classified as complex or smooth. Multiple complexes were defined as more than one complex lesion in one patient. Stenoses of at least 70% were described as tight. Calcium arc area was used as a new method to quantify coronary calcification.Results Fifty-six patients had positive remodeling target lesion, while 105 did not. The overall number of lesions with a diameter stenoses >30% was similar in patients with or without positive remodeling, and the frequency of angiographically complex lesions was higher in positive remodeling patients, especially at non-target site. Calcium arc area was smaller in patients with positive remodeling.Conclusions Positive remodeling on intravascular ultrasound was associated with more complex lesions angiographic findings, especially at non target site. Positive remodeling was found less calcified in patients with stable angina.

  15. Transient transmural reduction of myocardial blood flow, demonstrated by thallium-201 scintigraphy, as a cause of variant angina

    Energy Technology Data Exchange (ETDEWEB)

    Maseri, A.; Parodi, O.; Severi, S.; Pesola, A.

    1976-08-01

    In previous studies we demonstrated that variant angina could not be attributed to increased myocardial demands. In order to investigate whether a reduction of regional myocardial blood supply could be responsible for these ischemic episodes, we studied regional myocardial perfusion in six patients admitted to our coronary care unit. Myocardial scintigrams, obtained 5-7 min following i.v. injection of 1 mCi of thallium-201, performed during an episode of ST-segment elevation, showed transmural deficits of tracer uptake in the heart wall corresponding to the leads showing ST-segment elevation. These regional deficits had disappeared by 2 hours because of late uptake in previously ischemic myocardium. One week later, following injections performed in the absence of acute ischemia, no deficit was apparent. Tracer uptake in ischemic areas was 60 percent to 85 percent of that observed a week later. After adjusting for thallium-201 kinetics and counting geometry problems, these scintigrams actually represent large underestimations of actual flow reduction. Thus variant angina appears to be caused by massive transmural reduction of myocardial blood supply.

  16. Shexiang Baoxin Pill treatment of elderly patients with chronic stable angina pectoris%麝香保心丸治疗老年慢性稳定性冠心病心绞痛

    Institute of Scientific and Technical Information of China (English)

    刘锋

    2013-01-01

    Objective: To observe the curative ef ect of Shexiang Baoxin Pil in the treatment of elderly patients with chronic coronary heart disease and angina pectoris. Methods:68 patients with coronary heart disease in our hospital, were randomly divided into two groups, the control group oral isosorbide dinitrate, Baoxin Pil containing musk treatment group under the tongue. Results: the treatment group total ef ectiveness 97.1%, the control group the total ef ective 83.8%. Conclusion: the method has obvious curative ef ect, improve the life quality of the patients.%目的:观察麝香保心丸治疗老年慢性冠心病心绞痛的疗效。方法选择本院门诊68例冠心病患者,随机分两组,对照组口服消心痛,治疗组舌下含化麝香保心丸。结果治疗组总有效97.1%,对照组总有效83.8%。结论此法疗效显著,提高患者生活质量。

  17. The Effects of Xuefu Zhuyu and Shengmai on the Evolution of Syndromes and Inflammatory Markers in Patients with Unstable Angina Pectoris after Percutaneous Coronary Intervention: A Randomised Controlled Clinical Trial

    Directory of Open Access Journals (Sweden)

    Jie Wang

    2013-01-01

    Full Text Available We evaluated the effects of the Xuefu Zhuyu capsule (XFZY and the Shengmai capsule (SM on the evolution of syndromes and inflammatory markers in patients with unstable angina pectoris (UAP after percutaneous coronary intervention (PCI. Ninety patients with UAP after PCI were randomly and equally assigned to three groups: the XFZY group, the SM group, and the placebo group, with 30 patients in each group. Six syndrome factors (including Qi deficiency, yin deficiency, yang deficiency, blood stasis, phlegm, and Qi stagnation and 4 inflammatory markers (high-sensitivity C-reactive protein (Hs-CRP, endothelins-1 (ET-1, matrix metalloproteinases-9 (MMP-9, and homocysteine (Hcy were observed at week 0 and at the 1st, 4th and 12th weeks. In conclusion, the evolution of syndromes present in patients with UAP after PCI followed these trends (1 The deficiency syndromes gradually increased during a 12-week period, but the excess syndromes first gradually decreased and then mildly increased after PCI. (2 XFZY and SM can prevent excess syndromes from increasing in the later stages and prevent deficiency syndromes from increasing in all stages. (3 XFZY and SMcan reduce the levels of the inflammatory markers, especially in the later stages after PCI.

  18. Comparison of Outcomes of Patients ≥80 Years of Age Having Percutaneous Coronary Intervention According to Presentation (Stable vs Unstable Angina Pectoris/Non-ST-Segment Elevation Myocardial Infarction vs ST-Segment Elevation Myocardial Infarction)

    DEFF Research Database (Denmark)

    Antonsen, Lisbeth; Jensen, Lisette Okkels; Thayssen, Per;

    2011-01-01

    ,792 elderly patients (≥ 80 years old) were treated with PCI and the annual proportion increased from 224 (5.4%) in 2002 to 588 (10.2%) in 2009. The clinical indication was stable angina pectoris (SAP) in 30.2%, ST-segment elevation myocardial infarction (STEMI) in 35.0%, UAP/non-STEMI in 29.......08 to 4.85), UAP/non-STEMI (hazard ratio 1.95, 95% confidence interval 1.53 to 2.50), and ventricular arrhythmia or congestive heart failure (hazard ratio 2.75, 95% confidence interval 1.92 to 3.92). In patients with SAP target vessel revascularization decreased from 7.1% in 2002 to 2.5% in 2008....... In conclusion, the proportion of patients ≥ 80 years old treated with PCI increased significantly over an 8-year period. Patients with SAP had the lowest mortality rates and rates of clinically driven target vessel revascularization decreased over time....

  19. Transient myocardial ischemia during nifedipine therapy in stable angina pectoris, and its relation to coronary collateral flow and comparison with metoprolol

    DEFF Research Database (Denmark)

    Egstrup, K; Andersen, P E

    1993-01-01

    angina and coronary artery disease were randomized to a parallel double-blind study with nifedipine and metoprolol, and compared for effects on transient ischemic episodes during ambulatory electrocardiographic monitoring and exercise-induced ischemia. The effects were correlated to the presence...... at either the onset of transient ischemia out of the hospital or exercise-induced ischemia. This was in contrast with the effect in 21 patients treated with metoprolol (9 in group 1, and 12 in group 2) where significant reductions were observed in the frequency of both total (p

  20. 丹参多酚酸盐注射液治疗冠心病心绞痛的系统评价%Salvianolate injection for treatment of angina pectoris:A systematic review

    Institute of Scientific and Technical Information of China (English)

    赵业清; 朱慧娟; 文九芳

    2012-01-01

    Objective It is to assess the efficacy and safety of Salvianolate injection for the treatment of angina pectoris. Methods We electronically searched CNKI,VIP and CBM, we also checked the reference lists of all papers identified for further trials. Randomized controlled trials ( RCT ) of the effect of Salvianolate injection on angina pectoris were identified and assessed according to the Cochrane Handbook for Systematic Reviews of Interventions and then RevMan5.0 was used to undertake Mata analysis. Results Eight trials involving 867 patients were included, their method quality evaluation were all C degree. Mate-analysis showed that:①Compared with the controlled group, Salvianolate injection was capable of significantly decreasing the angina incidence( OR =2. 75 ,95% CI 1. 86 to 4. 05 ,P 、、的相关文献以及所获文献的参考文献,筛选到有应用丹参多酚酸盐注射液治疗冠心病心绞痛的随机对照试验(RCT),按照纳入与排除标准选择试验、评价质量和提取有效数据,而后采用RevMan 5.0软件进行Meta分析.结果 共纳入8个RCT,包括867例患者,其方法学质量评价均评为C级.Meta分析结果显示:①心绞痛发作有效率试验组高于对照组(OR=2.75,95%CI(1.86,4.05),P<0.00001);②心电图复查有效率试验组高于对照组(OR=1.96,95%CI(1.23,3.11),P=0.004);③不良反应:试验组与对照组有统计学差异(OR=0.16,95%CI(0.05,0.46),P=0.0007).结论 现有研究表明,丹参多酚酸盐注射液能有效改善冠心病心绞痛患者心绞痛的临床症状,使患者心电图复查有效率显著提高,并最终显著降低心绞痛发作率,且安全性更高.但由于本系统评价纳入研究证据强度不高,且样本量较小,故上述结论尚需更多高质量RCT进一步验证.

  1. [Effectiveness of nifedipine on exercise tolerance in patients with angina pectoris. Comparison with a nitroderivative and a beta-blocking agent].

    Science.gov (United States)

    De Ponti, C; Mauri, F; Fiorista, F; Ciliberto, G R; Carù, B; Rovelli, F

    1977-01-01

    The effect of nifedipine on effort angina was investigated by means of exercise tests with bycicle ergometer and compared, in the same patients, with the effects of a nitroderivative and a betablocking agent. Five patients with stable effort angina entered the study, after an hemodynamic and contrasto-graphic control. According to the protocol of a latin square 5 X 5, all the patients received in a random sequence the following treatments: placebo, 1 c. orally; isosorbide dinitrate, 5 mg sublingually; propranolol, 40 mg orally; nifedipine, 10 mg sublingually; nifedipine, 10 mg orally. No significant change of any of the considered parameters was observed after the placebo. Isosorbide dinitrate and nifedipine produced significant increases of the duration of work before appearance of pain and EKG positivity, and of total work performed before anginal pain. Only the duration of work before EKG positivity was improved by propranolol. The comparisons between treatments showed no significant difference of the effects of the administered doses of isosorbide dinitrate and nifedipine. The improvements observed after propranolol were significantly lower than that observed after isosorbide dinitrate and oral nifedipine. On the basis of the observed changes of cardiac rate, maximal arterial pressure, ejection time index and triple product, the authors evaluate the possible mechanism of action of nifedipine.

  2. Management of coronary risk factors by registered nurses versus usual care in patients with unstable angina pectoris (a chest pain evaluation in the emergency room [CHEER] substudy).

    Science.gov (United States)

    Allison, T G; Farkouh, M E; Smars, P A; Evans, R W; Squires, R W; Gabriel, S E; Kopecky, S L; Gibbons, R J; Reeder, G S

    2000-07-15

    This study examined whether nurses could manage coronary risk factors in patients with unstable angina more effectively than physicians practicing usual care. Three hundred twenty-six patients were randomized in the emergency room to a 6-month program of risk factor management by a registered nurse versus participation in usual care. The nurse intervention consisted of a 30-minute counseling visit at 6 to 10 days after the chest pain episode and a second 30-minute session 1 month later. Multiple risk factors were assessed and addressed: smoking, blood lipids, blood pressure, blood glucose, physical inactivity, weight, psychological stress, and social isolation. Compared with usual care, nurse intervention patients significantly reduced both triglycerides (-29 +/- 8 vs 5 +/- 6 mg/dl; p chest pain is feasible and more effective than usual care in terms of fostering lifestyle changes that may lower coronary risk.

  3. Parenterale und orale Glykoprotein IIb/IIIa-Antagonisten bei instabiler Angina pectoris - gibt es noch eine Chance für oral wirksame Substanzen?

    Directory of Open Access Journals (Sweden)

    Darius H

    2001-01-01

    Full Text Available Die intravenösen Glykoprotein IIb/IIIa-Antagonisten Abciximab, Tirofiban und Eptifibatide sind wissenschaftlich ohne Zweifel für die Therapie der instabilen Angina und als Begleitmedikation bei Koronarinterventionen etabliert, auch wenn die Anwendung dieser Substanzen in der klinischen Praxis noch ungenügend ist. Insbesondere für das Abciximab konnte eine Letalitätsreduktion auch 3 Jahre nach der Therapie für ein Hochrisikokollektiv von Patienten überzeugend nachgewiesen werden. Für die Therapie des akuten Myokardinfarktes zusammen mit verschiedenen Fibrinolytika werden alle drei Substanzen zur Zeit in größeren Studien untersucht. Die sehr umfangreichen Untersuchungen bei Patienten mit instabiler Angina und nach Koronarinterventionen, die mit den oralen Glykoprotein IIb/IIIa-Antagonisten durchgeführt wurden, haben allesamt enttäuschende Ergebnisse erbracht. Es konnten nur schwache therapeutische Effekte im Sinne einer Reduktion von ischämischen Rezidivereignissen festgestellt werden, wobei jedoch bei allen Untersuchungen eine Tendenz zu einer leicht erhöhten Letalität in der Therapiegruppe im Vergleich zur jeweiligen Placebogruppe festgestellt werden konnte. In einer Metaanalyse wurde eine ca. 35%ige Erhöhung der Sterblichkeit für die mit den oralen Antagonisten behandelten Patienten errechnet. Die Gründe für diesen therapeutischen Fehlschlag könnten in der geringen Bioverfügbarkeit der verschiedenen Substanzen liegen oder in dem bisher noch ungenügenden Verständnis des Verhaltens des thrombozytären GPIIb/IIIa-Rezeptors beim Versuch einer Langzeitblockade. Weitere Substanzen mit anderen pharmakokinetischen Eigenschaften sind derzeit noch in der klinischen Entwicklung.

  4. XuanYun Kang Decoction Combined with Betahistine in Treating 99 Cases of Stable Angina Pectoris%眩晕康汤联合倍他司汀治疗无痛性心绞痛99例

    Institute of Scientific and Technical Information of China (English)

    写国斌; 展存丽; 张军

    2016-01-01

    Objective: To observe clinical effects of XuanYunKang decoction jointed with betahistine in treating stable angina pectoris. Methods: All 198 patients were randomized into the observation group and the control group, 99 cases each group, both groups accepted routine treatment, the control group were treated by betahistine, the treatment group received XuanYunKang decoction and betahistine, both groups were treated for 14 days. Results: Total effective rates of the observation group and the control group were 94.9% and 84.8% respectively, the observation group was superior to the control group in clinical effects(P<0.05). The levels of LVEDD, LVESD, hsCRP and cTnI decreased obviously after treating (P<0.05), the decrease of the observation group was more obvious (P<0.05). The observation group was significantly lower than the control group in the incidences of the complications including discomforts in the upper abdomen, sour regurgitation, poor appetite, liver function damage and others (P<0.05). Conclusion: XuanYunKang decoction jointed with betahistine in treating stable angina pectoris could effectively improve heart function and decrease the expressions of inflammatory factors with high safety.%目的:观察眩晕康汤联合倍他司汀治疗气虚血瘀型无痛性心绞痛的临床疗效。方法:将198例患者随机分为观察组与对照组各99例,2组均给予常规基础治疗,对照组在此基础上给予倍他司汀治疗,治疗组给予眩晕康汤联合倍他司汀治疗,2组均治疗14天。结果:总有效率观察组、对照组分别为94.9%、84.8%,临床疗效观察组优于对照组(P<0.05)。左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)及超敏C-反应蛋白,肌钙蛋白(cTnI)值2组治疗后均明显下降,观察组下降更明显,2组比较差异有统计学意义(P<0.05)。治疗期间上腹部不适、反酸、纳差、肝功能损害等并发症发生率观察

  5. Clinical efficacy of Low-molecular-weight Heparin Sodium combined Aspirin in the treatment of unstable angina pectoris%低分子肝素钠联合阿司匹林治疗不稳定型心绞痛疗效分析

    Institute of Scientific and Technical Information of China (English)

    谢平

    2011-01-01

    目的:观察低分子肝素钠联合阿司匹林治疗不稳定型心绞痛(UA)的临床疗效.方法:将67例住院的UA患者随机分为对照组(34例)和治疗组(33例),治疗组使用低分子肝素钠加阿司匹林,对照组单用阿司匹林,疗程为1周,结果:治疗组总有效嘈<为96.96%,对照组为76.47%.两组疗效比较,差异有统计学意义(P<0.05).结论:低分子肝素钠联合阿司匹林治疗UA能明显减少心绞痛的发作,改善临床症状,具有安全有效的特点.%Objective: To observe the clinical efficacy of Low-molecular-weight Heparin Sodium combined Aspirin in the treatment of unstable angina pectoris. Methods: 67 cases of patients with unstable angina pectoris were randomly divided into control group (34 cases) and treatment group (33 cases). The control group was received Aspirin for 1 week. The treatment group was received Low-molecular-weight Heparin Sodium for 1 week based on the control group. Results: The total effective rate of treatment group was 96.96% and was significantly higher than that of control group (76.47%) (ρ<0.05). Conclusion: Low-molecular-weight Heparin Sodium combined with Aspirin is effective and safe in the treatment of unstable angina pectoris.

  6. 伊伐布雷定治疗稳定型心绞痛疗效的Meta分析%A Meta-analysis of efficacy and safty of trimetazidine in treatment of patients with stable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    张格格; 黄从新

    2014-01-01

    Objective System evaluation of ivabradine's effective and safty in treatment of stable angina pectoris . Methods From Chinese academic journal full text database (CNKI) (1997-2014.4), Wanfang database (1989-2014. 4), EMBASE (1974-2014.4), PUBMED (1966-2014.4) database retrieval of ivabradine randomized controlled trials on the treatment of stable angina pectoris , the observation group application of ivabradine therapy , the control group application of conventional drugs , with rest and maximum heart rate during exercise , the decreased value of ST segment depression in 1 mm threshold, the value and the movement exercise hypertension duration weighted 5 aspects of the weighted mean difference ( WMD) as indicators of efficacy , the relative risk ( RR) of adverse reactions in 2 groups as the safety index to perform the Meta-analysis.Results A total of 8 randomized controlled clinical trials were included , including 4 582 patients, including 2 439 cases in observation group , 2 143 cases in the control group .The results showed that , the observation group resting heart rate decrease obviously than that in the control group (WMD=4.83, 95% CI 2.39-7.28, P =0.000 1); motion maximum heart rate decrease obviously than that in the control group (WMD=7.22, 95% CI 2.60-11.85, P =0.002);ST segment depression in 1 mm threshold is better than that of the control group (WMD=12.04, 95%CI 2.84-21.25,P=0.01);exercise duration better than the control group (WMD=31.80, 95%CI 25.76-37.84, P <0.01);exercise blood pressure with the highest value of the control group had no significant difference (StdWMD=0.02,95% CI -0.52-0.56, P=0.93);there were no significant difference of adverse reaction between the observation group and the control group (RR=2.43, 95%CI 1.33-4.45, P =0.004).Conclusion Ivabradine in the treatment of stable angina pectoris is well , as well the safety, worthy of clinical application .%目的:系统评价伊伐布雷定治疗稳定型心绞痛的有效性和安全

  7. 瓜蒌薤白半夏汤对不稳定性心绞痛心脏室壁运动的影响%The effects of gualouxiebaibanxia decoction on the cardiac ventricular wall motion abnormalities in unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    林培森

    2012-01-01

    目的观察瓜蒌薤白半夏汤对不稳定性心绞痛(UAP)心脏室壁运动异常的疗效.方法将120例经心彩超证实有心脏室壁运动异常的UAP患者随机分为治疗组与对照组,每组各60例.对照组采用常规的西药治疗,治疗组在西药治疗基础上加用瓜蒌薤白半夏汤,疗程均为1个月.结果与对照组比较,治疗组在缓解心绞痛发作方面的有效率优于对照组(93.3% VS 83.3%),治疗组在胸痹证候改善方面的有效率也优于对照组(86.6% VS 73.3%),治疗组在改善心电图方面的有效率也优于对照组(81.6% VS 63.3%),治疗组在改善心脏室壁运动异常的有效率也优于对照组(78.3% VS 65%),差异均有显著性意义(P<0.05).结论应用瓜蒌薤白半夏汤治疗UAP疗效确切,可明显改善心电图及心脏室壁运动异常.%Objective: To observe the curative effects of gualouxiebaibanxia decoction on the cardiac ventricular wall motion abnormalities in unstable angina pectoris. Methods: 120 cases of patients with ustable angina pectoris and cardiac ventricular wall motion abnormalities were randomly divided into two groups, treatment group and control group, 60 cases in each group. Control group was treated with western medicine and treatment group with gualouxiebaibanxia decoction and western medicine for one month. Results: Compared with the control group, the efficacy of treatment group was better in relieving angina pectoris(81.6% VS 63.3%), improving chest syndrome(86.6% VS 73.3%), improving electrocardiograph (81.6% VS 63.3%), and improving cardiac ventricular wall motion abnormalities(78.3% VS 65%). The differences were significant (P <0.05). Conclusion: It is effective that treating unstable angina pectoris with gualouxiebaibanxia decoction, which can significantly improve electrocardiograph and cardiac ventricular wall motion abnormalities.

  8. Progression of Material Basis Related to Angina Pectoris of Ligusticum chuanxiong Based on Efficacy and Pharmacology%基于功效与药理作用川芎抗冠心病心绞痛的物质基础研究进展

    Institute of Scientific and Technical Information of China (English)

    龚彦胜; 李晓字; 孙蓉

    2011-01-01

    Objective To summarizing the current states of material basis of Ligusticum chuanxiong, identify effective composition and its molecular mechanisms in Ligusticum chuanxiong related with angina pectoris, offer the accordance and research ideas for further research of Ligusticum chuanxiong. Methods The related references in recent 20 years about Ligusticum chuanxiong were analyzed, collated and summarized. Results The main compositions in Ligusticum chuanxiong related with angina pectoris are ligustilide, chuanxiongzine and ferulic acid. Research is almost on their pharmacological characteristics, but on molecular mechanisms is not deep enough. Conclusion Ligusticum chuanxiong has obvious therapeutic effect on angina pectoris. The effective composition and its molecular mechanisms related to angina pectoris are still at an initial stage.%目的 总结川芎物质基础研究现状,明确川芎中与冠心病心绞痛相关的有效成分及其分子机制,为川芎在治疗冠心病心绞痛的应用提供文献依据和研究思路.方法 对近二十年与川芎有关的文献进行整理、分析、归纳.结果 川芎中与治疗冠心病心绞痛相关的成分主要有藁本内酯、川芎嗪、阿魏酸,对藁本内酯、川芎嗪、阿魏酸的药理作用研究较多,但对其作用机制及体内过程的研究尚不明确.结论 川芎在冠心病心绞痛的治疗中疗效显著,对其抗冠心病心绞痛的物质基础、作用机制及体内过程等研究还处于初级阶段.

  9. Are negative aspects of social relations predictive of angina pectoris? A 6-year follow-up study of middle-aged Danish women and men

    DEFF Research Database (Denmark)

    Lund, Rikke; Rod, Naja Hulvej; Christensen, Ulla

    2011-01-01

    after adjustment for age, gender, social class, cohabitation status and depression in a dose-response manner. For example, experiencing excessive demands or worries always/often from different roles in the social relations was associated with an increased risk: partner OR=3.53 (1.68 to 7.43), children...... OR=2.19 (1.04 to 4.61), other family OR=1.91 (1.24 to 2.96). Except for frequent conflicts with the partner and neighbours, conflicts with the social relations was not a risk factor for angina. The authors found no interaction of negative aspects of social relations with gender, age, social class......Background Social relations have been shown to be protective against ischaemic heart disease (IHD), but little is known about the impact of negative aspects of the social relations on IHD. Methods During a 6-year follow-up, the authors aimed to assess if negative aspects of social relations were...

  10. 体外心脏震波系统治疗顽固性心绞痛的临床探讨%Clinical study on treatment of extracorporeal cardiac shocK wave therapy in refractory angina pectoris patients

    Institute of Scientific and Technical Information of China (English)

    刘保逸; 陈聪霞; 张瑞生; 李文婵; 姚稚明; 何青

    2015-01-01

    Objective To evaluate the efficacy and safety of extracorporeal cardiac shock wave system ( CSWT ) in treating refractory angina pectoris patients. Methods Fifteen patients with severe coronary artery disease which was documented by coronary angiogram present with refractory angina pectoris were selected. The ischemic area was determined by the 99m Technetium-MIBI single-photon emission computed tomography (SPECT). The CSWT were performed in 3 months, and totally 9 times. The clinical evaluations include Canadian Cardiovascular Society ( CCS) class scores, New York Heart Association class ( NYHA ) , Seattle angina questionnaire ( SAQ ) , 6-min walking distance and the use of dosage of nitroglycerin;left ventricular end diastolic diameter ( LVEDD ) and left ventricular ejection of fraction ( LVEF) were also evaluated by echocardiography. The amelioration of ischemic myocardial was analyzed by SPECT, through comparison of myocardial perfusion scores and ischemic area before and after treatment. The variation of segment myocardial dysfunction was assessed by wall motion and wall thickening. Results CSWT obviously ameliorated CCS, NYHA, SAQ score, improved 6-min walking distance and decreased the use of nitroglycerin dose, but there was no significant changes in LVEDD and LVEF. SPECT date showed that in the treated segment, the rest myocardial perfusion score decreased from 1. 89 ± 0. 94 to 1. 37 ± 1. 07 (p=0. 004) and stress perfusion score also decreased from 2. 56 ±1. 19 to 1. 70 ±1. 27 (p=0. 000). The rest ischemic area decreased from 30. 81% ± 36. 60% to 17. 19% ± 28. 34% ( p =0. 004 ) and stress ischemic area from 61. 85% ± 30. 89% to 46. 31% ± 35. 72% ( p=0. 001 ) . The ventricular wall motion was improved from (6. 48 ± 2. 71) mm to (7. 49 ± 2. 43) mm (p=0. 007) and thickening from 44. 00% ± 22. 66% to 50. 46% ± 19. 91% (p=0. 038) in the rest, but no significant changes in the stress. There was no significant changes in CK, CKMB, TNT and there was no

  11. Comparison in regard to myocardial sympathetic denervation between {sup 123}I-MIBG and {sup 201}Tl in patients with vasospastic angina pectoris

    Energy Technology Data Exchange (ETDEWEB)

    Ohta, Katsuhisa [Kanazawa Medical Univ., Uchinada (Japan)

    1996-06-01

    Of the patients who were diagnosed as having vasospastic angina (VSA) with coronary spasm proven by acetylcholine (Ach) on coronary angiograms were used as the subjects. There were 39 males and 15 females. MIBG and Tl were administered to all of the 54 cases before coronary angiography. MIBG in a dose of 111 Mbq was injected intravenously at rest. A photograph was taken after 3 hours for a delayed image. Tl myocardial blood flow image was taken immediately after exercise loading and a redistribution image 3 hours later. Results of administration of MIBG and Tl were restudied 3 to 6 months after inception of the treatment in 14 out of 54 cases. The proportion of positive cases was significantly high with MIBG, with 52 (97%) out of 54 cases found positive with MIBG and 10 (19%) out of 54 cases with Tl (p<0.05). The number of cases which were positive with both MIBG and Tl was 10 (19%) but there was no positive case with Tl alone. 42 (78%) out of 54 cases were found positive with MIBG alone, which was significantly high compared with the Tl positive cases (P<0.01). The sensitivity of MIBG tended to be higher than that of Tl, with the sensitivity 19.6% and specificity 42.8% with Tl against the sensitivity 74.4% and specificity 36.8% with MIBG (P<0.1). A significant improvement (P<0.01) was noted with MIBG, with the defect score after treatment being -8.9{+-}6.0 against -13.5{+-}7.7 before treatment. With Tl no significant difference was found, with -5.2{+-}2.3 after treatment against -8.2{+-}4.3 before administration. In VSA, the frequency of the decline in accumulation was higher with MIBG than with Tl. MIBG is thought to sharply reflect past ischemia. With MIBG, a significant improvement in the defect score was seen before and after treatment. So MIBG considered useful for judging the therapeutic effect as well. (K.H.)

  12. Effect of short-term high-dose atorvastatin on systemic inflammatory response and myocardial ischemic injury in patients with unstable angina pectoris undergoing percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    Sun Fei; Yin Zhao; Shi Quanxing; Zhao Bei; Wang Shouli

    2014-01-01

    Background Percutaneous coronary intervention (PCI) could develop periprocedural myocardial infarction and inflammatory response and statins can modify inflammatory responses property.The aim of this study was to evaluate whether short-term high-dose atorvastatin therapy can reduce inflammatory response and myocardial ischemic injury elicited by PCI.Methods From March 2012 to May 2014,one hundred and sixty-five statin-naive patients with unstable angina referred for PCI at Department of Cardiology of the 306th Hospital,were enrolled and randomized to 7-day pretreatment with atorvastatin 80 mg/d as high dose group (HD group,n=56) or 20 mg/d as normal dose group (ND group,n=57) or an additional single high loading dose (80 mg) followed 6-day atorvastatin 20 mg/d as loading dose group (LD group,n=52).Plasma C-reactive protein (CRP) and interleukin-6 (IL-6) levels were determined before intervention and at 5 minutes,24 hours,48 hours,72 hours,and 7 days after intervention.Creatine kinase-myocardial isoenzyme (CK-MB) and cardiac troponin I (cTnl) were measured at baseline and then 24 hours following PCI.Results Plasma CRP and IL-6 levels increased from baseline after PCI in all groups.CRP reached a maximum at 48 hours and IL-6 level reached a maximum at 24 hours after PCI.Plasma CRP levels at 24 hours after PCI were significantly lower in the HD group ((9.14±3.02) mg/L) than in the LD group ((11.06±3.06) mg/L) and ND group ((12.36±3.08) mg/L,P <0.01); this effect persisted for 72 hours.IL-6 levels at 24 hours and 48 hours showed a statistically significant decrease in the HD group ((16.19±5.39) ng/L and (14.26±4.12) ng/L,respectively)) than in the LD group ((19.26±6.34) ng/L and (16.03±4.08) ng/L,respectively,both P <0.05) and ND group ((22.24±6.98) ng/L and (17.24±4.84) ng/L,respectively).IL-6 levels at 72 hours and 7 days showed no statistically significant difference among the study groups.Although PCI caused a significant increase in CK-MB and cTnl at

  13. Nitroglycerin alone and its combination with other drugs for treatment of unstable angina pectoris:A meta-analysis%硝酸甘油单用与联用治疗不稳定性心绞痛疗效的Meta分析

    Institute of Scientific and Technical Information of China (English)

    关秀萍; 黎明丽; 杨柳

    2011-01-01

    背景:在治疗不稳定性心绞痛时,联硝酸甘油合用药的疗效是否要优于单用,尚缺乏相关的循证医学证据.目的:评估硝酸甘油单用与联用治疗不稳定性心绞痛的疗效.方法:通过计算机和手工系统检索Cochrane 图书馆(2010 年第2 期)、Medline、Embase、Science Direct、SIGLE、GreyNet、中国生物医学文献数据库(CBMdisc)、中文科技期刊全文数据库(VIP)、中国期刊全文数据库(CNKI)和万方数据库,纳入硝酸甘油单用与联用比较用于治疗不稳定性心绞痛的临床随机对照试验,评价其方法学质量后采用RevMan 5.0 软件,对其疗效进行Meta 分析.结果与结论:纳入8 个单中心临床随机对照试验,共715 例患者,方法学质量均为B 级.Meta 分析结果显示:硝酸甘油联用的临床疗效和心电图疗效优于单独应用(RR =0.79,95%CI:1.56~3.08,P < 0.01;RR =0.72,95%CI:0.64~0.81,P <0.01).但上述结果可能存在各种偏倚,建议根据临床症状及循证医学证据选用恰当的联用药物而非滥用.%BACKGROUND: Nitroglycerin is widely used as first-line drug to treat unstable angina pectoris, but the development of tolerance is a major problem that may reduce its clinical efficacy. It has been suggested that the addition of other drugs to nitroglycerin can reverse the development of tolerance, potentiate the hemodynamic response to nitroglycerin and may improve therapy prognosis in unstable angina pectoris.OBJECTIVE: To evaluate whether nitroglycerin combined with drugs show better curative effects than nitroglycerin alone in treatment of unstable angina pectoris.METHODS: A computer-based online search of Cochrane Library, Medline(ovid), EMbase, Science direct, SIGLE, GreyNet,CBMdisc, VIP, CNKI and Wanfang Data for the clinical randomized controlled trials (RCTs) of nitroglycerin alone and its combination of drugs for treating unstable angina pectoris. Hand searching was also done to obtain any further information

  14. Feature of clinic and imageology in patients with unstable angina pectoris after radiation therapy to chest%经胸放射治疗后的不稳定型心绞痛患者冠状动脉影像学及临床特点分析

    Institute of Scientific and Technical Information of China (English)

    隋春兴; 刘文民; 周旭晨; 郑晓群

    2009-01-01

    目的 观察经胸放射治疗后冠心病患者的冠状动脉影像学及临床特点.方法 选择不稳定型心绞痛(UAP)患者58例,其中经胸放射治疗后的UAP患者28例(经胸放疗后组);普通UAP患者30例(普通心绞痛组).全部患者行冠状动脉多排螺旋CT(MSCT)检查、冠状动脉造影术(CAG)及经皮冠状动脉介入治疗(PCI),随访1年,测定两组患者脑钠尿肽(BNP)水平,观察心血管事件的发生率,并进行比较.结果 经胸放疗后组冠状动脉病变特点与普通心绞痛组比较,钙化病变、多支病变、血栓病变以及PCI术中夹层发生率明显升高,1年随访时BNP水平较普通心绞痛组高[(234.31±121.39)ng/L比(124.74±37.81)ng/L],室壁运动指数、新发心功能不全及再发心绞痛、再次血运重建的比例也较普通心绞痛组高,差异均有统计学意义(P<0.05).结论 经胸放射治疗后患者冠状动脉病变以复杂病变为主,同时因放射性心肌及瓣膜损伤,使得该类患者远期预后更差.%Objective To observe feature of clinic and imageology in patients with unstable angina pectoris after radiation therapy to chest. Methods The study enrolled 58 patients who had unstable angina pectoris. Twenty-eight patients were in the postradiation therapy to chest group, 30 patients were in the common unstable angina pectoris group. All patients underwent multislice spiral CT(MSCT) examination and coronary angiography (CAG). After one year follow-up, the levels of brain natriuretic peptide (BNP) and ventricular wall motion score index (WMSI) were measured , the incidence of cardiovascular events were observed in all patients. Results Calcific, multi-vessel, thrombotic disease and dissection were significantly different between the two groups, when one year follow-up , the levels of BNP were higher in the postradiation therapy to chest group than those in the common unstable angina pectoris group [ (234.31 ± 121.39) ng/L vs (124.74 ±37.81) ng/L] WMST

  15. 川芎嗪注射液治疗不稳定型心绞痛疗效的Meta分析%Meta-analysis of ligustrazine injection in the treatment of unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    刘光先

    2012-01-01

    Objective It is to systematacially evaluate the effectiveness of compound ligustraxine injection in treatment of unstable angina pectoris( UAP ) on the basis of normal therapy. Methods Databases of MEDLINE, the Cochrane Library, CNKI, CBM, VIP and Wanfang were searched by evidence based medicine method, randomized controlled trials( RCT ) of treatment of UAP with ligustraxine injection ( experiment group ) compared with treatment of UAP with normal therapy were collected. Bias risk of included RCTs was evaluated and homogeneity studies were meta-analyzed. Results 12 RCTs were gathered in tatal, meta-analysis results indicated that the difference in clinical symptoms excellent rate and electrocardiographic excellent rate were significant between experiment group and control group. RR = 1. 33, 95% Cl( 1.12, 1. 58 ), P = 0. 01, RR = 1. 54, 95% CI( 1. 16, 2.05 ), P =0.003. Conclusion Based on the recent clinical evidence, ligustraxine injection added to conventional therapy for the treatment of UAP is better than conventional treatment alone.%目的 系统的评价在常规用药基础上加用川芎嗪注射液治疗不稳定型心绞痛的疗效和安全性.方法 采用循证医学方法,全面检索MEDLINE、Cochrane图书馆、CNKI、CBM、维普和万方数据库,纳入在常规治疗基础上加用川芎嗪注射液(试验组)对比常规(对照组)治疗不稳定型心绞痛的随机对照试验,对纳入研究进行偏倚分析,对同质性结果进行合并分析.结果 共纳入12个试验,Meta分析结果显示,试验组和对照组临床症状疗效显效率和心电图疗效显效率都有显著性差异:RR=1.33,95%CI(1.12,1.58),P=0.01、RR=1.54,95%CI(1.16,2.05),P=0.003.结论 基于目前临床证据,在常规治疗基础上加用川芎嗪注射液治疗不稳定型心绞痛疗效优于单纯常规治疗.

  16. Effect of folic acid supplementation on levels of circulating Monocyte Chemoattractant Protein-1 and the presence of intravascular ultrasound derived virtual histology thin-cap fibroatheromas in patients with stable angina pectoris.

    Directory of Open Access Journals (Sweden)

    Kjetil H Løland

    Full Text Available BACKGROUND: Virtual Histology Intravascular Ultrasound (VH-IVUS may be used to detect early signs of unstable coronary artery disease. Monocyte Chemoattractant Protein-1 (MCP-1 is linked with coronary atherosclerosis and plaque instability and could potentially be modified by folic acid treatment. METHODS: In a randomized, prospective study, 102 patients with stable angina pectoris (SAP received percutaneous coronary intervention and established medical treatment as well as either homocysteine-lowering folic acid/vitamin B12 (± B6 or placebo (± B6 for 1 year before VH-IVUS was performed. The presence of VH-Thin-Cap Fibroatheroma (VH-TCFA in non-intervened coronary vessels was registered and serum levels of MCP-1 were measured. The patients were subsequently followed for incident myocardial infarction (MI. RESULTS: Patients treated with folic acid/vitamin B12 had a geometric mean (SD MCP-1 level of 79.95 (1.49 versus 86.00 (1.43 pg/mL for patients receiving placebo (p-value 0.34. VH-TCFA lesions were present in 7.8% of patients and did not differ between intervention arms (p-value 0.47. Serum levels of MCP-1 were 1.46 (95% CI 1.12 to 1.92 times higher in patients with VH-TCFA lesions than in those without (p-value 0.005. Afterwards, patients were followed for median 2.1 years and 3.8% experienced a myocardial infarction (MI, which in post-hoc Cox regression analyses was independently predicted by both MCP-1 (P-value 0.006 and VH-TCFA (p-value 0.01. CONCLUSIONS: In patients with SAP receiving established medical treatment, folic acid supplementation is not associated with either presence of VH-TCFA or levels of MCP-1. MCP-1 is however associated with VH-TCFA, a finding corroborated by increased risk for future MI. ClinicalTrials.gov Identifier: NCT00354081.

  17. A Meta-analysis of Salvianolate injection on treating unstable angina pectoris%丹参多酚盐治疗不稳定型心绞痛的Meta分析

    Institute of Scientific and Technical Information of China (English)

    刘莉

    2015-01-01

    目的:评价丹参多酚盐注射液治疗不稳定型心绞痛的疗效以及安全性。方法:检索并选取国内公开发表的有关丹参多酚盐注射液治疗不稳定型心绞痛的随机对照试验研究,采用Jadad评分法进行质量评价,运用RevMan4.3软件进行Meta分析。结果:9项研究经Meta分析结果显示丹参多酚盐注射液提高了不稳定型心绞痛患者的临床疗效;在改善心电图方面均优于对照组。结论:丹参多酚盐注射液对不稳定型心绞痛具有一定疗效,且不良反应发生率较低,但由于现有研究质量较低,仍需要设计严格、大样本的随机对照试验加以证实。%Objective:To evaluate the efficiency and safety of Salvianolate injection on unstable angina pectoris(UAP). Methods:Randomized controlled trials about Salvianolate injection on UAP were retrieved to screen the qualified researches. The Jadad score was used to evaluate the quality. The data was statistically analyzed by Meta-analysis. Results:9 studies were incorporated by Meta-analysis and the results showed that the treatment group was better than control group in terms of improving curative effect and improving ischemic ECG. Conclusion: Meta-analysis manifests that Salvianolate injection showed certain curative effect on UPA, and the occurrence rate of adverse drug reactions is lower. Because the quality of present researches was lower, these results should be verified by strictly-designed and large-scale sample randomized control trial.

  18. 基于冠心病心绞痛患者报告的临床结局评价量表的科学性考评%Scientific evaluation on rating scale based on angina pectoris patients-reported outcomes

    Institute of Scientific and Technical Information of China (English)

    何庆勇; 荆鲁; 农一兵; 王阶; 朱明军; 马长生; 叶勇; 林谦; 衷敬柏; 汤艳莉; 熊兴江

    2011-01-01

    Objective: Reliability, validity and responsiveness analysis of rating scale based on angina pectoris patientsreported outcomes.Methods: 237 patients with angina pectoris confirmed by coronary angiography were enrolled with multicenter.(Including 159 patients with angina pectoris, 78 patients with coronary artery sclerosis).Methodds of Cronbach's a coefficient and Guttman Split-half were used for reliability analysis.Factor analysis was used for assessment the construct validity of scale.The content validity and criteria validity of scale were assessed by Spearman rank correlation analysis.Discriminated validity of scale were assessed by independent samples t test, and responsiveness of scale were assessed by pair samples t test.Results: ① The Cronbach's α coefficient of scale was 0.813, split-half reliability was 0.707.②Total variance explained of scale was 50.08% by factor analysis.Each entry had a strong correlation with their respective field (P<0.01), each entry can be better to represent the theme of their respective field, except the first entry.The total scale, physical field, psychological field, the field of social relations and social environment of the field had good discriminated validity (P<0.05), except the independence of the field.The total of rating scale based on angina pectoris patients-reported outcomes and Seattle Angina Scale had a good correlation (correlation coefficient was 0.689, P<0.001).③The rating scale based on angina pectoris patients-reported outcomes had good responsiveness (P<0.001).Conclusion: The rating scale based on angina pectoris patients-reported outcomes have good reliability, validity and responsiveness.And the the rating scale based on angina pectoris patients-reported outcomes can be used for clinical evaluation.%目的:评价基于冠心病心绞痛患者报告的临床结局评价量表的信度、效度和反应度.方法:多中心收集了237例经冠脉造影证实的患者(159

  19. Therapeutic effect of atorvastatin combined trimetazidine on treating unstable angina pectoris%阿托伐他汀联合曲美他嗪治疗不稳定型心绞痛的疗效

    Institute of Scientific and Technical Information of China (English)

    廖永红

    2014-01-01

    目的:研究阿托伐他汀(ATO)联合曲美他嗪(TRZ)对不稳定型心绞痛(UAP)的疗效。方法:选择2011年3月到2013年3月在我院被确诊为UAP的患者100例。以数字法随机分为 ATO组(常规药物治疗基础上加入 ATO,50例),ATO+ TRZ组(在ATO组基础上另加用TRZ,50例)。对比两组疗效及治疗前后血脂水平情况。结果:ATO+TRZ组,总有效率为96.00%(48/50),显著高于 ATO组的76.00%(38/50)(P<0.05)。治疗后两组血脂水平均有显著改善,与 ATO 组比较,ATO+TRZ 组总胆固醇[TC,(4.78±0.65)mmol/L 比(4.12±0.60)mmol/L]、甘油三酯[TG,(1.54±0.51)mmol/L比(1.02±0.53)mmol/L]及低密度脂蛋白-胆固醇[LDL-C,(3.02±0.46)mmol/L比(2.32±0.45)mmol/L]水平显著降低,高密度脂蛋白胆固醇[HDL-C,(1.57±0.58)mmol/L比(2.12±0.55)mmol/L]显著升高,差异均有统计学意义(P 均<0.05)。结论:阿托伐他汀与曲美他嗪联合治疗不稳定型心绞痛患者,疗效更显著,值得临床推荐。%Objective:To study the therapeutic effect of atorvastatin (ATO)combined trimetazidine (TRZ)on un-stable angina pectoris (UPA).Methods:A total of 100 UAP patients in our hospital from Mar 2011 to Mar 2013 were enrolled.According to number table method,they were randomly divided into ATO group (received ATO ad-ditionally based on routine medication,n=50)and ATO+TRZ group (received TRZ additionally based on ATO group treatment,n=50).Levels of blood lipids and therapeutic effects were compared between two groups before and after treatment.Results:Total effective rate was 96.00% (48/50)in ATO+TRZ group,which was signifi-cantly higher than that of ATO group (76.00%),P<0.05.Compared with ATO group,there were significant re-ductions in levels of total cholesterol [TC,(4.78±0.65)mmol/L vs.(4.12±0.60)mmol/L],triglyceride [TG, (1.54±0.51)mmol/L vs.(1.02±0.53)mmol/L]and low density

  20. Clinical analysis of therapeutic efficiency of Danshentong on 566 patients with acute coronary syndrome unstable angina pectoris%丹参酮ⅡA磺酸钠治疗急性冠状动脉综合征不稳定型心绞痛566例疗效分析

    Institute of Scientific and Technical Information of China (English)

    司清霞

    2012-01-01

    Objective To observe the therapeutic efficiency of Danshentong II A on the patients with acute coronary syndrome ( unstable angina pectoris). Methods Totally 566 in - hospital patients with acute coronary syndrome ( unstable angina pectoris) were divided into 2 group: therapeutic group and control group. The characteristics of chest pain, frequency of attack, and way of relieve symptom were observed in two groups. The changes of ECG, blood lipid, level of BP were analyed in every patient. Side effects from the use of drugs were assessed. Results The clinical symptoms were improved obviously in all patients, and the all of clinical index in patients of Danshentong II A group were superior to the control group. Conclusions Danshentong II A injection is an marked effective drug for treating acute coronary syndrome (unstable angina pectoris).%目的 观察丹参酮ⅡA磺酸钠注射液治疗急性冠脉综合征不稳定型心绞痛患者的临床疗效.方法 选取566例住院患者(均符合入选标准),分成治疗组和对照组.分别观察两组治疗前后的胸痛的性质、部位、诱因、持续的时间和缓解的因素,发作的频率等情况;观察心电图、血脂、血压、心肌酶等的变化情况;观察药物的不良反应等.结果 治疗后临床症状明显改善,治疗组的各项检查指标优于对照组,差异均有统计学意义(P<0.05).结论 丹参酮ⅡA磺酸钠治疗急性冠脉综合征不稳定型心绞痛疗效显著.

  1. 循证护理对老年心绞痛患者医嘱依从性及生活质量的影响%Impact of Evidence-based Nursing Care on Medication Compliance and the Quality of Life of Elderly Patients With Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    王丹丹

    2016-01-01

    ObjectiveTo explore the effect of evidence-based nursing care on medication compliance and the quality of life of eldedy patients with angina pectoris.Methods 180 cases of elderly people with angina pectoris were divided into the control group(90 cases)and the observation group(90 cases).The control group was treated with cardiology common nursing,the observation group received evidence-based nursing care of psychological nursing,life nursing and medication compliance.The medication compliance and the quality of life after one year were analyzed and compared between the two groups.ResultsThe medication compliance rate of the observation group was higher than the control group,life quality score in the observation group were significantly higher than those in the control group(P<0.05).Conclusion Evidence-based nursing care can improve the medication compliance and the quality of life of elderly patients with angina pectoris.%目的:探讨循证护理对老年心绞痛患者医嘱依从性及生活质量的影响。方法将180例老年心绞痛患者随机分为对照组90例和观察组90例。对照组进行常规护理,观察组从心理护理、生活护理及医嘱依从等方面进行循证护理,比较2组患者医嘱依从性及生活质量的差异。结果观察组医嘱依从率均高于同期的对照组(P<0.05),观察组护理后生活质量评分均高于对照组(P<0.05)。结论循证护理可以提高老年心绞痛患者的医嘱依从性及生活质量。

  2. Gender differences of atherosclerotic plaque characteristics in elderly patients with stable angina pectoris%血管内超声评价老年冠心病患者冠状动脉钙化病变的性别差异

    Institute of Scientific and Technical Information of China (English)

    王小飞; 陈欣; 王佩显

    2011-01-01

    Objective To evaluate the gender differences of atherosclerotic plaque characteristics in elderly patients with stabel angina pectoris using intravascular ultrasound(IVUS). Methods Sixty-one elderly patients with stable angina pectoris,age ≥65 years,male 33,female 28. One 50% -70% stenosis plaque was selected as target plaque in each patient. Coronary artery angiography and target plaque IVUS were performed to compare the vascular volume, lumen volume, plaque volume and calcification burden with arc area(AA). Results The vascular volume,lumen volume in female elderly patients were less than in male elderly patients(P<0. 05) ,there were no differences in plaque volume between male and female. AA in female patients was more than in male pa-tients(P<0. 05). Conclusion Female elderly patients with stable angina pectoris has smaller coronary artery and lumen at plaque segment as plaque burden was not different. Calcification burden in the plaque is more in female than in male patients.%目的 应用血管内超声评价不同性别老年冠心病患者冠状动脉粥样硬化斑块钙化情况.方法 选择年龄≥65岁稳定性心绞痛患者61例.所有患者均行冠状动脉造影,选取一处狭窄50%~70%的斑块进行血管内超声检查,测量血管、管腔、斑块体积及斑块钙化的弧面积.结果 女性患者血管体积和管腔体积较男性明显缩小,斑块钙化弧面积明显增加(P<0.05).结论 在斑块体积相同条件下,女性患者冠状动脉粥样硬化斑块部位血管体积和管腔体积小于男性,女性患者斑块钙化负荷明显高于男性.

  3. RELATIONSHIPS BETWEEN PLASMA NT-PROBNP LEVEL AND SHORT-TERM PROGNOSIS OF UNSTABLE ANGINA PECTORIS%血浆NT-proBNP水平与不稳定型心绞痛近期预后的关系

    Institute of Scientific and Technical Information of China (English)

    王伟; 任国成; 高志广; 张晓莉; 宝凤梅

    2014-01-01

    目的:探讨血浆N末端-脑钠肽前体(NT-proBNP)水平与不稳定型心绞痛(UAP)患者近期预后的关系。方法:因胸痛住院并经冠状动脉造影检查确诊为UAP的患者52例,分别检测症状发作后18h和症状缓解96h血浆NT-proBNP水平,并计算差值比。对UAP患者随访30天,记录患者主要心血管事件(MACE)的发生情况,并应用受试者工作曲线(ROC)分析差值比对UAP患者发生近期心血管事件的预测价值。结果:发生心血管事件患者的NT-proBNP差值比高于未发生者,差异具有统计学意义(P<0.05)。ROC结果显示,NT-proBNP差值比为0.99时,其预测UAP患者近期发生心血管事件的灵敏度和特异度分别为64.3%和81.8%。结论:NT-proBNP差值比可用来预测UAP患者近期心血管事件的发生情况,可作为筛选高危病例的一个指标。%Objective:To explore the relationships between N-terminal pro-brain natriuretic peptide (NT-proBNP) level and short-term prognosis of unstable angina pectoris (UAP). Methods:52 UAP patients were hospitalized because of chest pain and confirmed by coronary angiography. The plasma NT-proBNP level of 52 patients was respectively detected 18hafter attacksofsymptoms andremissionofsymptoms for96h, and then calculated the D-value ratio.All the patients were followed up for 30 days and recorded the occurrence of main adverse cardiovascular event (MACE). ROC curve of D-value ratio was used to analyze the predictive value of D-value ratio for MACE.Results:The D-value ratio of patients with MACE was obviously higher than that of the patients no MACE (P<0.05).According to the ROC curve, the predictive sensitivity of MACE was 64.3%and specificity was 81.8%when D-value ratio was 0.99. Conclusions:The D-value ratio of NT-proBNPcanbe usedtopredictMACEinUAP,and can be used as a markerforscreening high-risk patients.

  4. 脑钠肽与不稳定型心绞痛患者左心功能相关性研究%Relationship between brain natriuretic peptide and left heart function in patients with unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    杨波; 夏勇

    2012-01-01

    Objective To observe the changing rule of plasma level of brain natriuretic peptide (BNP) and left ventricular end-diastolic pressure (LVEDP)in patients with unstable angina pectoris ( UAP) ,and explore the correlation between the changes of left heart function and BNP. Methods Fifty-seven cases who underwent coronary angiography( CAC) examination were included. Twelve cases with normal CAG examination results as control group, forty -five patients with UAP were divided into grade Ⅰ group(n = 16) ,grade Ⅱ group(n = 14) and grade Ⅲ group(n = 15) according to the class of Braunwald. The left atrial dianieter(LAD) ,left ventricular end-diastolic diameter( LVEDd), left ventricular posterior wall thickness( LVP-WT) ,intervenlricular septal thickness( IVST) ,left ventricular ejection fraction( LVEF)and E/A were detected in all cases by Doppler echocardiography. The value of LVEDP was detected by record left ventricular pressure curves in all cases. The plasma concentration of BNP was measured by radioimmunoassay. Results There were significant differences in the plasma levels of BNP and LVEDP in control group,grade Ⅰ, Ⅱ, Ⅲ groups(P 0.05). The plasma level of BNP was obviously correlated with LVEDP in all cases ( r = 0.756, P < 0.01). Conclusion The level of BNP could reflect the severity of cardiac ischemia in patients with UAP.it could reflect the severities of congestive heart failure to some extend.%目的 研究血浆脑钠肽(BNP)水平与左心室舒张末期压力(LVEDP)在不稳定型心绞痛(UAP)患者中的变化规律,探讨左心功能的变化与BNP变化的相关性.方法 选择57例冠状动脉造影(CAG)检查者为研究对象,CAG检查正常者12例作为对照组,45例UAP患者按Braunwald分级分为Ⅰ级组(16例)、Ⅱ级组(14例)和Ⅲ级组(15例).所有患者采用多普勒超声心动图检测左心房前后径(LAD)、左心室舒张末期内径(LVEDd)、左心室后壁厚度(LVPWT)、室间隔厚度(IVST)、左心室射血分

  5. 自拟血府瓜蒌汤联合西药治疗不稳定型心绞痛疗效观察%Observation of the Effect of Self-made Xuefu Gualou Soup Combined with Western Medicine in the ;Treatment of Unstable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    苏泽飞; 晏廷亮

    2015-01-01

    Objective:To observe the clinical effect of self-made Xuefu Gualou soup in the treatment of Coronary heart disease and unsteady type angina pectoris.Method:62 patients with unstable angina pectoris were randomly divided into western medicine group and observation group. The western medicine group do the guidelines and is given standardized treatments,which conclude antiplatelet,anticoagulation,nitrates drugs,beta blockers,calcium antagonists and angiotensin converting enzyme inhibitor(ACEI)or ARB,lipid regulating drugs,hypoglycemic agents etc. The observation group was cured with the western medicine plus the use of self-made Xuefu Gualou soup,then to determine the efficacy after 10 treatment days.Result:The observation group is greatly improved in the symptoms of angina pectoris, electrocardiogram,pain attack frequency,nitroglycerin dosage etc,and the curative effect was better than western medicine group.Conclusion:On the basis of western medicine standardized treatment combined with Xuefu Gualou soup, there is a better curative effect than the pure western medicine treatment in improving patients with unstable angina pectoris symptoms and related indexes,and the safety is good and no obvious adverse reaction.%目的:观察自拟血府瓜蒌汤治疗冠心病不稳定型心绞痛的临床疗效。方法:将62例不稳定型心绞痛患者随机分为西药组和观察组。西药组遵行指南给予抗血小板药、抗凝药、硝酸酯类药、β-受体阻滞剂、钙离子拮抗剂、血管紧张素转化酶抑制剂(ACEI)或ARB、调血脂药、降糖药等规范治疗;观察组在西药基础上加用自拟血府瓜蒌汤,共治疗10 d后进行疗效判定。结果:观察组在心绞痛症状、心电图、疼痛发作次数、硝酸甘油用量等方面均有较大改善,且疗效优于西药组。结论:在西药规范治疗的基础上加用血府瓜蒌汤,在改善不稳定型心绞痛患者的症状和相关指标方面均较单纯

  6. 丹参酮ⅡA 磺酸钠联合氯吡格雷对冠心病心绞痛疗效及血管内皮功能的影响%Effect of TanshinoneIIA Sulfonic Sodium combined with Clopidogrel on coronary heart disease and angina pectoris and vascular endothelium function

    Institute of Scientific and Technical Information of China (English)

    周芸羽; 吴敏; 叶张章; 陈明华

    2016-01-01

    Objective It is to explore the effect of TanshinoneIIA Sulfonic Sodium combined with Clopidogrel on coronaryheart disease and angina pectoris and vascular endothelium function .Methods 60 patients with coronary heart disease and anginapectoris were randomly divided into experimental group and control group , both the groups were given normal therapy , onthis basis the control group was treated with Clopidogrel , the experimental group was treated with TanshinoneIIA Sulfonic Sodi -um combined with Clopidogrel.The attack times and lasting time of angina pectoris and dosage needed of nitroglycerin beforeand after treatment were observed in both groups , and the levels of NO, ET and TXB2 were determined.Results The attacktimes and lasting time of angina pectoris and dosage needed of nitroglycerin, the levels of ET and TXB2 all decreased aftertreatment while that of NO increased in both groups compared with that before treatment , and the decrease or increase in experimentalgroup was more significant (P <0.05).The total effective rate in experimental group was obviously higher thanthat in control group (P <0.05).Conclusion TanshinoneIIA Sulfonic Sodium combined with Clopidogrel can promote coro -nary artery dilatation, improve vascular endothelium function in the treatment with coronary heart disease and angina pectoris ,the curative effect is good and it is worthy of popularization and application .%目的:探讨丹参酮ⅡA磺酸钠联合氯吡格雷对冠心病心绞痛疗效及血管内皮功能的影响。方法将冠心病心绞痛患者60例随机分为实验组和对照组,均给予常规治疗,对照组在此基础上联合氯吡格雷进行治疗,实验组在对照组治疗基础上加用丹参酮ⅡA磺酸钠进行治疗,观察2组治疗前后心绞痛发作次数、持续时间以及缓解所需硝酸甘油剂量,同时检测2组治疗前后血液内一氢化氮( NO)、内皮素( ET)及血栓素A2( TXB2)水平。结果2组治疗后

  7. Analysis of Predispositionand Risk Factors of Stable Angina Pectoris of Coronary Heart Disease with Phlegm and Stasis Combined Syndrome%痰瘀互结型冠心病稳定性心绞痛诱因及危险因素的分析

    Institute of Scientific and Technical Information of China (English)

    殷晓梅

    2013-01-01

    Objective:To investigate predispositionand risk factors of stable angina pectoris of coronary heart disease (CHD)with phlegm and stasis combined syndrome.Methods:240 cases with stable angina pectoris of coronary heart disease (CHD)with phlegm and stasis combined syndrome in the out-patient department and in-patient department of 10 hospitals,June 2011 to January 2012,were collected to make statistics analysis of their materials.Results:The survey found that patients with coronary heart disease cases were overweight or obese,dyslipidemia,cold,emotion,and other sports were the main cause of the disease.Conclusion:In many predisposition and risk factors,dyslipidemia,weight,cold,emotions and other sports were the highest proportion.Controling predispositionand and risk factors can avoid acute cardiovascular events.%目的:探讨痰瘀互结型冠心病稳定型心绞痛诱因及危险因素.方法:将2011年6月-2012年1月就诊于10家医院的240例冠心病稳定型心绞痛痰瘀互结型患者的资料进行列表统计分析.结果:调查发现冠心病患者发病多有超重或肥胖、血脂异常等危险因素,寒冷、情绪、运动等是发病的主要诱因.结论:在诸多诱因及危险因素中,血脂异常、体质指数、寒冷、情绪、运动等所占的比例最高.积极控制诱因和危险因素,可以避免急性心血管事件发生.

  8. Systematic Review of Randomize Controlled Trials on Xuefu Zhuyu Capsule for Angina Pectoris in Patients with Coronary Heart Disease%血府逐瘀胶囊治疗冠心病心绞痛随机对照试验的系统评价

    Institute of Scientific and Technical Information of China (English)

    郑国华; 谌海英; 褚剑锋; 刘建平

    2012-01-01

    Objective To assess the therapeutic effect and safety of Xuefu Zhuyu Capsule (Capsule for removing blood stasis in the chest) on angina pectoris in patients with coronary heart disease (CHD). Methods Published literatures, till October 2010, in Chinese and English, on Xuefu Zhuyu Capsule treating angina pectoris in CHD patients, were searched from Cochrane library, PubMed, CBM, CNKI, VIP, CMCI, etc. Included were randomize controlled trials (RCTs) on the therapeutic effect of Xuefu Zhuyu Capsule or Xuefu Zhuyu Capsule plus conventional western medicines in comparison with the conventional western medicine treatment on angina pectoris in CHD patients. The data were extracted according to the Table of Data Extraction. The methodological quality of the included literatures was evaluated by Jadad criterion. The data were analyzed with Rev-Man 5. 0. 1 software. The outcome was shown as relative risk (RR) and its 95% confidence interval (CD. Results Totally 14 literatures of RCTs including 1001 patients met the inclusion criterion, of which, only one double-blind RCT was of high quality in methodology, and others were low. Compared with the conventional therapy of western medicine, the RR of ineffective rate of angina pectoris of Xuefu Zhuyu Capsule was 0. 93, and the 95% CI was between 0. 48 and 1. 81, the RR of ineffective rate of electrocardiogram (ECG) was 0. 98, and the 95% CI was between 0. 71 and 1. 36, and their difference was not statistically significant. Compared with the conventional therapy of western medicine, the RR of ineffective rate of angina pectoris of Xuefu Zhuyu Capsule plus conventional western medicines was 0. 31, and the 95% CI was between 0. 21 and 0. 45, the RR of ineffective rate of ECG was 0. 61, and the 95 % CI was between 0. 49 and 0. 75, and the difference between was statistically significant. There was no serious adverse effect found in the patients treated by Xuefu Zhuyu Capsule. Conclusion Xuefu Zhuyu Capsule plus conventional western

  9. Usefulness of fractional flow reserve measurements to defer revascularization in patients with stable or unstable angina pectoris, non-ST-elevation and ST-elevation acute myocardial infarction, or atypical chest pain.

    Science.gov (United States)

    Potvin, Jean-Michel; Rodés-Cabau, Josep; Bertrand, Olivier F; Gleeton, Onil; Nguyen, Can Nanh; Barbeau, Gerald; Proulx, Guy; De Larochellière, Robert; Déry, Jean-Pierre; Batalla, Nuria; Dana, Ali; Facta, Alvaro; Roy, Louis

    2006-08-01

    This study determined the safety of deferring coronary revascularization based on a fractional flow reserve (FFR) value > or = 0.75 in a series of consecutive unselected coronary patients with moderate coronary lesions, including patients with unstable angina, myocardial infarction (MI), and/or positive noninvasive test findings. The study included 201 consecutive coronary patients (mean age 62 +/- 10 years; 65% men) with 231 lesions evaluated by FFR measurement for which revascularization was deferred based on a FFR value > or = 0.75. Lesions associated with a positive noninvasive test result were those located in an artery supplying a myocardial territory in which myocardial ischemia was demonstrated by a noninvasive test. Cardiac events (cardiac death, MI, revascularization) and Canadian Cardiovascular Society angina class were evaluated at follow-up. Indications for coronary angiography included unstable angina or MI (62%), stable angina (30%), or atypical chest pain (8%). Forty-four patients (22%) had > or = 1 coronary lesion associated with a positive noninvasive test result in which FFR was evaluated. Mean FFR value was 0.87 +/- 0.06 and mean lesion percent diameter stenosis was 41 +/- 8%. At 11 +/- 6 months of follow-up, cardiac events occurred in 20 patients (10%), and no significant differences were observed between patients with unstable angina or MI and those with stable angina (9% vs 13%, p = 0.44) or between patients with and without lesions associated with positive noninvasive test results (9% vs 10%, p = 1.00). At the end of follow-up, 88% of patients were asymptomatic in angina class 0 or I, with no differences across various groups. In conclusion, these results suggest that patients with moderate coronary lesions can be safely managed without revascularization on the basis of FFR measurements, irrespective of clinical presentation and/or presence of positive noninvasive test results.

  10. Comparison Between Elective PCI and Simple Optimal Drug Therapy for Senile Unstable Angina Pectoris%经择期PCI和单纯优化药物治疗老年不稳定性心绞痛的比较研究

    Institute of Scientific and Technical Information of China (English)

    郝翠平

    2015-01-01

    目的:探究经择期PCI和单纯优化药物治疗老年不稳定性心绞痛的临床效果。方法整群选取自2012年1月-2014年3月该院收治的老年不稳定性心绞痛患者134例为该次研究对象,将其随机分成实验组与对照组,分别予以择期PCI、单纯优化药物治疗,观察两组左心室功能改善情况及并发症发生情况。结果实验组出院90 d时LVEF (63.23±8.72)%vs(51.23±9.43)%、心输血量(6.97±2.82)vs (5.72±1.72)mL较对照组明显增加,LVEDD(50.23±10.64)mm vs (53.24±11.72)mm较对照组显著下降,再发心绞痛发生率10.44%vs 26.86%低于对照组,差异有统计学意义(P<0.05)。造影剂肾病、出血发生率11.94%vs 0;17.91%vs 4.47%高于对照组,但经过及时对症治疗,均可得到治愈。结论经择期PCI治疗老年不稳定性心绞痛临床疗效优于单纯优化药物治疗,安全指数高,能有效调节患者左心室功能,改善患者预后,临床上应引起足够重视。%Objective To explore the effect of elective PCI and simple optimal drug therapy in the treatment of senile unstable angina pectoris. Methods Based on the completely randomized digital table method, 134 patients with senile unstable angina pec-toris in our hospital from January 2012 to March 2014 were selected as the study objects and divided into experimental group and control group. Elective PCI and simple optimal drug therapy were performed in the two groups respectively. The improvement of left ventricle function and occurrence of complications of the two groups were observed, respectively. Results For experimental group, when they left hospital after 90days, the LVEF was (%63.23±8.72 vs 51.23±9.43), the heart blood transfusion volume was (ml:6.97±2.82 vs 5.72±1.72) which was obviously increased compared to control group. The LVEDD (mm:50.23±10.64 vs 53.24±11.72) was obviously decreased compared to control group. Recurrence of angina morbidity (%:10.44 vs 26

  11. The Clinical Observation of Alprostadil Lipid-microsphere Injection in Treatment of Elderly Patients with Stable Angina Pectoris of Coronary Heart Disease%前列地尔脂微球注射液治疗老年冠心病稳定型心绞痛的临床观察

    Institute of Scientific and Technical Information of China (English)

    闫秀莲

    2014-01-01

    Objective:To observe the clinical effect of Lipo-PGE1 injection in treatment of elderly patients with stable angina pectoris of coronary heart disease.Method:120 stable angina patients in department of Cardiology from September 2012 to September 2013 were selected,they were divided into the alprostadil treatment group and the control group according to the random number table method,60 cases in each group.The control group was given conventional treatment,the alprostadil treatment group took the alprostadil Lipo-PGE1 injection of 10 μg into the small pot of intravenous injection on the basis of conventional therapy,1/d.Both of the two groups took 7 days for a course of treatment, a total of 3 courses of treatment.The total effective rate,total effective rate of ECG,blood rheology changes and adverse reactions of the two groups were observed.Result:After 3 courses of treatment,the angina pectoris and ECG total effective rate in alprostadil group were significantly higher than those of control group,the degree of blood rheology indexes of the two groups after treatment were significantly lower than before treatment,and those in the alprostadil group were significantly lower than the control group,the differences were statistically significant(P<0.05),and both of the two groups were no serious adverse reactions.Conclusion:Alprostadil lipid microsphere injection is safe and effective in the treatment of elderly patients with stable angina pectoris of coronary heart disease,clinical reference can be used.%目的:观察前列地尔脂微球注射液辅助治疗老年冠心病稳定型心绞痛的临床效果。方法:选取本院心内科2012年9月-2013年9月收治的120例老年冠心病稳定型心绞痛患者,按照随机数字表法将其分为前列地尔组和对照组各60例。对照组给予常规治疗,前列地尔组在常规治疗的基础上将前列地尔脂微球注射液10μg入小壶静脉滴注,1次/d。两组均以7 d

  12. 氯吡格雷联合血栓通注射液治疗不稳定型心绞痛的临床疗效及其对血液流变学指标的影响%Clinical Effect of Clopidogrel Combined with Xueshuantong Injection on Unstable Angina Pectoris and Its Impact on Hemodynamic Index

    Institute of Scientific and Technical Information of China (English)

    朱洪斌

    2015-01-01

    Objective To investigate the clinical effect of clopidogrel combined with xueshuantong injection on unstable angina pectoris and its impact on hemodynamic index. Methods A total of 104 patients with unstable angina pectoris were selected in the People's Hospital of Kai County from 2012 to 2014,and they were divided into control group and treatment group according to random number table,each of 52 cases. After admission,all of the patients stayed in bed for rest,received continuous low - flow oxygen inhalation,low - fat diet and conventional medical treatment,while patients of treatment group received extra clopidogrel sulfate combined with xueshuantong injection;both groups treated for 2 weeks. Clinical effect,attack frequency and duration of angina pectoris,nitroglycerin dosage,index of heart rate variability( including SDNN,SDANN, RMSSD and PNN50)and hemodynamic index(including fibrinogen,whole blood high shear viscosity,whole blood low shear viscosity and plasma viscosity)before and after treatment were compared between the two groups. Results The clinical effect of treatment group was statistically significantly better than that of control group(u = 11. 28,P ﹤ 0. 05). No statistically significant differences of attack frequency or duration of angina pectoris,or nitroglycerin dosage was found between the two groups before treatment(P ﹥ 0. 05);after treatment,attack frequency of angina pectoris and nitroglycerin dosage of treatment group were statistically significantly lower than those of control group,and duration of angina pectoris of treatment group was statistically significantly shorter than that of control group(P ﹤ 0. 05). No statistically significant differences of SDNN,SDANN,RMSSD or PNN50 was found between the two groups before treatment( P ﹥ 0. 05);while SDNN,SDANN,RMSSD and PNN50 of treatment group were statistically significantly higher than those of control group after treatment( P ﹤ 0. 05). No statistically significant differences of

  13. [Vertebrogenic chest pain--"pseudoangina pectoris": etiopathogenesis, clinical manifestations, diagnosis, differential diagnosis and therapy].

    Science.gov (United States)

    Grgić, Vjekoslav

    2007-01-01

    Vertebrogenic pain localised in the anterior thorax can imitate anginal pain ("pseudoangina pectoris"). The most common causes of vertebrogenic chest pain are segmental dysfunction and degenerative changes at the level of the lower cervical and upper middle thoracic spine. Segmental dysfunction is a source of pseudoradicular pain, and degenerative changes, before all disc hernia and dorsal osteophytes which are compressing corresponding nerve roots, are the sources of radicular pain which irradiates in the chest. Because of its similarity with angina pectoris, the intense chest pain caused by the cervical radiculopathy which is often followed by heart rhythm disorders and nonspecific changes of the ST-T-segment in ECG, is called "cervicogenic angina". The attacks of vertebrogenic chest pain are not rare even in patients with angina pectoris. Because of superimposed vertebrogenic pain, the manifestation of pain in patients with angina pectoris can be considerably changed which can be misinterpreted as unstable angina. From therapeutic aspect it is very important to distinguish vertebrogenic from anginal pain. That is, the change of cardiological therapy will not eliminate possible attacks of vertebrogenic pain in patients with angina pectoris. From the aspect of most recent understandings, the article describes etiopathogenesis, characteristics, diagnosis and therapy of vertebrogenic chest pain, and also the differences between vertebrogenic and anginal pain.

  14. The effect of stent implantation on the quality of sexual activity in middle and old age male patients with exertional angina pectoris%冠状动脉支架植入对中老年男性劳力性心绞痛患者性生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    闫哲; 豆颖; 王明太; 孙福成

    2013-01-01

    目的 探讨冠状动脉支架植入对中老年男性劳力性心绞痛患者性生活质量的影响及其机制.方法 172例劳力性心绞痛患者根据治疗情况分为对照组(94例)和冠状动脉介入治疗组(78例).对照组采用常规药物治疗.冠状动脉介入治疗组除常规药物治疗外,适时植入药物涂层支架.采用国际勃起功能评分(IIEF)-5量表观察治疗前后患者性功能,统计治疗前后每个月性交次数.心绞痛评价采用加拿大心血管病学会(CCS)心绞痛分级.心功能评价指标采用6 min步行试验结束时患者心率变化及步行距离.超声心动图测量左室射血分数(LVEF).结果 冠状动脉介入治疗组在治疗后3个月IIFE-5总分、性交满意度评分、性交次数、CCS心绞痛分级较同期对照组均有明显改善[(20.58±7.36)分比(16.38 ±6.35)分、(4.32±1.38)分比(2.51±1.89)分、(6.3±3.2)次/月比(3.5±1.6)次/月、(1.10±0.43)级比(2.50±1.10)级],差异有统计学意义(P<0.05);冠状动脉介入治疗组在治疗后3个月6 min步行试验距离和试验结束时心率、LVEF较同期对照组均有明显改善[(386±82)m比(281±86)m、(95±18)次/min比(122±25)次/min、(65.2±11.2)%比(55.6±13.8)%],差异有统计学意义(P<0.05).结论 冠状动脉支架植入对于中老年男性劳力性心绞痛患者运动耐量和性生活质量有显著的改善作用,其机制主要是冠状动脉支架植入增加了患者性生活时的运动耐量和减少性生活时心绞痛发作.%Objective To explore the effect and mechanism of stent implantation on the quality of sexual activity in middle and old age male patients with exertional angina pectoris.Methods One hundred and seventy-two male patients with exertional angina pectoris were enrolled in this study,and they were divided into control group (94 patients) and percutaneous coronary intervention group (78 patients).The patients in control group were given routine pharmacotherapy

  15. Cervical Angina

    Science.gov (United States)

    Sussman, Walter I.; Makovitch, Steven A.; Merchant, Shabbir Hussain I.

    2015-01-01

    Cervical angina has been widely reported as a cause of chest pain but remains underrecognized. This series demonstrates the varied clinical presentation of patients with cervical angina, the delay in diagnosis, and the extensive cardiac examinations patients with this condition typically undergo prior to a definitive diagnosis. Recognition of this condition in patients with acute chest pain requires a high index of suspicion and an awareness of the common presenting features and clinical findings of cervical angina. PMID:25553225

  16. Influence factors of success rate of serum LDL-C in patients with unstability angina pectoris taking atorvastatin%服用阿托伐他汀的不稳定型心绞痛患者血清LDL-C达标率的影响因素

    Institute of Scientific and Technical Information of China (English)

    于薇; 孟存良; 容春莉; 曹东平; 吕军娥; 彭应心

    2011-01-01

    目的 分析使用阿托伐他汀的不稳定型心绞痛患者低密度脂蛋白胆固醇(LDL-C)达标率的临床影响因素.方法 选择血清LDL-C水平未达标的不稳定型心绞痛患者146例,阿托伐他汀20 mg口服,1次/d,疗程8周.分析年龄、性别、体质量指数(BMI)、膳食控制、糖基化血红蛋白A1c(HbA1c)等因素对服用阿托伐他汀后LDL-C达标率的影响.结果服用阿托伐他汀8周后,LDL-C总达标率为49.3%;经逐步多元Logistic回归分析,年龄与LDL-C达标率无显著相关性;BMI正常组、超体质量组和肥胖组的组间比较,LDL-C达标率差异无统计学意义(P>0.05);膳食控制组较无膳食控制组患者LDL-C达标率高;血糖控制良好的患者LDL-C达标率高.结论 膳食及血糖控制水平为服用阿托伐他汀的不稳定型心绞痛患者LDL-C达标率的独立影响因素.%Objective To analyze the clinical influence factors of success rate of serum low density lipoprotein-cholesterol(LDL-C) in patients with unstability angina pectoris taking aorvastatin. Methods 146 patients with unstability angina pectoris and unsuccessful level of serum LDL-C were collected. 20 mg atorvastatin were taken orally once a day with treatment course of 8 weeks.Effects of clinical factors such as age, gender, body mass index(BMI), diet control and glycosylated hemoglobin Alc (HbAlc) on success rate of serum LDL-C after aorvastatin administration were analyzed. Results The overall success rate of serum LDL-C was 49.3 % after 8 weeks of aorvastatin administration;Age had no significant correlation with the success rate of LDL-C according to stepwise multivariate Logistic regression analysis;Comparison of the success rates of LDL-C among BMI normal group,overweight group and obesity group,there were no statistically significant(P>0.05) ;Success rates of LDL-C of patients in diet control group were higher than that in non-diet control group;Patients with well-controlled blood glucose showed

  17. Effects of fluvastatin on exercise-induced myocardial ischemia in patients with stable exertional angina pectoris and hypercholesterolemia%氟伐他汀对高脂血症伴冠心病患者的临床疗效评价

    Institute of Scientific and Technical Information of China (English)

    霍永佳

    2011-01-01

    目的:探讨氟伐他汀调脂治疗对稳定劳力型心绞痛合并高胆固醇血症患者运动诱发心肌缺血的影响.方法:选择运动试验阳性且血浆总胆固醇浓度增高的稳定劳力型心绞痛患者90例,随机分为治疗组和对照组,治疗组给予氟伐他汀12周,对照组仅给予饮食控制,治疗前后行心电图运动试验,比较两组运动试验结果.结果:经治疗12周后,治疗组总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL-C)均显著降低、高蜜度脂蛋白(HDL-C)显著升高(P<0.05),而对照组血脂各项指标的变化均无统计学意义.氟伐他汀组治疗后运动耐量显著提高,运动试验阳性率明显降低,ST段下移1 mm时间明显延长,ST段下移值显著减少(P<0.05),而对照组治疗前后各项指标的变化均无统计学意义.结论:氟伐他汀在降低血脂的同时,还可明显减轻稳定劳力型心绞痛合并高胆固醇血症患者运动诱发的心肌缺血.%AIM: To investigate the effects of fluvastatin on myocardial ischemia induced by exercise testing in patients with stable exertional angina pectoris and hypercholesterolemia.METHODS: Ninety patients with stable exertional angina pectoris, positive exercise test and hypercholesterolemia were randomly divided into a 12-week treatment period either diet plus fluvastatin (n=45) or diet alone(n=45). All the patients underwent exercise testing before and after the treatment period. RESULTS:Fluvastatin -treated patients had a significant decrease in total cholesterol, triglyccrides, high-density lipoprotein cholesterol and low-density lipoprotein cholesterol after treatment ( P < 0.05). After treatment, the patients in the fluvastatin group had significantly increase in exercise tolerance,longer time in ST depression of 1.0 mm and decrease in the severity of ST depression. CONCLUSION: Fluvastatin can reduce exercise-induced myocardial ischemia in patients with stable exertional angina pectoris and

  18. 前列地尔注射液与麝香保心丸联合治疗冠心病心绞痛的疗效观察%Observation of the curative effect on Alprostadil Injection combined with Shexiang Baoxin Wan on angina pectoris

    Institute of Scientific and Technical Information of China (English)

    宋国良; 裴兆辉; 漆满英

    2012-01-01

    目的 观察前列地尔注射液与麝香保心丸联合应用对冠心病心绞痛的治疗效果.方法 将120例心绞痛患者采用随机单盲对照法分为三组,对照组给予口服硝酸酯类、阿司匹林、他汀类调脂、β受体拮抗剂和钙离子拮抗剂等常规治疗药物.麝香保心丸组在对照组基础上加用麝香保心丸口服(2丸,每日3次),前列地尔组在麝香保心丸治疗组基础上加用前列地尔注射液(10 μg,静脉滴注,每日1次).治疗10 d后观察三组临床、心电图疗效.结果 前列地尔组临床疗效总有效率(95.0%)高于麝香保心丸组(80.0%)及对照组(57.5%),差异有统计学意义(P < 0.05).前列地尔组心电图疗效总有效率(82.5%)高于麝香保心丸组(60.0%)及对照组(40.0%),差异有统计学意义(P < 0.05).结论 前列地尔联合麝香保心丸治疗心绞痛疗效好.%Objective To observe the therapeutic effect of Alprostadil Injection combined with Shexiang Baoxin Wan on angina pectoris. Methods 120 patients with angina pectoris were randomly divided into 3 groups with random single-blind contrast method. The patients in control group (38 cases) were given conventional treatment including Aspirin, statins tune es -ter, P receptor antagonists and calcium channel blockers. The patients in Shexiang Baoxin Wan group (42 cases) were giv -en Shexiang Baoxin Wan per os (2 pills, three times a day) in addition to the conventional treatment. The patients in Al -prostadil group were given Alprostadil (10 |xg intravenous push, one time a day). The patients in 3 groups were observed for 15 days to check the efficacy of treatment and ECG changes. The clinical effects and ECG curatives were recorded after treatment for 15 days. Results The clinical total effective rate in Alprostadil group (95.0%) was higher than those of Shexiang Baoxin Wan group (80.0%) and control group (57.5%), the difference was significant (P < 0.05). The total effective rate of ECG in

  19. Clinical analysis of 21 cases of hypertrophic obstructive cardiomyopathy misdiagnosed as coronary heart disease and angina pectoris%21例肥厚梗阻型心肌病误诊为冠心病心绞痛的临床分析

    Institute of Scientific and Technical Information of China (English)

    周明刚

    2016-01-01

    Objective To study the hypertrophy cardiomyopathy obstruction type misdiagnosed as angina pectoris of coronary heart disease and identify key points. SelectionMethods From May 2011 to May 2015 were 21 cases of hypertrophic cardiomyopathy obstruction type misdiagnosed as angina, coronary heart disease patients, the clinical data were to research and analysis, find the misdiagnosis factors. Results After the misdiagnosis after drug response analysis to diagnose patients as hypertrophy cardiomyopathy obstruction type, and then to suit the medicine treatment, 21 patients were recovered, the cure rate is 100%.Conclusion The need for a detailed to identify the patient, distinguish different conditions may cause diseases, and the representation can help reduce the clinical misdiagnosis rate.%目的:探讨肥厚梗阻型心肌病误诊为冠心病心绞痛的原因及鉴别要点。方法:选取我院2011年5月到2015年5月间收治的21例肥厚梗阻型心肌病误诊为冠心病心绞痛患者,对其临床资料进行重新研究与分析,找寻误诊因素。结果:经误诊后用药反应分析后重新确诊患者为肥厚梗阻型心肌病,然后给予对症药物治疗后,21例患者均获得痊愈,治愈率达到100%。结论:需要对患者的病情进行细致鉴别,分清不同病症的表现形式与可能引发的疾病种类,有助于降低临床误诊率。

  20. Therapeutic efficacy of intravenous drip of puerarin combined with acupuncture points drug line implant and Self-acupressure in the Treatment of Angina Pectoris%葛根素静滴配合穴位埋植药线和自我穴位指压治疗心绞痛疗效观察

    Institute of Scientific and Technical Information of China (English)

    王文莉

    2012-01-01

    目的 探讨治疗心绞痛更为有效的治疗方法.方法 选择100例冠心病心绞痛患者作为研究对象,随机分为观察组和对照组,每组各50例.对照组在内科常规治疗的基础上采用葛根素注射液100 mL(含0.2 g),静脉点滴,2次/d.观察组在上述治疗的基础上给予穴位埋植药线并配合自体指压穴位.两组均治疗14 d为1个疗程,连续治疗2个疗程后评定疗效.主要观察两组患者临床症状,心绞痛程度及发作频率以及心电图缺血状态等的改变情况.结果 两组治疗后心绞痛症状和心电图疗比较差异具有高度统计学意义(均P 0.05),治疗后具有非常显著性差异(P 0.05), but were after treatment (P < 0.01). Number of angina attacks in the observation was significantly reduced compared with that in the control group. Conclusion Intravenous drip of puerarin combined with self-acupressure and acupuncture points drug line implant were effective and reliable in the treatment of angina pectoris.

  1. 通心络胶囊与丹参滴丸治疗冠心病心绞痛间接比较的系统评价%Indirect Comparison of Tongxinluo Capsule and Danshen Dripping Pill for Angina Pectoris: A Systematic Review

    Institute of Scientific and Technical Information of China (English)

    贾永亮; 张时开; 鲍菲飞; 黄芳艺; 梁少伟

    2011-01-01

    Objective Danshen dripping pill (DSP) and tongxinluo capsule (TXL) are popular Chinese medicinal products and often compared with isosorbide dinitrate (ISDN) in treating angina pectoris. Hundreds of randomized controlled trials (RCTs) about DSP and TXL have been published; however, there has been no systematic review on comparing DSP with TXL. This study aims to provide a comprehensive PRISMA-compliant systematic review with sensitivity analysis and subgroup analysis to valuate indirectly the efficacies of DSP and TXL in treating angina pectoris. Methods RCTs published between 1994 and 2009 on DSP and TXL in treating angina pectoris for four or more weeks were retrieved from databases. The qualities of RCTs included were evaluated with Jadad scale. Meta-analysis was performed on overall effects of symptomatic and electrocardiographic (ECG) improvements. Odds ratios (OR) and 95% confidence intervals (95%CI) were used to measure the effect size. Subgroup analysis, sensitivity analysis and meta-regression were conducted on basic characteristics of RCTs. Results 65 RCTs with 6 969 participants were included. Average Jadad score was 2.11. Overall ORs were 3.66 (95%CI 2.67 to 5.02) for TXL versus ISDN and 2.38 (95%CI 1.90 to 2.99) for DSP versus ISDN. There was a significant difference (W=521.5, P=0.049 45) in ORs between DSP and TXL. Statistical analyses found no significant factors affecting overall efficacies of TXL and DSP. The rates of adverse events under DSP and TXL treatments were 2.37% and 2.11%, respectively. Conclusion DSP and TXL are more effective than ISDN in treating angina pectoris. TXL might be more effective than DSP. However, further RCTs of larger scale, multi-centre/country, longer follow-up periods and higher quality are still required to verify.%目的 已有数百篇关于复方丹参滴丸和通心络胶囊治疗冠心病心绞痛的随机对照试验报告发表,但尚未见相关系统评价.本研究旨在遵循PRISMA声明,系统

  2. 奥扎格雷钠注射液与低分子肝素钙治疗不稳定型心绞痛的疗效观察%Observation on the curative effect of Ozagrel Sodium Injection and low molecular weight heparin calcium on unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    周雷

    2014-01-01

    目的:探讨奥扎格雷钠注射液与低分子肝素钙联合应用在不稳定型心绞痛中的治疗效果。方法选择本院82例不稳定型心绞痛患者,上述患者随机分为观察组和对照组,两组均给予常规治疗,对照组同时给予奥扎格雷钠注射液,观察组给予奥扎格雷钠注射液联合低分子肝素。评定两组疗效,观察血液流变学指标改变情况。结果观察组总有效率为95.0%,对照组总有效率为75.6%,观察组总有效率高于对照组(P<0.05)。观察组治疗后全血粘度高切、全血粘度低切和血液粘度分别与对照组治疗后比较,差异有统计学意义(P<0.05)。结论奥扎格雷钠注射液与低分子肝素钙治疗不稳定型心绞痛效果显著,有助于改善患者血液流变学指标,值得借鉴。%Objective To explore the effect of combined application of Ozagrel Sodium Injection and low molecular weight heparin on unstable angina pectoris. Methods 82 cases with unstable angina patients, the patients were randomly divided into observation group and control group, two groups were given conventional treatment, the control group was treated ozagrel sodium Injection, the observation group was given ozagrel sodium Injection combined with low molecular weight heparin. the efficacy of two groups was evaluated, the changes of blood rheology was observed. Results The total effective rate in the observation group, was 95%, the total effective rate in the control group was 75.6%, the total effective rate in observation groupwas higher than that in the control group (P<0.05). The whole blood high shear viscosity, whole blood low shear viscosity and blood viscosity in the observation group after treatment compared with those in the control group after treatment, the difference was statistically significant (P<0.05). Conclusion Ozagrel sodium Injection combined with low molecular weight heparin calcium on unstable angina pectoris has significant effect

  3. Effect on treadmill exercise capacity, myocardial ischemia, and left ventricular function as a result of repeated whole-body periodic acceleration with heparin pretreatment in patients with angina pectoris and mild left ventricular dysfunction.

    Science.gov (United States)

    Miyamoto, Shoichi; Fujita, Masatoshi; Inoko, Moriaki; Oba, Muneo; Hosokawa, Ryohei; Haruna, Tetsuya; Izumi, Toshiaki; Saji, Yoshiaki; Nakane, Eisaku; Abe, Tomomi; Ueyama, Koji; Nohara, Ryuji

    2011-01-15

    Whole-body periodic acceleration (WBPA) has been developed as a passive exercise device capable of improving endothelial function by applying pulsatile shear stress to vascular endothelium. We hypothesized that treatment with WBPA improves exercise capacity, myocardial ischemia, and left ventricular (LV) function because of increased coronary and peripheral vasodilatory reserves in patients with angina. Twenty-six patients with angina who were not indicated for percutaneous coronary intervention and/or coronary artery bypass grafting were randomly assigned to remain sedentary (sedentary group) or undergo 20 sessions of WBPA with the motion platform for 4 weeks (WBPA group) in addition to conventional medical treatment. WBPA was applied at 2 to 3 Hz and approximately ±2.2 m/s² for 45 minutes. We repeated the symptom-limited treadmill exercise test and adenosine sestamibi myocardial scintigraphy. In the WBPA group, the exercise time until 0.1-mV ST-segment depression increased by 53% (p images at rest, LV end-diastolic volume index decreased by 18% (p exercise capacity, myocardial ischemia, and LV function.

  4. Clinical and cost-effectiveness analysis of an open label, single-centre, randomised trial of spinal cord stimulation (SCS versus percutaneous myocardial laser revascularisation (PMR in patients with refractory angina pectoris: The SPiRiT trial

    Directory of Open Access Journals (Sweden)

    Khan SN

    2008-06-01

    Full Text Available Abstract Background Patients with refractory angina have significant morbidity. This study aimed to compare two of the treatment options, Spinal Cord Stimulation (SCS and Percutaneous Myocardial Laser Revascularisation (PMR in terms of clinical outcomes and cost-effectiveness. Methods Eligible patients were randomised to PMR or SCS and followed up for exercise tolerance time (ETT, Canadian Cardiovascular Society (CCS classification and the quality of life measures SF-36, Seattle Angina Questionnaire and the EuroQoL at 3, 12 and 24 months. Utilities were calculated using the EQ-5D and these and costs were compared between groups. The incremental cost-effectiveness ratio (ICER per QALY for SCS compared to PMR was also calculated. Results At 24 months post-randomisation, patients that had SCS and PMR had similar ETT (mean difference 0.05, 95% CI -2.08, 2.18, p = 0.96 and there was no difference in CCS classification or quality of life outcomes. The difference in overall mean costs when comparing SCS to PMR was GBP5,520 (95% CI GBP1,966 to GBP8,613; p Conclusion Outcomes after SCS did not differ appreciably from those after PMR, with the former procedure being less cost-effective as currently applied. Larger studies could clarify which patients would most benefit from SCS, potentially increasing cost-effectiveness. Trial registration Current Controlled Trials ISRCTN09648950

  5. Analysis of Curative Effect of Simvastatin in the Treatment of Unstable Angina Pectoris%辛伐他汀治疗不稳定型心绞痛疗效观察

    Institute of Scientific and Technical Information of China (English)

    王亚新

    2014-01-01

    Objective Simvastatin treatment of unstable angina clinical results were evaluated. Methods 120 patients were randomly divided into a control group and the observation group. Changes in two groups of patients before and after treatment LDL cholesterol, ECG and angina time for comparison. Results Efficacy results after treatment showed that patients in the observation group reached 96% of the total efficiency of the control group patients achieved a total ef iciency of 80%, a significant difference was statistical y significant ( <0.05), after treatment LDL cholesterol was observed between the groups compared with the control group, significant dif erence was statistical y significant ( <0.05).Conclusion In the treatment of unstable angina when using simvastatin with ten male significant effect, worthy of promotion and application in clinical practice.%目的对辛伐他汀治疗不稳定型心绞痛的临床效果进行评价。方法随机的将120例患者分为对照组以及观察组。对两组患者在治疗前后的各项指标进行比较。结果经过治疗后的疗效比较结果显示,观察组患者达到了96%的总有效率,而对照组患者达到了80%的总有效率,差异显著具有统计学意义(<0.05),在治疗之后,观察组与对照组之间的低密度脂蛋白胆固醇相比较,差异显著具有统计学意义(<0.05)。结论在对不稳定型心绞痛进行治疗的时候采用辛伐他汀具有十分显著的疗效。

  6. Observer variability in the evaluation of dual-isotope Tl-201/Tc-99m sestamibi rest/stress myocardial perfusion SPECT in men and women with known or suspected stable angina pectoris

    DEFF Research Database (Denmark)

    Johansen, Allan; Høilund-Carlsen, Poul Flemming; Christensen, Henrik Wulff

    2004-01-01

    BACKGROUND: Observer variability of dual-isotope myocardial perfusion imaging (MPI) with single photon emission computed tomography has rarely been investigated. The aim of our study was to evaluate the interpretive reproducibility with this technique. METHODS AND RESULTS: We report on 507 patients...... with known or suspected stable angina who were studied before coronary angiography. A 1-day thallium 201/technetium 99m sestamibi rest/stress MPI protocol was used. MPI was interpreted by 2 independent observers without knowledge of clinical data, using a 20-segment scoring model. By consensus, the overall...... rate of abnormal MPI was 49% (59% in men and 34% in women). The interobserver agreement for the whole group (kappa = 0.85) and for men and women separately (kappa = 0.86 and 0.82, respectively) was excellent with regard to the overall diagnosis (normal, reversible, or fixed defects) as well as left...

  7. Effect of Jiangzhi Tongluo Soft Gelatin Capsule Combined with Western Medication on Adiponectin and Malondialdehyde in Angina Pectoris Patients%降脂通络软胶囊联合西药对冠心病心绞痛患者血清脂联素及丙二醛的影响

    Institute of Scientific and Technical Information of China (English)

    张爱军; 庞花艳; 周珊珊; 王琳琳

    2012-01-01

    Objective To explore the effect and mechanism of Jiangzhi Tongluo Soft Gelatin Capsule (soft gelatin capsule for lowering lipid and freeing the network vessels) on angina pectoris. Methods Ninety-eight cases of angina pectoris were randomized into the observation group of 50 cases, and control group of 48 cases. Both groups were given the conventional therapy including antithrombotic therapy, stabling plague, calcium antagonists, β-receptor blocker, while Jiangzhi Tongluo Soft Gelatin Capsule and isosorbide mononitrate tablet was added in the observation group and the control group respectively through oral administration. The treatment course lasted for 12 weeks. The angina attack, chest tightness and the dosage of nitroglycerin were recorded daily. The levels of adiponectin (APN) and malondialdehyde (MDA) were detected before and after the treatment. Results Comparing in group, the angina attack and the dosage of nitroglycerin reduced significantly in both groups after the treatment (P0. 05). After treatment, the level of APN increased and the level of MDA decreased significantly in the observation group, while the increase of APN and the decrease of MDA in the control group was not significant (P>0. 05). The levels of triglycerides (TG), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) were decreased significantly in the observation group after the treatment. There was significant difference in TG and high-density lipoprotein cholesterol (HDL-C) between groups after treatment (P<0. 01). The differences between groups in TG and high-density lipoprotein cholesterol (HDL-C) were statistically significant (P<0. 01). Conclusion Jiangzhi Tongluo Soft Gelatin Capsule is effective for angina as combined with the conventional therapy, which maybe relevant to inhibitting the inflammatory reaction and oxidative stress.%目的 探讨降脂通络软胶囊治疗冠心病心绞痛的疗效及作用机制.方法 将98例冠心病心绞痛患者经过2周

  8. Effectiveness Evaluation of Danhong Injection Combined with Naoxintong Capsule in the Treatment of Unstable Angina Pectoris of Coronary Heart Disease%丹红注射液与脑心通胶囊联用对冠心病不稳定型心绞痛的有效性评价

    Institute of Scientific and Technical Information of China (English)

    卢旭升

    2016-01-01

    Objective To investigate the clinical effectiveness of Danhong Injection combined with Naoxintong Capsule in the treatment of patients with unstable angina pectoris. Methods 124 UAP patients from Department of Cardiology in our hospital from January 2013 to March 2015 were selected and divided randomly into OBG group (63 patients) and COG group (61 patients). Pa-tients in the two groups were treated with Danhong Injection and Naoxintong Capsule respectively, whose statistical data were compared and analyzed. Results Of the 63 patients in the OBG group, there were 33 excellent cases (χ2=8. 796, P=0. 015), 28 effective cases and 2 void cases. The effective rate was 96. 83%, which was statistically significant ( P<0. 05 ) compared with the COG group. After treatment, time of chest pain, palpitations, shortness of breath, abnormal ECG and other symptoms was significantly shorter than that in the COG group. The difference in ECG and blood rheology indexes between the two groups were statistically signifi-cant (P<0. 05). Conclusion Danhong Injection combined with Naoxintong Capsule can effectively improve clinical symptoms and prognosis of patients, shorten the disappearance time of chest pain, palpitations, shortness of breath and electrocardiographic abnor-mality, and improve the prognosis of patients, which is worth using for reference and popularizing.%目的:研究丹红注射液(Danhong Injection, DHI)与脑心通胶囊(Naoxintong Capsules, NXTC)联合治疗不稳定型心绞痛( Unstable Angina Pectoris, UAP)的临床有效性。方法将我院心内科2013年1月至2015年3月间收治的124例UAP患者作为观察对象,按随机数字表法分为OBG组(63例)和COG组(61例),分别采用DHI、 NXTC+DHI进行治疗,统计两组患者的治疗数据进行对比分析。结果 OBG组63例患者显效33例(χ2=8.796, P=0.015),有效28例,无效2例,治疗有效率96.83%与COG组存在显著差异,具有统计学意义, P<0.05。患者治疗后胸痛

  9. 高敏心肌肌钙蛋白在不稳定型心绞痛心肌早期损伤诊断的应用研究%Study of application of high-sensitivity cardiac troponin in diagnosis of early myocardial damage in unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    陈波; 杨万勇; 周利龙; 郭乃芸; 程奎山; 曾庆贤

    2012-01-01

    Objective To investigate the value of serum high-sensitivity cardiac troponin T (hs-cTnT) determination in the early clinical diagnosis of minor myocardial damage of unstable angina pectoris (UAP). Methods For the 60 patients diagnosed with UAP, the venous blood was collected for hs-cTnT test at the 2nd, 6th, 8th, 12th and 24th hour of chest pain attack. The UAP group, the SAP group and the healthy control group were compared; the low, medium and high risk groups were compared. Results At the 2nd hour of chest pain attack, positive samples appeared in the patients of the UAP group. The serum positive rate was 53.3% in the UAP group, which was higher than the 13.3% in the SAP group and 1.7% in the control group, with significant differences (P < 0.05); among UAP patients, the positive rates of medium and high risk groups were 78.9% and 93.7%, which were significantly higher than the 5.3% of the low risk group (P < 0.05). Conclusion Serum hs-cTnT determination is a sensitive and specific indicator reflecting patients' early myocardial damage, and is of high clinical value in the early diagnosis of minor myocardial damage in patients with unstable angina pectoris.%目的 探讨血清高敏心肌肌钙蛋白T(hs-cTnT)测定在不稳定型心绞痛(UAP)患者心肌轻微损伤的早期临床诊断价值.方法 检测最终确诊的60例不稳定型心绞痛患者,分别于胸痛发作2、6、8、12、24 h采静脉血进行hs-cTnT检测,分别对UAP组与稳定型心胶痛(SAP)组及健康对照组低、中、高危险组间患者进行比较.结果 UAP患者胸痛2 h既有阳性标本出现,UAP组血清阳性率为53.3%,高于SAP组的13.3%和对照组的1.7%,差异有统计学意义(P < 0.05);UAP患者中、高危险组阳性率为78.9%和93.7%,明显高于低危险组的5.3%(P < 0.05).结论 血清hs-cTnT测定是反映患者心肌早期损伤的敏感性和特异性指标,对UAP患者轻微心肌损伤的早期诊断有较高临床价值.

  10. The relationship between plasminogen activator inhibitor-1 gene-844G→A polymorphism and rotatable angina pectoris%纤溶酶原激活物抑制物-1基因-844G→A多态性与不稳定心绞痛的关系

    Institute of Scientific and Technical Information of China (English)

    路雅茹; 秦勤; 毛用敏; 李广平; 赵炳让

    2012-01-01

    Objective To investigate the relatione relationship between level of PAI-1 antigen,its geng promoter -844G->A polymorphism and unstable angina pectoris. Methods 121 patients with unstable angina pectoris (UAP group) and 108 patients with angiography-proved no stenosis (control group) were studied. The level of PAI-1 antigen was measured by ELISA. The specific DNA segment of PAI-1 was amplified by PCR, and incised by endonuclease XhoI.The genotype of PAI-1 gene promoter-844 site was confirmed by Agarose Electrophoresis. Results The level of PAI-1 antigen in UAP group was significantly higher than that in control group (68.15 ± 45.29) jig/Las (53.39 ± 20.62) |xg/L, PA polymorphism has no relationship with the occurrence of UAP,but there is higher level of PAI-1 antigen in carriers with A allele.%目的:探讨纤溶酶原激活物抑制物-1(plasminogen activator inhibitor-1,PAI-1)抗原水平及其基因启动子-844G→A多态性与不稳定心绞痛(UAP)的关系.方法:UAP患者121例(UAP组)和非冠心病者108例(对照组),以ELISA法测定PAI-1抗原水平.PCR扩增特定DNA片段,XhoI酶切、琼脂糖电泳确定PAI-1基因启动子-844位点基因型.结果:UAP组PAI-1抗原水平(68.15±45.29)μg/L显著高于对照组(53.39±20.62)μg/L,P<0.001.PAI-1抗原水平与血糖、总胆固醇(TC)、低密度脂蛋白胆固醇(LDLc)水平正相关,r分别为0.147、0.151、0.144(P<0.05).A、G等位基因频率为0.40、0.60,AA、AG、GG三种基因型在两组间分布差异无统计学意义,A等位基因与较高的PAI-1抗原水平有关.结论:高PAI-1抗原水平是UAP发生的危险因素,PAI-1基因启动子-844G→A基因多态性与UAP发病无关.但A等位基因携带者存在较高的PAI-1抗原水平.

  11. Observation on curative effects of low molecular weight heparin of prolongable curative course on treating unstable angina pectoris%低分子肝素延长疗程治疗不稳定型心绞痛疗效观察

    Institute of Scientific and Technical Information of China (English)

    胡亚力; 苏珍; 白洪雁; 苏晓燕; 刘怡

    2001-01-01

    目的:观察低分子肝素延长疗程治疗不稳定型心绞痛的疗效。方法:同期入院的不稳定型心绞痛患者168例,随机分为2组,均在常规治疗基础上应用低分子肝素(立迈青)皮下注射,每日2次。A组应用1周,B组应用3周,第1周用量2组均为每次120 IU/kg,第2~3周B组用量每次100 IU/kg。结果:早期(第7日)观察2组总有效率分别为75.9%、77.4%,疗效无显著差异(P>0.05);心血管意外事件(急性心肌梗死、心脏性或非心脏性死亡、药物无法控制病情需行急性血运重建术)及出血,在2组的发生率无显著差异(P>0.05) 。晚期(第8~30日)观察2组总有效率分别为87.2%、97.5%,有显著性差异(P0.05) 。结论:低分子肝素延长疗程治疗不稳定型心绞痛疗效较短程应用疗效为好,且不增加出血发生率。%Objective:To observe the curative effect of low molecular weight heparin of prolongable curative course on treating unstable angina pectoris.Methods:One hundred and sixtyeight cases with unstable angina pectoris who were admitted into hospital at the same period were randomly divided into two groups.Both groups were subcutaneously injected by low molecular weight heparin combined with conventional therapy,two times a day for one week in group A and three weeks in group B respectively.In the first week,the dosage of heparin in group A and B was 120 IU/kg every time,from second to third week,the dosage of heparin in group B was 100 IU/kg every time.Results:The total effective rates in group A and group B were 75.9% and 77.4% respectively in early stage (seventh day),and the difference was not significant (P>0.05).The incidences of cardiovascular accidental events (acute myocardial infarction,cardiac death,uncardiac death,the illness which could not be controlled by the medicine and should be treated with acute reconstruction of blood circulation) and haemorrhage in both groups had not significantly different

  12. 不稳定性心绞痛患者的血管内皮生长因子水平及其相关因素%Concentration of plasma vascular endothelial growth factor and related factors in patients with unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    何文芳; 王喆; 蔡军; 池洪杰; 杨新春

    2015-01-01

    Objective To observe plasma vascular endothelial growth factor(VEGF) levels and related factors in patients with unstable angina pectoris (UAP).Methods A total of 108 consecutive patients with chest pain hospitalized in our department from October to December 2014 were included.They were divided into UAP (n =78) and non-CHD group (n =30) bv the result of coronary angiography (CAG).Coronary artery lesion was assessed according to the Gensini score,serum lipids,homocysteine (Hcy) levels and other biochemical indicators were also determined.The peripheral arterial tonometrv was evaluated by reactive hyperemia index (RHI) measured by Endo-PAT2000 Noninvasive Diagnostic System.The level of plasma VEGF was detected in patients with unstable angina pectoris.Multiple linear regression analysis was used to analyze the correlations between VEGF and various related factors.Results Percent of male gender,triglyceride (TG) and Hcy levels were significantly higher in UAP group than in no-CHD group(all P < 0.05).VEGF values was significantly higher ((102.1 ± 55.7) ng/L vs.(80.9 ± 38.1)ng/L,P < 0.05),while RHI was significantly lower (1.53 ± 0.27 vs.1.65 ± 0.32,P < 0.05) in UAP group than in no-CHD group.Multiple linear regression analvsis showed that VEGF value was significantly correlated with degree of coronary artery stenosis,Gensini score and RHI (β =38.03,P < 0.01;β =0.51,P < 0.01;β =-69.30,P =0.03;respectively).Conclusion VEGF levels are significantly increased in patients with unstable angina pectoris,and VEGF level is significantly associated with the degree of coronarv artery stenosis,Gensini score and RHI.VEGF level might serve as a new biochemical indicator for coronary artery lesion in patients with UAP.%目的 评估不稳定性心绞痛患者的血管内皮生长因子(VEGF)水平及其相关因素方法 连续入选2014年10至12月在北京朝阳医院住院的胸痛待查患者108例,其中不稳定性心绞痛组78例,冠状

  13. Clinical evaluation of Yiqifumai combined with Alprostadil in the treatment of cardiac insufficiency with unstable angina pectoris%益气复脉联合前列地尔治疗老年人心功能不全伴不稳定心绞痛的临床观察

    Institute of Scientific and Technical Information of China (English)

    赵春杰; 曹明英; 姚朱华

    2014-01-01

    Objective To assess the therapeutic effects of Yiqifumai combined with Alprostadil injection on patients with chronic cardiac insufficiency and angina pectoris.Methods One hundred and fifty patients with heart dysfunction (NYHA [Ⅱ-Ⅲ) and angina pectoris were randomly divided into three groups,the control group (n=50),the Yiqifumai group (n=50),and the Yiqifumai plus Alprostadil group (n=50).Parameters including clinical effectiveness,electrocardiograph (ECG),heart function and hemodynamics were evaluated.Results The overall clinical effectiveness rate in the Yiqifumai plus Alprostadil group (94 %) was higher than those in the Yiqifumai group (78 %) and the control group (54%) (P<0.05 for both).The overall effectiveness rate in ECG changes was higher in the Yiqifumai plus Alprostadil group (84%) than in the Yiqifunai group (58%) and the control group (42%) (P<0.05 for both).While no significant difference in the left ventricular ejection fraction (LVEF) was found among the three groups before treatment,evident improvement in LVEF was observed in the Yiqifunai group and the Yiqifumai plus Alprostadil group 14 days after treatment,compared with pre-treatment data [(49±9)% vs.(40±10)% and (59±9)% vs.(41±10) %,respectively; P<0.05 for both].However,there was no significant difference between the two groups (P>0.05).There was no improvement in LVEF in the control group after treatment (P >0.05).No difference in hemodynamic parameters,including cardiac output,cardiac index and left ventricular stroke work index,was found among the three groups before treatment (P>0.05),but they showed improvement in the Yiqifunai group and the Yiqifumai plus Alprostadil group after treatment (P<0.05 for both),with greater improvement in the latter group.The improvement was not significant in the control group before and after treatment (P>0.05).Conclusions Yiqifumai combined with Alprostadil in the treatment of cardiac insufficiency with

  14. Variation in the use of coronary angiography in patients with unstable angina is related to differences in patient population and availability of angiography facilities, without affecting prognosis

    NARCIS (Netherlands)

    A.J.M. van Miltenburg-van Zijl (Addy); M.L. Simoons (Maarten); P.M.M. Bossuyt (Patrick); T.R. Taylor (Thomas); M.J. Veerhoek

    1996-01-01

    textabstractOBJECTIVES: Examination of the difference in management strategies with respect to coronary angiography in patients with unstable angina pectoris, and the consequences of this difference on prognosis. DESIGN: Prospective registration of consecutive patients admitted to two different hosp

  15. [Ludwig's angina].

    Science.gov (United States)

    De Bast, Y; Appoloni, O; Firket, C; Capello, M; Rocmans, P; Vincent, J L

    2000-06-01

    Ludwig's angina is a rare infectious condition originating in the oropharyngeal region, most commonly from the teeth. The principal symptoms consist of cervical pain, dyspnea, dysphagia, symmetrical neck swelling and fever. Serious complications include respiratory collapses, mediastinitis, pleural empyema, pericarditis and pericardial tamponade, and may result in the death of the patient. The most useful investigations in patients with suspected Ludwig's angina are clinical assessment, a cervico-thoracic CT-scan to determine the extent of the lesions, microbiological examination and panoramic radiography to detect possible dental focuses of infection. Treatment consists of ensuring adequate ventilation by securing the upper airways, broad spectrum antibiotic therapy, eradication of the source of infection, and often early surgical decompression may be necessary. Rapid diagnosis and appropriate treatment can reduce the mortality rate to 10%.

  16. Cardiac catheterization in patients with unstable angina. Recent onset vs crescendo pattern.

    Science.gov (United States)

    Plotnik, G D; Fisher, M L; Carliner, N H; Becker, L C

    1980-08-01

    Among patients with unstable angina pectoris, those with crescendo angina seem to be at high risk for death and myocardial infarction. We reviewed the clinical, arteriographic, and hemodynamic findings in 218 consecutive catheterized patients with unstable angina. Unstable angina was defined as ischemic cardiac pain at rest associated with transient ECG changes but no evidence for acute myocardial infarction. Patients were divided into two groups according to the duration of symptoms: 134 patients with crescendo angina (new, or increasing, rest pain with previous ischemic symptoms present for more than three months) and 84 with recent onset angina (symptoms present for less than three months). Compared with patients with recent onset symptoms, patients with crescendo angina had more extensive coronary disease and lower ejection fractions, which may explain their poor prognosis.

  17. Urban angina in the mountains: effects of carbon monoxide and mild hypoxia on subjects with chronic stable angina; Angine de poitrine dans les villes de montangne: effets du monoxyde de carbone et d'une hypoxie legere chez des patients atteints d'angor stable

    Energy Technology Data Exchange (ETDEWEB)

    Kleinman, M.T.; Leaf, D.A.; Kelly, E.; Caiozzo, V.; Osann, K.; O' Neill, T.

    2001-01-01

    The aim of this study is the effects of a carbon monoxide exposure and the altitude on the coming of pectoris angina during physical exercise and on the cardiopulmonary functions for coronary disease patients. (A.L.B.)

  18. Angina treatments and prevention of cardiac events: an appraisal of the evidence.

    Science.gov (United States)

    Winchester, David E; Pepine, Carl J

    2015-12-01

    Angina pectoris is the symptomatic manifestation of transient myocardial ischaemia. At the most fundamental level, angina arises when myocardial oxygen demand exceeds the ability of the coronary circulation to provide adequate oxygen delivery to maintain normal myocardial metabolic function. In vivo, the balance of oxygen demand and delivery is a complex physiological process that can be altered by a variety of interventions. Lifestyle modification is a cornerstone of cardiovascular disease management, with or without angina. Additional pharmaceutical and physical interventions are usually applied to patients with angina. Mechanisms of action for these interventions include heart rate modulation, vascular smooth muscle relaxation, metabolic manipulation, revascularization, and others. A number of these interventions have overlapping mechanisms that target angina. Additionally, some interventions may directly or indirectly prevent or delay adverse outcomes such as myocardial infarction or death. This review summarizes current evidence for many applied ischaemia treatments documented to modify angina and comments on available evidence relating to improvement in cardiovascular outcomes.

  19. 冠状动脉造影对非典型心绞痛伴焦虑抑郁情绪者特征的分析%Analysis of anxiety and depression in patients with nontypical angina pectoris by coronary arteriography

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    @@ INTRODUCTION There are dramatic differences in induction factors, nature, locus,duration, relief manner of pain between typical and nontypicalangina pectoris. Causes and pathogenesis of pain are complicated,and may be correlated with anxiety and depression.

  20. 降香舒心胶囊对气滞血瘀型不稳定型心绞痛患者血管内皮功能的影响%Effects of Jiangxiang Shuxin Capsules on Endothelial Function in Patients with Unstable Angina Pectoris of Qi Stagnation and Blood Stasis Type

    Institute of Scientific and Technical Information of China (English)

    常智玲; 何江; 李溥; 管慧; 周锦勇; 李世红; 廖沙; 阳淑芳

    2012-01-01

    目的:探讨降香舒心胶囊对气滞血瘀型不稳定型心绞痛的临床疗效及血管内皮功能的影响.方法:采用随机双盲安慰剂对照试验设计方法,选择158例气滞血瘀型不稳定型心绞痛患者随机分为治疗组81例和对照组77例,两组均采用最佳西医治疗方案,治疗组在西医治疗基础上口服降香舒心胶囊(4粒/次,3次/d),对照组口服安慰剂胶囊(4粒/次,3次/d).治疗疗程均为8周.并观察两组患者治疗前后心绞痛发作、中医证候以及检测血清一氧化氮(NO)、内皮素(ET)、血管性血友病因子(vWF)、超氧化物歧化酶(SOD)、丙二醛(MDA)水平及肱动脉血流介导的血管扩张变化率(FMD).结果:治疗组与对照组心绞痛缓解总有效率分别为93.82%,68.83%,中医症状疗效总有效率分别为98.76%,66.23%;两组患者胸痛、胸闷、气短、心悸等各单项评分及总分与治疗前比较均降低(P<0.01).治疗组与对照组比较,差异有统计学意义(P<0.05);与治疗前比较,治疗后两组患者血清ET,vWF降低,NO,FMD均升高(P<0.01)).治疗组血清SOD水平明显升高,MDA水平显著下降(P<0.01),而对照组SOD和MDA水平无变化.结论:降香舒心胶囊能改善气滞血瘀型不稳定型心绞痛患者临床症状和血管内皮功能,是安全有效的辅助治疗药物.其机制可能与抗脂质过氧化作用有关.%Objective: To investigate the effect of Jiangxiang Shuxin capsules on vascular endothelium in patients with unstable angina pectoris ( UAP) of Qi stagnation and blood stasis type. Method; A design of randomized, placebo-controlled, double-blind trial was adopted; 158 cases of UAP of Qi stagnation and blood stasis type were selected and randomly divided into treatment group and control group, with 81 cases in treatment group and 77 in control group. The best western medical therapy solution was applied to both groups, on which basis Jiangxiang Shuxin capsules and placebo capsules

  1. 丹参酮ⅡA磺酸钠注射液治疗不稳定型心绞痛疗效和安全性的Meta分析*%Meta-analysis on Effectiveness and Safety of TanshinoneⅡA Sulfonate Sodium Injection in Treatment of Unstable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    马晓聪; 李建橡; 许明东; 邓学秋; 岳桂华; 郑景辉

    2015-01-01

    This paper was aimed to study the effectiveness and safety of TanshinoneⅡA Sulfonate Sodium Injection in the treatment of unstable angina pectoris (UAP). Keywords such as coronary atherosclerotic heart disease, coronary heart disease, unstable angina, chest impediment, cardialgia, TanshinoneⅡA Sulfonate Sodium Injection, tanshinone injection, tanshinoneⅡA sulfonate, unstable, angina, randomized controlled trial (RCT), and clinical trials were searched in CNKI, VIP, Wanfang and Pubmed from the construction of database until October 31st, 2014. The inclusion criteria were RCT with clinical data integrity, similar literature research methods, and good balance between groups. The Jadad score method was used to carry out quality assessment. Meta-analysis was conducted by RevMan5.2 software. Count data was processed by odds ratio (OR). Measurement data was processed with the weighted mean differences (WMD). The 95% confidence interval (CI) was also calculated. The heterogeneity test result of included literatures was P > 0.05. The fixed effects model was used in the meta-analysis. On the other hand, random effect model was used. For the analysis results of more than 10 papers, the funnel plot was used in the analysis of publication bias. The results showed that a total of 34 studies were included. The results of meta-analysis suggested that the total efficiency of conventional treatment plus TanshinoneⅡA Sulfonate Sodium Injection for UAP was [OR = 3.83, 95%CI (3.11, 4.71),P < 0.000 01]. The electrocardiogram improvement rate was [OR = 3.34, 95%CI (2.61,4.28),P < 0.000 01]; plasma viscosity improvement was [WMD = -0.20, 95%CI (-0.38, -0.03),P = 0.03]; high shear viscosity of whole blood improvement was [WMD = -0.67, 95%CI (-0.85, -0.50),P < 0.000 01]; C-reactive protein improvement was [WMD = -2.66, 95%CI (-3.31, -2.00),P < 0.000 01]. It was concluded that the conventional treatment plus TanshinoneⅡA Sulfonate Sodium Injection for UAP had certain clinical

  2. Successfully treated unstable angina pectoris in a young Japanese female.

    Science.gov (United States)

    Umetani, K; Nakagawa, K; Oagawa, R; Iida, T; Kohno, I; Osada, M; Sawanobori, T; Ijiri, H; Komori, S; Tamura, K

    2001-05-01

    A 25-year-old Japanese female complaining chest oppression and palpitation was admitted to hospital under the presumptive diagnosis of ischemic heart disease (IHD), although no obvious underlying disease associated with IHD was detected. Coronary angiography showed stenosis at the proximal site of left anterior descending artery (LAD), with dilatation and tortuosity at the bifurcation of the first and the second septal branches. Intravascular ultrasound imaging of the LAD showed intimal thickness without calcification at the site of stenosis. The stenosis was successfully and smoothly dilated by percutaneous transluminal angioplasty. Even with precise evaluation, the cause of the coronary artery disease in this young female patient was not clarified. Further careful follow-up is needed.

  3. ASSESSMENT OF CORONARY FLOW RESERVE IN PATIENTS WITH ANGINA PECTORIS

    Institute of Scientific and Technical Information of China (English)

    沈卫峰; 蔡煦; 张大东; 张宪; 郑爱芳; 龚兰生

    1995-01-01

    ASSESSMENTOFCORONARYFLOWRESERVEINPATIENTSWITHANGINAPECTORISShengWeifeng(沈卫峰);CaiXu(蔡煦);ZhangDadong(张大东);ZhangXian(张宪);ZhengAi...

  4. Nifedipine gastrointestinal therapeutic system versus atenolol in stable angina pectoris

    NARCIS (Netherlands)

    deVries, RJM; vandenHeuvel, AFM; Lok, DJA; Claessens, RJJ; Bernink, PJLM; Pasteuning, WH; Kingma, JH; Dunselman, PHJM

    1996-01-01

    The gastrointestinal therapeutic system formulation of nifedipine enables a once-daily dosing resulting in predictable, relatively constant plasma concentrations. To evaluate the efficacy and safety of this formulation and to compare this with the beta-blocker atenolol, we conducted a double-blind,

  5. 超声斑点追踪二维纵向应变评价心绞痛患者冠状动脉介入治疗术前后左心室心肌收缩功能%Assessment of left ventricular myocardial function before and after percutaneous coronary intervention in patients with angina pectoris using two-dimensional longitudinal strain echocardiography

    Institute of Scientific and Technical Information of China (English)

    黄冬梅; 夏稻子; 张宇虹; 礼广森; 崔洪岩

    2011-01-01

    目的 应用超声二维纵向应变探讨心绞痛患者冠状动脉介入治疗术(PCI)前后左心室心肌收缩功能改变情况.方法 32例心绞痛(左前降支病变)患者和30例正常人(对照组),分别记录PCI术前、术后3个月和正常人心尖四腔切面,二腔切面,左心室长轴高帧频图像,应用二维应变软件测量各个节段的收缩期峰值纵向应变值.结果 PCI术前患者(术前组)与对照组比较,心肌节段的纵向应变值减低(P<0.05),且与冠状动脉造影左前降支病变分布范围相一致;与PCI术前相比,术后3个月患者(术后组)相应节段心肌收缩期纵向应变值较前改善(P<0.05),且部分节段与对照组比较差异无统计学意义(P>0.05).结论 超声斑点追踪二维纵向应变不但能定位诊断节段性室壁运动异常,而且能够定量地评价心绞痛患者PCI术后左心室心肌收缩功能改善情况.%Objective To explore the characteristics of two-dimensional strain of left ventricular myocardial function before and after percutaneous coronary intervention( PCI) in the patients with angina pectoris ( AP ) by speckle tracking echocardiography. Methods A total of 32 patients with AP and 30 healthy volunteers were involved. High frame rate two-dimensional images were recorded from the apical four-chamber view, two-chamber view and long-axis view of the left ventricle, respectively. The peak systolic longitudinal strain was measured in all of these views using two-dimensional strain software. Results Compared to the control group, the left ventricular peak systolic longitudinal strain values in part of segments were lower in patients with AP before and after PCI ( P < 0.05 ). Left ventricular peak systolic longitudinal strain values in part of segments were significantly improved at 3 month after PCI compared to those patients before PCI ( P<0. 05 ). Conclusions Two-dimensional strain echocardiography can be used to precisely quantify regional

  6. 穴位敷贴治疗稳定型心绞痛的临床随机对照试验文献质量评价%Quality Evaluation of Randomized Controlled Trials in the Treatment of Point Application Therapy for Stable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    张玲霖; 张洁; 李德华; 赵凌; 梁繁荣

    2015-01-01

    目的:评价穴位敷贴治疗稳定型心绞痛的临床随机对照试验研究的文献质量。方法:检索PubMed、Cochrane图书馆、Clinical trials、MEDLINE等英文数据库,以及WanFang Data (1990~2013年)、CBM(1990~2013年)、CNKI(1990~2013年)、VIP(1990~2013年)等中文数据库。筛选、纳入符合标准的研究,并对纳入研究的质量(包括研究的方法学质量、诊断标准、纳入标准、排除标准、干预措施、疗效评价标准、终点指标、不良反应等)进行评价。结果:共纳入9篇随机对照试验, Jadad评分为低质量研究(I<3分)。9篇研究有明确的诊断标准,4篇研究有较完整的纳入、排除标准,2篇研究有明确的疗效评价标准,3篇研究报道了不良反应。结论:有限的纳入文献显示,穴位敷贴治疗稳定型心绞痛的文献整体质量偏低,缺乏高质量的临床研究。%Objective:To evaluate the quality of randomized controlled trials on treatment of point application therapy for stable angina pectoris ( SAP) .Methods:We performed an extensive literature search in four English medical databases which were PubMed,Cochrane Library,Clinical trials and MEDLINE,and four Chinese medi-cal databases that were WanFang Data ( 1990 -2013 ) , CBM ( 1990 -2013 ) , CNKI ( 1990 -2013 ) and VIP (1990-2013)for randomized controlled trials(RCTs).The appropriate RCTs in accordance with inclusion and exclusion criteria were included.We evaluated the quality of the included trials,containing methodological qual-ity,diagnostic criteria,inclusion and exclusion criteria,intervention measures,curative effect evaluation stand-ards,endpoint criteria and adverse effects.Results:Our literature search identified 10 RCTs relevant to point ap-plication therapy for SAP.But the 10 studies were of low quality according to the Jadad scale (I<3).The in-cluded studies had clear diagnostic criteria;4 trials had integrated inclusion

  7. Value of heart-type fatty acid binding protein to predicting senile unstable angina pectoris%心脏型脂肪酸结合蛋白预测老年不稳定型心绞痛患者预后的价值

    Institute of Scientific and Technical Information of China (English)

    钱海燕; 黄觊; 杨跃进; 杨艳敏; 张朝阳

    2013-01-01

    Objective To explore the value of heart fatty acid binding protein (H-FABP) to predicting the prognosis of senile unstable angina pectoris (UAP).Methods A total of 175 UAP patients aged 60 years or older were divided into positive H-FABP group and negative H-FABP group,and were recorded and analyzed the clinical data and 12-month follow-up survey results.Results The age was older,body mass index was larger,and the proportions of smoking history,family history of coronary heart disease,previous myocardial infarction and coronary artery bypass history,and diabetes mellitus were higher in positive group than those in negative group (P<0.05).The left ventricular ejection fraction was lower in positive group than that in negative group (P<0.05).Coronary angiography results showed that the rates of multi-vessel lesions,diffusive and occlusive lesions,and left main and left anterior descending lesions were higher in positive group than those in negative group (P<0.05).After the follow-up survey for 12 months,the incidence of major adverse cardiovascular events was significantly higher in positive group than that in negative group (P<0.01).Conclusion H FABP is valuable to identify the high risk population and to predict the prognosis of UAP patients aged 60 years or older.%目的 探讨心脏型脂肪酸结合蛋白(heart type fatty acid binding protein,H-FABP)预测老年不稳定型心绞痛患者预后的价值.方法 年龄≥60岁不稳定型心绞痛患者175例,分为H-FABP阳性组48例和阴性组127例,记录并分析2组资料及12个月随访结果.结果 阳性组年龄、体质量指数大于阴性组(P<0.05),吸烟、冠心病家族史、既往心肌梗死病史、冠状动脉介入和旁路移植手术史及合并糖尿病比例明显高于阴性组(P<0.05),左室射血分数低于阴性组(P<0.05);冠状动脉造影显示,阳性组多支、弥漫甚至闭塞病变、累及左主干和前降支比例高于阴性组(P<0.05);随访12个

  8. 稳定性心绞痛患者发生急性冠状动脉综合症前后血浆炎性因子水平的变化及意义%The changes of plasma IL-18 and IL-10 in stable angina pectoris patients before and after occurrence of acute coronary syndromes

    Institute of Scientific and Technical Information of China (English)

    李巧汶; 李志樑; 邱健; 阮云军; 顾晓龙

    2011-01-01

    Objective To investigate the changes of plasma IL-18 and IL-10 in stable angina pectoris(SAP) patients before and after occurrence of acute coronary syndrome(ACS), probe the role of inflammation in developing ACS and provide new ideas for prevention of ACS.Methods The plasma IL-18, IL-10 of 211 SAP patients were measured.The patients were divided into 2 groups: developing ACS group(38 patients) and no ACS group(173 patients) according to the results of the 24 months' follow-up.Results Plasma IL-18 level and IL-18/IL-10 ratio in ACS group were higher than those in no ACS group (P < 0.01),plasma IL-10 level in the ACS group was lower' than that in no ACS group (P < 0.01).In ACS group,plasma IL-18 level and IL-18/IL-10 ratio were higher after developing ACS than before (P < 0.05), on the contrary, plasma IL-10 level was lower after developing ACS than before (P < 0.05).Conclusions The plasma IL-18 and IL-10 levels in the SAP patients are closely related to the development of ACS, which suggests that inflammation plays an important role in developing ACS, and anti-inflammatory treatment might be a new means for preventing ACS.%目的 观察稳定性心绞痛患者发生急性冠状动脉综合症(ACS)前后血浆白细胞介素(IL)-18、IL-10水平的变化,探讨炎症在ACS发生中的作用及防治的新途径.方法 检测211例稳定性心绞痛患者IL-18、IL-10水平变化,随访24个月,根据随访结果将患者分为ACS组(38例)及无ACS组(173例),并进行比较.结果 ACS组患者血浆IL-18水平及IL-18/IL-10比值明显高于无ACS组(P<0.01),血浆IL-10水平明显低于无ACS组(P<0.05);ACS组患者发生ACS后血浆IL-18水平及IL-18/IL-10比值明显高于ACS发生前(P<0.01),发生ACS后血浆IL-10水平明显低于ACS发生前(P<0.05).结论 稳定性心绞痛患者血浆IL-18、IL-10水平与ACS的发生密切相关,提示机体炎症在ACS发生中发挥重要作用,抗炎治疗可能是防治ACS的途径之一.

  9. Relationship between N-terminal pro brain natriuretic peptide and insulin sensitivity index in pa-tients with unstable angina pectoris%血浆NT-proBNP水平及胰岛素敏感性指标与不稳定型心绞痛危险分层相关研究

    Institute of Scientific and Technical Information of China (English)

    王培; 郑晓晖; 胡丰朝; 杨睿

    2014-01-01

    Objective To study the correlation of N-terminal pro brain natriuretic peptide( NT-proBNP)with insulin sensitivity index( FBG,FINS,FINS/FBG,ISI)in UAP patients,and its clinical significance. Methods One hundred patients with UAP were enrolled as the observation group,30 pa-tients with stable angina pectoris( SAP)as SAP group,and 30 healthy people as the normal control (COM)group. According to the Braunwald UAP,patients in UAP group were graded into 3 sup-groups( grade 1 ,grade 2 and grade 3 ). The plasma NT-proBNP and insulin sensitivity indexes were detected in each group,and then the results were analyzed and the linear correlation analysis was made. Results The concentration of plasma NT-proBNP,FINS,FINS/FBG in patients with UAP and SAP group were significantly higher than those in COM group( P﹤0. 05 ),but ISI was lower than that in COM group( P ﹤0. 05 ). The concentration of plasma NT-proBNP,FINS,FINS/FBG in patients with UAP were significantly higher than those in patients with SAP( P﹤0. 05 ),but ISI was lower than that in patients with SAP(P﹤0. 05),and there was no significant difference in FBG between the two groups. The concentration of plasma NT-proBNP,FINS,FINS/FBG in patients with grade 2 and grade 3 were significantly higher than those in patients with grade 1( P﹤0. 05 ),but ISI was lower in the grade 2( P﹤0. 05). No significant diference was found between grade 2 and grade 3. In UAP patients,the plasma NT-proBNP concentration was positively correlated with FINS,FINS/FBG( r =0. 38,P =0. 046,r =0. 56 ,P=0. 039 ),and negative correlated with ISI( r = -0. 62 ,P =0. 028 ),and with no correlation with FBG. Conclusions The concentration of plasma NT-proBNP was elevated and insulin sensitivity decreased in UAP, especially in Braunwald UAP grade 2 and grade 3( rest angina ),the concentration of NT-proBNP was negatively cor-related with insulin sensitivity. The combined determination is significant in risk grading reference of UAP.%目的:

  10. 肌钙蛋白Ⅰ对老年不稳定型心绞痛患者危险分层的判断价值%The value of cardiac troponin Ⅰ in risk stratification of elderly patients with unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    党彦平; 耿秀双

    2009-01-01

    Objective To study the value of serum troponin I(cTnI)in risk stratification of elderly patients with unstable angina pectoris(UAP).Methods Serum cTnI levels were measured in 22 healthy subjects(control group),27 stable angina peetoris(SAP)and 72 UAP elderly patients,respectively.Cardiac events(non fatal myocardial infarction,cardiac sudden death)were observed within 1 month of hospitalization.Serum cTnI≥1.5 μg/L was considered as the cutoff level for myocardial damage.Results Serum cTnI levels in the UAP group were higher than those in the SAP and control group [(1.96±0.61)μg/L,(0.68±0.19)μg/L and(0.46±0.10)μg/L,respectively](P<0.01).In the UAP group,serum cTnI levels increased with increase of Braunwald classification class[(1.25±0.38)μg/L,(2.12±0.34)μg/L and(3.06±0.72)μg/L,respectively](P<0.05).In Braunwald class Ⅲ patients,the rate of cardiac events in patients with serum cTnI≥1.5 μg/L was much higher than that in those with cTnI<1.5μg/L(16.7%vs 6.3%,P<0.05),risk ratio 2.05(95%confidence limit 1.02-9.78).The positive predictive value of serum cTnI≥1.5μg/L for cardiac events was 44.3%and the negative predictive value was 84.8%.Conclusions Detection of serum cTnI has clinical value in risk stratification of elderly atients with UAP.%目的 探讨心脏肌钙蛋白Ⅰ(cTnI)对老年不稳定型心绞痛(UAP)患者危险分层的价值.方法 对72例老年UAP患者、27例稳定型心绞痛(SAP)患者及22例健康对照者分别进行血清cTnI测定,并观察住院1个月内心脏事件发生情况.结果 UAP组血清cTnI值为(1.96±0.61)μg/L,明显高于SAP组的(0.68±0.19)μg/L及对照组的(0.46±0.10)μg/L(P均<0.01).UAP组内,随着Braunwald临床分级增高,Ⅰ~Ⅲ级血清cTnI值相应增高[分别为(1.25±0.38)μg/L、(2.12±0.34)μg/L及(3.06±0.72)μg/L](P<0.05).对照组、SAP组及Braunwald Ⅰ级UAP患者无一例发生心脏事件;18例Ⅱ级患者中,1例(其血清cTnI≥1.5μg/L)发

  11. Correlation between lipoprotein-associated phospholipase A2 and main risk factors in unstable angina pectoris patients%血清脂蛋白相关磷脂酶A2与不稳定心绞痛患者主要危险因素的相关性

    Institute of Scientific and Technical Information of China (English)

    张卫萍; 马云龙; 马琼; 陈涛; 郜珊珊

    2016-01-01

    目的:探讨血清脂蛋白相关磷脂酶A2(Lp-PLA2)与不稳定心绞痛患者主要危险因素的相关性。方法选择本院心脏内科2015-03~2015-06不稳定心绞痛住院就诊的52例患者为研究组,同期58例因胸痛行冠状动脉造影术( CAG)冠状动脉狭窄<30%且排除冠心病的患者为对照组。不稳定心绞痛患者入院后24 h内采用TIMI评分进行危险分层以及Gensi-ni积分,并检测血压,心率,肝、肾功能,血脂,凝血功能,心肌酶,N端脑利钠肽前体( NT-proBNP),高敏性C反应蛋白等指标。ELISIA法测定血清Lp-PLA2水平,并评价Lp-PLA2与不稳定心绞痛主要危险因素的相关性。结果不稳定心绞痛组脂蛋白( a)、低密度脂蛋白、肌钙蛋白I、肌酸激酶、NT-proBNP、纤维蛋白降解产物( FDP)、hs-CRP和Lp-PLA2水平明显高于对照组(P<0.05或P<0.01),Apo-A1则明显降低(P<0.05);TIMI评分高危组和中危组Lp-PLA2水平与Gensini积分高于低危组(P<0.01);不稳定心绞痛组血清Lp-PLA2水平与TIMI评分、Gensini积分、LDL、脂蛋白a、APTT以及D-二聚体呈现明显的正相关(P<0.05);Lp-PLA2水平与TIMI评分、Gensini积分、LDL和脂蛋白a呈线性回归。结论 Lp-PLA2水平是不稳定心绞痛高危人群危险程度和冠脉病变严重程度的有力预测因素,并且Lp-PLA2水平的升高也直接反映了LDL和脂蛋白( a)与动脉粥样硬化不稳定斑块发展的相关性。%Objective To investigate the correlation between lipoprotein-associated phospholipase A2(Lp-PLA2) and main risk factors of unstable angina pectoris( UA) . Methods Totally 52 patients with UA in Department of Cardiovascular Medicine from March 2015 to June 2015 were chosen as study group, and 58 chest pain patients with coronary stenosis<30% detected by coronary angiography and non-coronary heart disease were chosen as control group. All UA patients were subjected to risk assessment and stratification with TIMI risk score and Gensini score

  12. Influences of pioglitazone on quantity of endothelial progenitor cells and adiponectin level in patients with unstable angina pectoris complicating diabetes%吡格列酮对不稳定型心绞痛合并糖尿病患者内皮祖细胞数量及脂联素水平的影响

    Institute of Scientific and Technical Information of China (English)

    陈立东; 肖敏; 张绪国; 朱艳霞; 梁鹏飞; 邹兆坤

    2015-01-01

    目的:探讨吡格列酮对不稳定型心绞痛(UAP)合并2型糖尿病患者内皮祖细胞(EPCs)数量及脂联素水平的影响。方法入选自2010年6月至2011年5月在湖北医药学院附属太和医院住院的有UAP合并2型糖尿病患者57例,随机分为吡格列酮组(n=28)和对照组(n=29),吡格列酮组应用吡格列酮(30 mg/d)治疗,对照组患者不使用噻唑烷二酮类药物。治疗前及治疗12周时通过流式细胞技术双色分析法检测所有患者外周血中EPCs占有核细胞的百分比,其中EPCs用CD34+/KDR+双标记定位,比较两组患者在干预前后内皮祖细胞数量的变化及血清脂联素水平的变化。结果两组患者在治疗前EPCs的数量无统计学差异(P>0.05)。治疗12周时,吡格列酮组患者EPCs数量较治疗前明显增加(0.023±0.010 vs.0.051±0.012,P<0.01);对照组患者EPCs数量在治疗前后无统计学差异(P>0.05);12周时,吡格列酮组患者EPCs数量高于对照组患者(P<0.028)。吡格列酮组血清脂联素水平在治疗前、后有统计学差异(P<0.05);对照组患者血脂联素水平在治疗前、后无统计学差异(P>0.05);12周时,吡格列酮组患者血清脂联素水平高于对照组患者(P<0.05)。结论吡格列酮能够促进冠心病合并糖尿病患者EPCs的动员,提高患者血清脂联素水平。%Objective To investigate the influences of pioglitazone on quantity of endothelial progenitor cells (EPCs) and adiponectin level in patients with unstable angina pectoris (UAP) complicating type 2 diabetes mellitus (T2DM). Methods The patients (n=57) were randomly divided into pioglitazone group (n=28) and control group (n=29), and pioglitazone group was treated with pioglitazone (30 mg/d) and control group was not given TZD drugs. The percentage of peripheral EPCs in karyocytes was detected by using flow cytometry and double color analysis before

  13. 贵阳市居民对冠心病心绞痛治疗药物支付意愿的调查分析%Investigation and Analysis of the Willingness-to-pay for Angina Pectoris Treatments of Guiyang Citizens

    Institute of Scientific and Technical Information of China (English)

    伍红艳

    2015-01-01

    OBJECTIVE:To explore the willingness-to-pay and influential factors of citizens for angina pectoris treatment. METHODS:Close-ended questionnaire and open-ended questionnaire that are the two question types of contingent valuation meth-od was adopted to interview the citizens in Guiyang city by face to face and one to one,and the result was analyzed. RESULUTS:Totally 351 questionnaires were sent out and 351 were valid with effective rate of 100%. The average age was 40.72 years old (SD=16.86) with 51.28%(108 pearsons) males. And willingness-to-pay price of 67.24%(708 pearsons or times) was higher than initial setting price;an average of 457.44 yuan per month was given to the treatment with 98% effectiveness(the initial set-ting price was 200 yuan per month);and an average of 28.41 yuan per month was given to the treatment with 10% effectiveness (the initial setting price was 20 yuan per month). The better the effectiveness,the larger the willingness-to-pay value was given,a woman,belonging to the minority group,aged 45 and above,college educational level and above,or never do physical exercise gave the larger willingness-to-pay values;moreover,the larger willingness-to-pay values were given when the severity of original hypothesis health state was severe,or the questions were displayed with the high effectiveness of treatment followed the low effec-tiveness. CONCLUSIONS:The effectiveness of treatment,the order of willingness-to-pay questions,the original hypothesis of health state,the characteristics and habits of patients are the factors affecting the willingness-to-pay of patients. Contingent valua-tion method is an effective way to investigate the willingness-to-pay values.%目的:探讨居民对冠心病心绞痛治疗药物的支付意愿及其影响因素.方法:采用条件价值评估法中开放式及封闭式问题相结合的方式设计调查问卷,对贵阳市部分居民进行面对面、一对一对地调查访谈,并就调查结果进

  14. A STUDY OF HIGH SENSITIVITY C-REACTIVE PROTEIN IN UNSTABLE ANGINA

    Directory of Open Access Journals (Sweden)

    Satish

    2014-11-01

    Full Text Available BACKGROUND: Unstable angina has a wide variability in its natural history, changing concepts of Pathophysiology, and newer approaches to its management strategies. So, unstable angina still has importance and prime interest in research work. Various ongoing research works has provided newer insights in pathophysiology of unstable angina syndrome and helps in recognition of clinical variability and unpredictability of it. C - reactive protein being the most sensitive acute phase reactant currently held. A recent previous study has estimated the levels and values of high-sensitivity C - reactive protein in both stable and unstable angina pectoris. Data provided by the study indicated need for further studies in this field. With all these facts, the present study is carried out to estimated Hs CRP levels as a marker of inflammation in patient of unstable angina. AIMS AND OBJECTIVES: The present study was carried out with the following Aims and Objectives. To estimate Hs-CRP levels as a marker of inflammation in patients of unstable angina. To compare Hs-CRP levels in cases of unstable angina, with Hs-CRP levels in patients of stable angina and in healthy age and sex matched controls. MATERIAL AND METHODS: This study was carried out at Basaveshwar Teaching and General Hospital, Gulbarga, MRMC Gulbarga. Approximate duration of study was 1 ½ year from June-2008 to November, 2010. OBSERVATION: Following are the conclusions drawn from the present study.

  15. Ivabradine: the evidence of its therapeutic impact in angina

    OpenAIRE

    Guillaume Marquis-Gravel; Jean-Claude Tardif

    2008-01-01

    Guillaume Marquis-Gravel, Jean-Claude TardifMontreal Heart Institute, Université de Montréal, Montreal, Quebec, CanadaIntroduction: Stable angina pectoris (SAP) is a widely prevalent disease affecting 30 000 to 40 000 per million people in Europe and the US. SAP is associated with reductions in quality of life and ability to work, and increased use of healthcare resources. Ivabradine is a drug with a unique therapeutic target, the If current of the sinus node, developed ...

  16. Intravenous nitroglycerin for rest angina. Potential pathophysiologic mechanisms of action.

    Science.gov (United States)

    DePace, N L; Herling, I M; Kotler, M N; Hakki, A H; Spielman, S R; Segal, B L

    1982-10-01

    Twenty patients with refractory rest angina pectoris were treated with intravenously (IV) administered nitroglycerin (mean dosage, 72.4 micrograms/min; range, 15 to 226 micrograms/min). There was a considerable reduction or abolition in the number of ischemic episodes in 85% of patients without overall substantial changes in heart rate, mean arterial BP, pulmonary capillary wedge pressure (PCWP), and pulmonary arterial mean pressure. However, those patients with an initial PCWP of more than 12 mm Hg or a systolic pressure of more than 130 mm Hg had a substantial reduction in PCWP and systolic BP following IV nitroglycerin. We conclude that IV nitroglycerin may relieve rest angina by different pathophysiologic mechanisms. In some patients, IV nitroglycerin favorably altered the hemodynamic determinants of myocardial oxygen consumption. In others, however, no change in these determinants occurred, suggesting a direct effect on the coronary circulation.

  17. [Constant-frequency trans-esophageal electric atrial stimulation for evaluation of the severity of illness in patients with stenocardia and the anti-angina effect of erinit].

    Science.gov (United States)

    Gasilin, V S; Sidorenko, B A; Lazarev, I A; Smirnov, M Iu

    1990-12-01

    Constant-frequency transesophageal atrial pacing was used in 87 patients with coronary heart disease concurrent with stable angina pectoris of various functional classes (I-IV). This technique, as a bicycle ergometric test, allows one to assess the functional class of patients with angina and to ascertain the antianginal effect of agents, which was exemplified by erinit given in doses of 80 and 120 mg.

  18. Ivabradine: the evidence of its therapeutic impact in angina

    Directory of Open Access Journals (Sweden)

    Guillaume Marquis-Gravel

    2008-12-01

    Full Text Available Guillaume Marquis-Gravel, Jean-Claude TardifMontreal Heart Institute, Université de Montréal, Montreal, Quebec, CanadaIntroduction: Stable angina pectoris (SAP is a widely prevalent disease affecting 30 000 to 40 000 per million people in Europe and the US. SAP is associated with reductions in quality of life and ability to work, and increased use of healthcare resources. Ivabradine is a drug with a unique therapeutic target, the If current of the sinus node, developed for the treatment of cardiovascular diseases including SAP. It has an exclusive heart rate reducing effect, without any negative effect on left ventricular function or coronary vasodilatation.Aims: The aim of this paper is to review the evidence concerning the use of ivabradine in the treatment of SAP.Evidence review: Ivabradine is an effective antianginal and antiischemic drug, not inferior to the beta blocker atenolol and the calcium channel antagonist (CCA amlodipine. It decreases the frequency of angina attacks and increases the time to anginal symptoms during exercise. Because of its exclusive chronotropic effect, ivabradine is not associated with the typical adverse reactions associated with beta blockers or other antianginal drugs.Clinical value: Clinical evidence shows that ivabradine is a very good antiischemic and antianginal agent, being as effective as beta blockade and CCA therapy in controlling myocardial ischemia and symptoms of stable angina. Ongoing studies will determine the potential of ivabradine to improve morbidity and mortality in coronary artery disease and heart failure.Key words: evidence, If current, ivabradine, outcomes, stable angina pectoris, treatment

  19. Breath markers of oxidative stress in patients with unstable angina.

    Science.gov (United States)

    Phillips, Michael; Cataneo, Renee N; Greenberg, Joel; Grodman, Richard; Salazar, Manuel

    2003-01-01

    Cardiac chest pain is accompanied by oxidative stress, which generates alkanes and other volatile organic compounds (VOCs). These VOCs are excreted in the breath and could potentially provide a rational diagnostic marker of disease. The breath methylated alkane contour (BMAC), a 3-dimensional surface plot of C4-C20 alkanes and monomethylated alkanes, provides a comprehensive set of markers of oxidative stress. In this pilot study, we compared BMACs in patients with unstable angina pectoris and in healthy volunteers. Breath VOCs were analyzed in 30 patients with unstable angina confirmed by coronary angiography and in 38 age-matched healthy volunteers with no known history of heart disease (mean age +/- SD, 62.7 +/- 12.3 years and 62.5 +/- 10.0, not significant). BMACs in both groups were compared to identify the combination of VOCs that provided the best discrimination between the 2 groups. Forward stepwise entry discriminant analysis selected 8 VOCs to construct a predictive model that correctly classified unstable angina patients with sensitivity of 90% (27 of 30) and specificity of 73.7% (28 of 38). On cross-validation, sensitivity was 83.3% (25 of 30) and specificity was 71.1% (27 of 38). We conclude that the breath test distinguished between patients with unstable angina and healthy control subjects.

  20. 浅谈心绞痛患者的临床护理体会%Study on clinical nursing experience of patients with angina

    Institute of Scientific and Technical Information of China (English)

    尹燕红

    2014-01-01

    目的:分析心绞痛患者的临床护理体会。方法回顾性分析116例心绞痛患者的临床资料,将其随机分为观察组与对照组,各58例,对照组采用常规护理方法,观察组在对照组的基础上针对心绞痛进行护理干预,比较两组患者心绞痛的发作减少程度。结果观察组总有效率显著高于对照组,差异具有统计学意义(P<0.05)。结论针对心绞痛患者加强环境护理、心理护理、健康指导及饮食护理可有效减少患者心绞痛发作次数。%Objective To analyze the clinical experience of nursing care of patients with angina pectoris. Methods Retrospective analysis of the clinical data of 116 cases of angina patients, randomly divided them into observation group and control group, 58 cases in each group, the control group using conventional methods of nursing, the observation group in the control group on angina pectoris of nursing intervention to reduce the degree of seizure, compared two groups of patients with angina pectoris. Results Total effective rate of observation group was signiifcantly higher than that of the control group, the difference has statistical signiifcance (P<0.05). Conclusion For the patients with angina pectoris and strengthen environmental nursing, psychological nursing, health guidance and diet nursing care can effectively reduce the number of episodes in patients with angina pectoris.

  1. Comparison of Results of Coronary Angioplasty in Patients with Unstable vs. Stable Angina

    Institute of Scientific and Technical Information of China (English)

    梅卫义; 杜志民; 罗初凡; 胡承恒; 李怡; 马虹

    2002-01-01

    Objectives To comparethe short and mid - term outcomes in cases of percuta-neous transluminal coronary angioplasty (PTCA) inpatients with unstable v stable angina. MethodsPatients selected for PTCA/stenting were divided into two groups, one with stable angina pectoris (SAgroup, n--92) and one with unstable angina pectoris(UA group, n = 112). The outcomes of coronary angiographies (CAG), initial (30-d) success of theprocedure, and follow- up status in the two groupswere compared. Results Baseline characteristicswere similar, although the patients with unstablesymptoms more females ( P< 0.05), and had a higheraverage CCS class ( P< 0.05) and a higher incidenceof postinfarction angina ( P< 0. 01 ). The frequency of"complex" stenosis in patients with unstable anginawas higher than that of patients with stable angina,33% v 20% (P<0.01). A total of 309 vessels accepted the procedure; including 210 stents were successfully delivered to 156 patients. 143 and 67 stentswere implanted in the UA and SA group, respectively(P< 0.01 ). No major complication occurred in thetwo groups, except 12 patients experienced reoccurring chest pain initially, 9 in UA group v 3 in SAgroup ( P< 0.05). The averaged six - month follow -up status was compared too. Only 3 cases developedmyocardial infarction, including 2 patients with unstable angina. 12 and 16 reoccurring chest pains werefound in the two groups, respectively (13% in SAgroup vs 14% in UA group). There were no significant differences between groups in rates of clinicalrestenosis, follow- up angina class, or overall clinicalsuccess. Conclusions Patients with unstable anginareceiving PTCA/stenting have similar complication,restenosis, and initial and midterm success rate ascompared to patients with stable symptoms with strictcases select and careful preparation.

  2. Angina de Prinzmetal Angina de Prinzmetal Prinzmetal's angina

    OpenAIRE

    Eduardo Contreras Zuniga; Juan Esteban Gomez Mesa; Sandra Ximena Zuluaga Martinez; Vanesa Ocampo; Cristian Andres Urrea

    2009-01-01

    Essa síndrome é causada por um espasmo focal de uma artéria coronária epicárdica, levando a isquemia miocárdica grave. Embora freqüentemente acredite-se que o espasmo ocorra em artérias sem estenose, muitos pacientes com angina de Prinzmetal apresentam espasmo adjacente a placas ateromatosas. A causa exata do espasmo não está bem definida, mas pode estar relacionada à hipercontratilidade do músculo liso vascular devido a mitógenos vasoconstrictores, leucotrienos ou serotonina. Em alguns pacie...

  3. Stable and unstable angina: Identifying novel markers on circulating leukocytes.

    Science.gov (United States)

    Brown, Angus; Lattimore, Jo-Dee; McGrady, Michele; Sullivan, David; Dyer, Wayne; Braet, Filip; Dos Remedios, Cristobal

    2008-01-01

    There is currently no blood-based test that can rapidly and objectively distinguish between chest pain which is initiated by increased myocardial oxygen demand (stable angina pectoris (SAP)) and chest pain initiated due to decreased coronary blood flow (unstable angina pectoris (UAP)). Since leukocytes play an active role in the progression of coronary artery disease (CAD), we hypothesize these can provide novel markers of SAP and UAP. Here we use a microarray of 82 cluster of differentiation (CD) antibodies (plus controls) to selectively immobilize peripheral blood mononuclear cells. We find that the pattern of leukocyte immobilization from patients with CAD significantly differs from healthy donors. Within the CAD group, 15 SAP patients exhibited significant (p<0.05) changes in 8 of 82 CD antibody spots compared to 19 age-matched healthy blood donors. An additional ten CD antigens differed between healthy donors and patients with UAP (p<0.05). Furthermore, seven CD antibody spots are significantly different between SAP and UAP patients. These preliminary data suggest it is now appropriate to undertake a larger clinical trial to test the hypothesis that these antibody microarrays can monitor the progression from SAP to UAP.

  4. Increased expression and plasma levels of myeloperoxidase are closely related to the presence of angiographically-detected complex lesion morphology in unstable angina

    NARCIS (Netherlands)

    Naruko, T.; Furukawa, A.; Yunoki, K.; Komatsu, R.; Nakagawa, M.; Matsumura, Y.; Shirai, N.; Sugioka, K.; Takagi, M.; Hozumi, T.; Itoh, A.; Haze, K.; Yoshiyama, M.; Becker, A.E.; Ueda, M.

    2010-01-01

    Background Myeloperoxidase (MPO) is a leucocyte enzyme that catalyses the formation of a number of reactive oxidant species. Objective The purpose of this study is to evaluate the relationship between angiographic coronary plaque morphology in patients with unstable angina pectoris (UAP) or stable a

  5. Angina de Prinzmetal Angina de Prinzmetal Prinzmetal's angina

    Directory of Open Access Journals (Sweden)

    Eduardo Contreras Zuniga

    2009-08-01

    Full Text Available Essa síndrome é causada por um espasmo focal de uma artéria coronária epicárdica, levando a isquemia miocárdica grave. Embora freqüentemente acredite-se que o espasmo ocorra em artérias sem estenose, muitos pacientes com angina de Prinzmetal apresentam espasmo adjacente a placas ateromatosas. A causa exata do espasmo não está bem definida, mas pode estar relacionada à hipercontratilidade do músculo liso vascular devido a mitógenos vasoconstrictores, leucotrienos ou serotonina. Em alguns pacientes, é uma manifestação de distúrbio vasoespástico e está associado à migrânea, fenômeno de Raynaud ou asma induzida por aspirina. Apresentamos um caso associado com depressão transitória do segmento ST.Este síndrome es causado por un espasmo focal de una arteria coronaria epicárdica, llevando a isquemia miocárdica grave. Aunque frecuentemente se crea que el espasmo ocurra en arterias sin estenosis, muchos pacientes con angina de Prinzmetal presentan espasmo adyacente a placas ateromatosas. La causa exacta del espasmo no está bien definida, pero puede estar relacionada a la hipercontractilidad del músculo liso vascular debido a mitógenos vasoconstrictores, leucotrienos o serotonina. En algunos pacientes, es una manifestación de disturbio vasoespástico y está asociado a la migraña, fenómeno de Raynaud o asma inducida por aspirina. Presentamos un caso asociado con depresión transitoria del segmento ST.This syndrome is due to focal spasm of an epicardial coronary artery, leading to severe myocardial ischemia. Although it is frequently thought that the spasm occurs in arteries without stenosis, many Prinzmetal patients have spasm adjacent to atheromatous plaques. The exact cause of the spasm has not been well defined, but it may be related to the hypercontractility of the vascular smooth muscle due to vasoconstrictor mitogens, leukotrienes, or serotonin. In some patients, it is a manifestation of a vasospastic disorder and it

  6. Relationship Between Unstable Angina Pectoris CHD and MMP-1, MMP-2 and MMP-3%冠心病不稳定型心绞痛与MMP-1、MMP-2、MMP-3相关性研究

    Institute of Scientific and Technical Information of China (English)

    王莹威; 蒋宁; 高嵩山; 魏明慧

    2013-01-01

    目的:研究冠心病不稳定型心绞痛(UA)患者血清MMP-1、MMP-2、MMP-3的表达,并探讨其与冠状动脉狭窄程度和斑块不稳定性之间的关系.方法:分离出30例UA和30例CPS患者血清,采用酶联免疫吸附法(ELISA)检测其中的MMP-1、MMP-2、MMP-3表达水平,并进行相关性研究.结果:UA和CPS组患者血清中MMP-1、MMP-2、MMP-3有统计学意义(P<0.005).结论:冠心病不稳定型心绞痛患者血清中MMP-1、MMP-2、MMP-3表达水平增高,提示其可能是动脉粥样硬化不稳定斑块的发病机制之一.%Objective:To investigate patients with unstable angina(UA) serum expressions of MMP-1,MMP-2 and M MP-3,and explore the relationship between the coronary stenosis and plaque instability.Methods:The serum from 30 patients with UA and 30 patients with CPS was isolated in which MMP-1,MMP-2,MMP-3 expression levels were tested by enzyme-linked immunosorbent assay (ELISA),and related research was carried on.Results:UA and CPS groups' MMP-1,MMP-2,MMP-3 expressions had statistical significance(P < 0.005).Conclusion:The serum expression levels of MMP-1,MMP-2 and MMP -3 in coronary heart disease patients with unstable angina were increased,suggesting that it may be one of the unstable plaque pathogenesis of atherosclerosis.

  7. 比较复方丹参滴丸与地奥心血康胶囊治疗心绞痛随机对照临床试验的系统评价和meta分析%Systematic review and meta-analysis of randomized controlled trials comparing Chinese patent medicines Compound Danshen Dripping Pills and Di'ao Xinxuekang in treating angina pectoris

    Institute of Scientific and Technical Information of China (English)

    吴翠珊; 王善萍; 张君隆; 吴玉丹; 贾永亮; 梁少伟

    2012-01-01

    CI:1.03~4.12; P总效应=0.04).6篇报告心电图疗效的RCT中复方丹参滴丸对地奥心血康胶囊的优势比为1.92(95%CI:1.23~3.00; P心电图疗效=0.004).亚组分析及敏感性分析未发现可以显著影响结果稳定性的因素.结论:研究结果表明复方丹参滴丸治疗冠心病心绞痛的疗效优于地奥心血康,但尚需要更多高质量的RCT以确定疗效的差异程度.%BACKGROUND: Chinese patent medicines Compound Danshen Dripping Pills (DSP) and Di'ao Xinxuekang(DXK) capsules were both found effective in treating angina pectoris. However, there is no systematic reviewcomparing their efficacy.OBJECTIVE: This systematic review aims to compare the efficacy of DSP and DXK in treating angina pectorisbased on randomized controlled trials (RCTs) comparing their efficacy.SEARCH STRATEGY: RCT reports published between 1994 and 2011 were retrieved from databasesincluding China Doctoral Dissertations Full-text Database, Chinese Journal Full-text Database, China Master'sTheses Full-text Database, Wanfang Data, Cochrane Library, Excerpta Medica Database, ScienceDirect,MEDLINE (EBSCOhost) and PubMed. The last retrieval was performed on April 7, 2011.INCLUSION CRITERIA: RCT reports comparing the effects of DSP and DXK were included, regardlesspublishing language.DATA EXTRACTION AND ANALYSIS; Included RCT reports were assessed for their study quality by usingthe Jadad scale and the Cochrane risk of bias tool. Data including overall effect and electrocardiography(ECG) improvements were extracted from the included RCTs for meta-analysis. The effect sizes based onoverall and ECG diagnosis were measured by odds ratio (OR) and 95% confidence interval (CD. Subgroupanalysis and sensitivity analysis were also performed.RESULTS; Nine RCT reports with 926 participants were included. Eight were scored 2 and the other one wasscored 4 by using the Jadad scale. The OR between DSP and DXK based on overall diagnosis was 2. 06(95% Cl: 1. 03 - 4. 12

  8. Value of iodine-123 metaiodobenzylguanidine scintigraphy in patients with vasospastic angina

    Energy Technology Data Exchange (ETDEWEB)

    Taki, Junichi; Nakajima, Kenichi; Matsunari, Ichiro; Takayama, Teruhiko; Tonami, Norihisa [Kanazawa Univ. School of Medicine (Japan). Dept. of Nuclear Medicine; Yasuhara, Shuichiro; Takamatsu, Tsuyoshi; Tatami, Ryozo; Ishise, Syozo [Maizuru Kyosai Hospital (Japan). Dept. of Internal Medicine

    1998-03-01

    To assess the presence and location of presynaptic myocardial sympathetic abnormality in patients with vasospastic angina, iodine-123 labelled metaiodobenzylguanidine (MIBG) single-photon emission tomography (SPET) was performed. Fifty patients suspected of having vasospastic angina pectoris were enrolled in the study. All patients underwent a provocative test with intracoronary ergonovine infusion during coronary angiography, in which 99%-100% obstructive spasm was defined as a positive result. Twenty-five patients were diagnosed as having vasospastic angina based on a positive provocative test. MIGB SPET was performed at 20 min and 3 h after administration of 111 MBq of MIBG. On early images, only 5 of 25 patients with vasospastic angina showed a mild reduction in MIBG uptake, whereas 3-h delayed images demonstrated MIBG abnormality in 20 patients (80%). The location of the MIBG abnormality was completely or partially consistent with the spastic coronary territory in 18 patients. On the other hand, only 4 of 25 patients (16%) with a negative provocative test demonstrated reduced MIBG uptake. Accordingly, positive and negative predictive values of MIBG SPET for the provocative test were 83% (20/24) and 81% (21/26) respectively. In conclusion, MIBG scintigraphy with SPET can permit the non-invasive detection and evaluation of suspected vasospastic angina. (orig.)

  9. 中青年高血压合并不稳定心绞痛患者动态脉压、脉压指数与 MMP-9、Hs-CRP 的相关性%Relationship between ambulatory pulse pressure and pulse pressure index with MMP-9 and Hs-CRP in middle-aged patients with hypertension and unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    刘冬梅; 谢艳凤; 马丽; 苗昌荣; 王晓蕊; 赵紫英

    2016-01-01

    目的:观察中青年高血压合并不稳定心绞痛患者动态脉压、脉压指数水平的变化,并探讨其与血清基质金属蛋白酶-9(MMP-9)、超敏 C 反应蛋白(Hs-CRP)水平的关系。方法选择中青年高血压合并不稳定心绞痛患者102例作为观察组,采用酶联免疫吸附法(ELISA)测定 MMP-9与 Hs-CRP 水平,选择同期健康体检者94例为对照组。将观察组按动态脉压进行分层,分为41~60 mmHg、61~80 mmHg、≥81 mmHg 3个水平;脉压指数进行分层,分为 APPI≤0.400、0.401~0.500、≥0.5013个水平;比较不同动态脉压和脉压指数水平时MMP-9、Hs-CRP 水平的变化,并进行 MMP-9与 Hs-CRP 之间的直线相关和回归分析。结果观察组 MMP-9、Hs-CRP 水平明显高于对照组;动态脉压与脉压指数水平越大,观察组血清 MMP-9、Hs-CRP 水平越高;直线相关和回归分析表明,MMP-9与 Hs-CRP 呈显著正相关。结论血清 MMP-9、Hs-CRP 水平升高与中青年高血压合并不稳定心绞痛密切相关;动态脉压、脉压指数与 MMP-9、Hs-CRP 密切相关。%Objective To observe the ambulatory pulse pressure(APP)and pulse pressure index(APPI)in the middle-aged patients with hypertension and unstable angina pectoris(UAP),and to probe into relationship between ambulatory pulse pressure(APP)and pulse pressure index(APPI)with matrix metalloproteinase-9(MMP-9)and High-sensitive C-reactive protein(Hs-CRP). Methods The 102 middle-aged patients with hypertension and UAP were the observation group,in which levels of MMP-9 and Hs-CRP were examined by eyzyme-linked immuno sorbent assay(ELISA). In the same period,94 healthy physical examinees were included in the control group. The observation group were divided into 3 layers according to the level of APP(41-60 mmHg,61-80 mmHg,≥81mmHg respective-ly);According to the level of APPI,there were also three layers(≤0. 400,0. 401-0. 500,≥0. 501 respectively)in the

  10. Angina de Prinzmetal

    OpenAIRE

    Contreras Zuniga,Eduardo; Gomez Mesa,Juan Esteban; Zuluaga Martinez,Sandra Ximena; Ocampo,Vanesa; Andres Urrea,Cristian

    2009-01-01

    Essa síndrome é causada por um espasmo focal de uma artéria coronária epicárdica, levando a isquemia miocárdica grave. Embora freqüentemente acredite-se que o espasmo ocorra em artérias sem estenose, muitos pacientes com angina de Prinzmetal apresentam espasmo adjacente a placas ateromatosas. A causa exata do espasmo não está bem definida, mas pode estar relacionada à hipercontratilidade do músculo liso vascular devido a mitógenos vasoconstrictores, leucotrienos ou serotonina. Em alguns pacie...

  11. Comparison of results of intracoronary stenting in patients with unstable vs. stable angina.

    Science.gov (United States)

    Malosky, S A; Hirshfeld, J W; Herrmann, H C

    1994-02-01

    Percutaneous transluminal coronary angioplasty (PTCA) has higher complication and restenosis rates when performed in the setting of unstable angina. Balloon-expandable intracoronary stenting is a new technique with the potential to improve the results of PTCA. In order to determine whether stenting is associated with a poorer outcome in patients with unstable angina, we retrospectively examined our experience with the Palmaz-Schatz balloon-expandable intracoronary stent in 105 patients. Patients were divided into 2 groups on the basis of symptoms at the time of stent insertion: group I (n = 57) had stable angina pectoris, and group II (n = 48) had unstable angina defined as pain at rest despite antianginal therapy (Braunwald class II, III). Initial (30-d) and final (6-mo) success rates were defined as stent insertion without myocardial infarction, need for bypass surgery, death, and significant angina. Baseline characteristics were similar, although the patients with unstable symptoms were older, more likely to be female, and had a higher incidence of postinfarction angina. A total of 136 stents were successfully delivered to 97 target sites in 92% of patients. Major complications occurred in 4 patients (4%) and were due to subacute thrombosis in 3 of them. There were no differences in complication rates between patients receiving stents electively with stable vs. unstable symptoms (2% vs. 6%, p = NS). Six-mo. follow-up status was ascertained in 96% of patients and revealed overall clinical success in 83% with angiographic restenosis (> or = 50% stenosis) in 28% of patients. There were no significant differences between groups in rates of restenosis, follow-up angina class, or overall clinical success.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Spinal cord stimulation for refractory angina in patients implanted with cardioverter defibrillators: five case reports

    DEFF Research Database (Denmark)

    Enggaard, Thomas P; Andersen, Claus; Scherer, Christian

    2010-01-01

    successful long-term treatment with SCS in five patients implanted with cardioverter defibrillators. The combined treatments with ICD and thoracic epidural electrical stimulation were used in five patients with refractory angina pectoris. During the procedure of the implantation, testing with the maximal...... tolerable level of stimulation was carried out to exclude inference with the ICD. The following treatment with SCS has in all cases been successful, with significant pain relief and improved quality of life. There were no incidences of inappropriate defibrillator shocks. Spinal cord stimulation...

  13. 低分子肝素联合银杏达莫注射液治疗不稳定型心绞痛的临床观察%Clinical observation on therapeutic effect of low-molecule heparin integrated with Ginkgo-dipyidamolum injection on unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    罗炽权; 黄仕洲

    2011-01-01

    Objective To study the therapeutic effect of low-molecule heparin (LMWH) and Ginkgo-dipyidamolum injection for unstable angina (UA). Methods One hundred and seventy-five cases with UA were chosen from March 2006 to March 2010, completely randomly divided into treatment group (58 cases) and control group Ⅰ (52 cases) and control group Ⅱ (65 cases). On the basis of routine therapy, control and treatment groups for UA patients were established, and for experimental group, 58 patients were treated with both LMWH and Ginkgo-dipyidamolum injection. Results Statistically,compared with control group, the treatment of experimental group is more effective on aspects as follows: easing clinical symptoms, allaying myocardial ischemia diagnosed by electrocardiogram, and preventing composite of non-fatal stroke, myocardial infarction and cardiovascular death[82.76% (48/58 ) vs 65.38% (34/52) ,63.08% (41/65) ;77.59% (45/58) vs 55.77% (29/52) ,53.85% (35/65) ;18.97% (11/58)vs36.54%(19/52),35.38%(23/65),P<0. 05,P<0.01]. Conclusion LMWH and Ginkgo-dipyidamolum injection are more effective than that of either LMWH or Ginkgo-dipyidamolum injection on abirritating myocardial blooding and relieving clinical symptom.%目的 探讨低分子肝素( LMWH)联合银杏达莫注射液治疗不稳定型心绞痛的疗效。方法 选择2006年3月至2010年3月不稳定型心绞痛患者175例,完全随机分为治疗组(58例)、对照Ⅰ组(52例)和对照Ⅱ组(65例)。在常规治疗的基础上,治疗组应用LMWH联合银杏达莫注射液治疗,对照Ⅰ组应用LMWH治疗,对照Ⅱ组应用银杏达莫注射液治疗,疗程均为2周。比较3组临床症状改善、心电图缺血改善及复合终点事件发生情况。结果 治疗后治疗组临床症状改善总有效率、心电图缺血改善总有效率、复合终点事件发生率方面明显优于对照Ⅰ组和对照Ⅱ组[分别为82.76%( 48/58)比65.38% (34/52)、63.08

  14. Omega-3多不饱和脂肪酸对不稳定型心绞痛血清炎症因子的影响%Effects of Omega-3 polyunsaturated fatty acids on serum inflammatory factors in patients with unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    臧书文; 王开成

    2015-01-01

    目的:观察Omega-3多不饱和脂肪酸对不稳定型心绞痛患者血清炎症因子的影响及疗效。方法:选择未行冠脉成形术(percutaneous coronary intervention,PCI)治疗的不稳定型心绞痛(unstable angina,UA)患者54例,随机分为Omega-3多不饱和脂肪酸组及安慰剂治疗组各27例。分别于入院时及治疗8周后检测患者空腹血清中白介素6、肿瘤坏死因子α、高敏C反应蛋白、IL-10及转化生长因子β等炎症因子表达变化;记录不良反应及半年内心血管事件发生率。结果:治疗后Omega-3组血清IL-6、TNF-α及CRP表达水平均较治疗前显著下降(P0.05);与对照组比较, Omega-3组用药8周后血清IL-6、TNF-α及CRP表达水平显著降低,IL-10、TGF-β表达显著上升;差异均有统计学意义(P0.05),两组不良反应发生比较差异无统计学意义。结论:不稳定型心绞痛患者口服Omega-3多不饱和脂肪酸能显著抑制炎症,纠正促炎和抑炎失衡,发挥其抗动脉粥样硬化作用。%Objective:To evaluate the changes and effects of Omega-3 polyunsaturated fatty acids(PUFAs) on serum levels of inflammatory factors in patients with unstable angina(UAP). Methods:54 patients with UAP admitted between Mar 2013 and June 2014 were randomly divided into the Omega-3 PUFAs group(n=27) who received Omega-3 PUFAs, and the placebo group(n=27). The serum levels of inflammatory factors such as tumor necrosis factor(TNF-α), interleukin 6(IL-6), High sensitivity C reactive protein(Hs-CRP), IL-10 and transforming growth factorβ(TGF-β)were measured before and after treatment, and Major adverse cardiovascular event and side effects were observed. Results:after treatment, The serum expression levels of TNF-α, IL-6 and CRP in the Omega-3 PUFAs group were lower than the placebo group(P<0.05), and the serum expression levels of IL-10 and TGF-βwere higher than in the placebo group(P<0.05). The incidence rate of

  15. Percutaneous Device to Narrow the Coronary Sinus: Shifting Paradigm in the Treatment of Refractory Angina?

    Directory of Open Access Journals (Sweden)

    Daniela Benedetto

    2016-10-01

    Full Text Available Refractory angina pectoris is defined as a chronic debilitating condition characterized by the presence of chronic anginal symptoms due to a severe obstructive and/or diffuse coronary artery disease that cannot be controlled by the combination of medical therapy and / or revascularization (percutaneous or surgical. In addition the presence of myocardial ischemia as a cause of the symptoms must have been documented. The coronary sinus Reducer (CSR is a recently introduced percutaneous device to treat patients with severe anginal symptoms refractory to optimal medical therapy and not amenable to conventional revascularization. The purpose of this review is to describe the current evidence from available studies measuring the clinical effect of the CSR implantation on the health and well-being of patients with refractory angina.

  16. Plasma resistin is increased in patients with unstable angina

    Institute of Scientific and Technical Information of China (English)

    HU Wen-lan; QIAO Shu-bin; HOU Qing; YUAN Jian-song

    2007-01-01

    Background Resistin, a novel adipokine linked to insulin resistance and obesity in rodents, which is derived mainly from macrophages and identified in atheromas in human, has been shown to play a potential role in atherosclerosis.Resistin levels were reported to increase in coronary artery disease (CAD), while data concerning resistin in different stages of CAD in Chinese people are lacking. The aim of this study was to assess whether plasma concentrations of resistin differed between patients with unstable and stable angina pectoris.Methods Plasma resistin levels were determined by means of enzyme-linked immunosorbent assay (ELISA) in 46 patients with unstable angina (UAP), 37 with stable angina (SAP) and 31 control subjects.Results Plasma concentrations of resistin were significantly increased in UAP group (geometric mean (interquartile range) 12.09 ng/ml (8.40, 18.08)) in comparison with SAP (9.04 ng/ml (7.09, 11.44)) and control groups (8.71 ng/ml (6.58,11.56)). No differences in resistin levels were found between patients with SAP and controls. We also found that plasma resistin positively correlated with leukocyte counts (r=0.21, P=0.027), high sensitive C-reactive protein (hs-CRP) (r=0.25,P=0.008), and endothelin-1 (r=0.21, P=0.025) after adjustment for age, sex and BMI.Conclusion Resistin may be involved in the development of CAD by influencing systemic inflammation and endothelial activation.

  17. Critical evaluation of ivabradine for the management of chronic stable angina

    Directory of Open Access Journals (Sweden)

    Khan W

    2011-09-01

    Full Text Available Waqas Khan, Jeffrey S BorerDivision of Cardiovascular Medicine and the Department of Medicine, State University of New York Downstate Medical Center and College of Medicine, Brooklyn and New York, NY, USAAbstract: Angina pectoris is the most common symptom of coronary artery disease (CAD. Angina results from an imbalance between myocardial oxygen supply and demand. Heart rate (HR reduction can beneficially alter both elements of this imbalance by increasing diastolic filling time and reducing myocardial oxygen demand. Therefore, HR reduction is an accepted approach to angina prevention. ß-blockers, calcium-channel blockers, and long-acting nitrates are currently the cornerstones in prevention and management of stable angina. However, use of these treatments may be limited by adverse effects or development of tolerance. Thus, additional approaches to angina prevention may be useful for many patients with CAD. The discovery of the f-channel and the resulting current, If, that modulates the rate of spontaneous diastolic depolarization of sinoatrial nodal (SAN myocytes led to the study of these channels as targets for lowering HR. This resulted in the development of a novel agent, ivabradine, a selective and specific If inhibitor. Ivabradine slows the slope of diastolic depolarization of the action potential in the SAN cells, decreasing HR at rest and during exercise, but has no other cardiovascular effects. In different subpopulations with chronic stable angina, ivabradine markedly improves exercise capacity and significantly decreases the number of ambient angina attacks. In a post-hoc analysis of the BEAUTIFUL trial (morBidity-mortality EvAlUaTion of the If inhibitor ivabradine in patients with coronary disease and left-ventricULar dysfunction, ivabradine also reduced mortality, myocardial infarctions, and heart failure hospitalizations among patients with angina. To date, the drug has been well tolerated; transient visual disturbances and

  18. [Informative value of programmed electric stimulation of the ventricles, 24-hour ECG monitoring and bicycle ergometry in the diagnosis of electric instability of the myocardium in various clinical variants of stenocardia].

    Science.gov (United States)

    Makhotina, V N; Rimsha, E; Kaĭk, Iu

    1991-01-01

    The informative value of programmed ventricular pacing (PVP), Holter monitoring (HM), and bicycle ergometry (BEM) in the diagnosis of myocardial electric instability was assessed in various clinical types of angina pectoris. An examination was made of 20 patients with first exercise-induced angina (FEIA), 33 with progressive exercise-induced angina (PEIA), 17 with spontaneous angina (SA), 30 with stable exercise-induced angina (SEIA), and postinfarction angina. Myocardial electric instability was estimated from HM and BEM findings in patients with FEIA, SA, as well as in PEIA, SEIA in the presence of preserved myocardial contractility as evidenced by ventriculography. A clear-cut correlation was found between transient myocardial ischemia and the occurrence of high-grade ventricular arrhythmias for the patients from the above-mentioned groups. Lower myocardial contractility despite the nature of angina is an indication for PVP.

  19. Living with heart disease and angina

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000576.htm Living with heart disease and angina To use the sharing features on ... pain and reduce your risks from heart disease. Heart Disease and Angina CHD is a narrowing of the ...

  20. Bradycardiac angina: haemodynamic aspects and treatment.

    Science.gov (United States)

    Fowler, P B; Ikram, H; Maini, R N; Makey, A R; Kirkham, J S

    1969-01-11

    A patient with a sinus bradycardia and angina is described who was unable to increase his heart rate on vigorous exercise by more than a few beats. His severe angina was attributed to the bradycardia. Atrial pacing of his heart abolished his angina and increased his exercise tolerance. Circulatory changes at rest, on exertion, and with atrial pacing are described. The cause of angina in this patient is discussed.

  1. Menstruation angina: a case report

    Directory of Open Access Journals (Sweden)

    Choo Wai Kah

    2009-03-01

    Full Text Available Abstract Introduction Menstruation is commonly associated with migraine and irritable bowel but is rarely correlated with angina or myocardial ischaemia. Only a small number of cases have been reported suggesting a link between menstruation and myocardial ischaemic events. Case presentation A case of menstruation angina is reported in order to raise awareness of this association. A 47-year-old South Asian woman presented with recurrent chest pains in a monthly fashion coinciding with her menstruations. Each presentation was associated with troponin elevation. Angioplasty failed to resolve her symptoms but she eventually responded to hormonal therapy. Conclusions The possibility of menstruation angina should always be taken into account in any female patients from puberty to menopause presenting with recurrent chest pains. This can allow an earlier introduction of hormonal therapy to arrest further myocardial damage.

  2. PHARMACOECONOMIC ASPECTS OF NICOTINE ADDICTION TREATMENT IN PATIENTS WITH ANGINA REQUIRING CARDIAC SURGERY

    Directory of Open Access Journals (Sweden)

    A. V. Rudakova

    2015-12-01

    Full Text Available Smoking is a major risk factor in patients with angina pectoris. Interventions that facilitate the rejection of it are an important part of the treatment. Aim. To analyze the cost effectiveness of the partial agonist of nicotinic receptors, varenicline, in patients with angina who require cardiac interventions. Material and methods. The estimation was conducted using a Markov model based on the results of clinical trials and epidemiological studies. The cost of treatment of complications were calculated on the basis of compulsory medical insurance rates for St. Petersburg in 2011. Results. The varenicline therapy in 70-year-old patients before cardiac surgery reduces hospital mortality at an extremely high cost-effectiveness (the cost of preventing one death - 148.8 thousand rubles. The cost/effectiveness ratio in the analysis for the period of survival of patients in this situation was 31.3 thousand rubles for 1 additional year of life. Life expectancy will be increased by an average of 0.147 years. Analysis for the period of survival of 50-year-old patients has shown that in patients after cardiac surgery cost-effectiveness of varenicline is extremely high (in the analysis from the perspective of the health care system the cost/effectiveness ratio was 36.0 thousand rubles for 1 additional year of life, in the analysis, taking into account the social perspective – 17.9 thousand rubles for 1 additional year of life. Increase in the life expectancy of 50 year-old patients will be 0.291 year in average. Conclusion. Varenicline therapy of patients with angina pectoris is the economy before cardiac surgery , and after their execution, and this applies not only young, but older patients. The desirability of varenicline including to federal and regional programs to reduce cardiovascular morbidity and mortality is shown.

  3. PHARMACOECONOMIC ASPECTS OF NICOTINE ADDICTION TREATMENT IN PATIENTS WITH ANGINA REQUIRING CARDIAC SURGERY

    Directory of Open Access Journals (Sweden)

    A. V. Rudakova

    2012-01-01

    Full Text Available Smoking is a major risk factor in patients with angina pectoris. Interventions that facilitate the rejection of it are an important part of the treatment. Aim. To analyze the cost effectiveness of the partial agonist of nicotinic receptors, varenicline, in patients with angina who require cardiac interventions. Material and methods. The estimation was conducted using a Markov model based on the results of clinical trials and epidemiological studies. The cost of treatment of complications were calculated on the basis of compulsory medical insurance rates for St. Petersburg in 2011. Results. The varenicline therapy in 70-year-old patients before cardiac surgery reduces hospital mortality at an extremely high cost-effectiveness (the cost of preventing one death - 148.8 thousand rubles. The cost/effectiveness ratio in the analysis for the period of survival of patients in this situation was 31.3 thousand rubles for 1 additional year of life. Life expectancy will be increased by an average of 0.147 years. Analysis for the period of survival of 50-year-old patients has shown that in patients after cardiac surgery cost-effectiveness of varenicline is extremely high (in the analysis from the perspective of the health care system the cost/effectiveness ratio was 36.0 thousand rubles for 1 additional year of life, in the analysis, taking into account the social perspective – 17.9 thousand rubles for 1 additional year of life. Increase in the life expectancy of 50 year-old patients will be 0.291 year in average. Conclusion. Varenicline therapy of patients with angina pectoris is the economy before cardiac surgery , and after their execution, and this applies not only young, but older patients. The desirability of varenicline including to federal and regional programs to reduce cardiovascular morbidity and mortality is shown.

  4. Mycotic aortocoronary saphenous vein graft aneurysm presenting with unstable angina pectoris.

    Science.gov (United States)

    Hirsch, Glenn A; Johnston, Peter V; Conte, John V; Achuff, Stephen C

    2004-10-01

    We report the case of a 60-year-old man with a history of coronary bypass surgery 20 years prior who had a fever, chest pain, and a mediastinal mass develop after a complicated postoperative course of abdominal aortic aneurysm resection. A mycotic aneurysm of the saphenous vein graft to his left anterior descending coronary artery was diagnosed based on blood culture results and visualization of the aneurysm before resection. A summary of the saphenous vein graft aneurysm and pseudoaneurysm cause, diagnosis, and management is detailed.

  5. [Bilateral coronary artery-pulmonary artery fistulas in a case with unstable angina pectoris].

    Science.gov (United States)

    Kepez, Alper; Kaya, Ergün Bariş; Aytemir, Kudret; Oto, Ali

    2008-03-01

    Bilateral coronary artery fistulas originating from both right and left coronary arteries are rare congenital abnormalities. A 58-year-old man presented with chest pain unrelated to exertion. Coronary angiography showed a fistula originating from the level of the first diagonal branch of the left anterior descending (LAD) coronary artery and a 95% stenosis just distal to the fistula. Right coronary angiography showed another fistula originating from the ostium of the right coronary artery. Both fistulas drained into the pulmonary artery. Coronary bypass surgery was performed for the LAD lesion using the left internal mammary artery graft, during which both fistulas were ligated. No complications were encountered postoperatively.

  6. Usefulness of diabetes mellitus to predict long-term outcomes in patients with unstable angina pectoris.

    Science.gov (United States)

    Farkouh, Michael E; Aneja, Ashish; Reeder, Guy S; Smars, Peter A; Lennon, Ryan J; Wiste, Heather J; Traverse, Kay; Razzouk, Louai; Basu, Ananda; Holmes, David R; Mathew, Verghese

    2009-08-15

    The objective of this study was to determine short- and long-term cardiovascular outcomes in unselected patients with diabetes mellitus (DM) with acute ischemic chest pain (AICP). In patients with DM presenting to the emergency department with AICP, short-term cardiovascular outcomes remain discordant between trials and registries, whereas long-term outcomes are not well-described. A consecutive cohort of all residents of Olmsted County, Minnesota, presenting with AICP from January 1, 1985, to December 31, 1992, was followed for a median duration of 16.6 years. The primary outcome was long-term all-cause mortality. Other outcomes included a composite of death, myocardial infarction, stroke, and revascularization (major adverse cardiovascular and cerebrovascular events [MACCEs]) as well as heart failure (HF) events at 30 days and at a median of 7.3 years, respectively. Of the 2,271 eligible patients, 336 (14.8%) were classified with DM. The crude 30-day MACCE rate was 10.1% in patients with DM and 6.1% in those without DM (p = 0.007). HF events were more common in patients with DM at 30 days (9.8% vs 3.1%, p <0.001). At 7.3 years, patients with DM were more likely to experience MACCEs and HF events than those without DM (71.2% vs 45.1%, unadjusted hazard ratio 2.15%, 95% confidence interval 1.87 to 2.48, p <0.001, and 45.1% vs 18.2%, p <0.001, respectively). Over the follow-up period, 272 patients with DM (81.9%) died, compared with 936 (49.2%) without DM (p <0.001). In conclusion, DM is associated with a higher short-term risk for MACCEs and HF and a higher long-term risk for mortality in unselected patients with AICP. DM should be included as a high-risk variable in national acute coronary syndrome guidelines.

  7. Modulation of plasma fibrinogen levels by ticlopidine in healthy volunteers and patients with stable angina pectoris

    NARCIS (Netherlands)

    Maat, M.P.M. de; Arnold, A.E.R.; Buuren, S. van; Paul Wilson, J.H.; Kluft, C.

    1996-01-01

    Elevated plasma fibrinogen levels represent an increased risk for cardiac events. Ticlopidine is a drug that inhibits the ADP-induced aggregation of blood platelets and it also has been described that ticlopidine can decrease the plasma fibrinogen level in patients with vascular diseases. The mechan

  8. Modulation of plasma fibrinogen levels by ticlopidine in healthy volunteers and patients with stable angina pectoris

    NARCIS (Netherlands)

    Maat, M.P.M. de; Arnold, A.E.R.; Buuren, S. van; Wilson, J.H.P.; Kluft, C.

    1996-01-01

    Elevated plasma fibrinogen levels are associated with an increased risk for cardiac events. Ticlopidine is a drug that inhibits the ADP-induced aggregation of blood platelets and it also has been described that ticlopidine can decrease the plasma fibrinogen level in patients with vascular diseases.

  9. Percutaneous transluminal coronary angioplasty for angina pectoris after a non-Q-wave acute myocardial infarction

    NARCIS (Netherlands)

    H. Suryapranata (Harry); K.J. Beatt (Kevin); P.J. de Feyter (Pim); J. Verrostte; M.J.B.M. van den Brand (Marcel); F. Zijlstra (Felix); P.W.J.C. Serruys (Patrick)

    1988-01-01

    textabstractDespite initially favorable prognosis in patients with non-Q-wave acute myocardial infarction (AMI), long-term mortality in this subset of patients appears to be similar to or even greater than that in patients with Q-wave AMI. The relatively poor late prognosis is primarily due to a hig

  10. Coronary Anomaly and Coronary Artery Fistula as Cause of Angina Pectoris with Literature Review

    Directory of Open Access Journals (Sweden)

    Jayanth Koneru

    2011-01-01

    Full Text Available Coronary artery fistulas are rare anomalies of the coronary arteries that may sometimes cause symptoms by shunting blood flow away from the myocardial capillary network. We report the case of a 46-year old lady which shows the right coronary cusp giving rise to left main coronary artery called anomalous origin of a coronary artery (AOCA, and also a fistula between the left coronary artery and pulmonary artery. We describe our diagnostic approach and review the literature on the epidemiology, pathophysiology, the diagnostic modalities, and treatment options.

  11. Coronary Anomaly and Coronary Artery Fistula as Cause of Angina Pectoris with Literature Review

    Science.gov (United States)

    Koneru, Jayanth; Samuel, Anish; Joshi, Meherwan; Hamden, Aiman; Shamoon, Fayez E.; Bikkina, Mahesh

    2011-01-01

    Coronary artery fistulas are rare anomalies of the coronary arteries that may sometimes cause symptoms by shunting blood flow away from the myocardial capillary network. We report the case of a 46-year old lady which shows the right coronary cusp giving rise to left main coronary artery called anomalous origin of a coronary artery (AOCA), and also a fistula between the left coronary artery and pulmonary artery. We describe our diagnostic approach and review the literature on the epidemiology, pathophysiology, the diagnostic modalities, and treatment options. PMID:22937462

  12. Case of angina pectoris at rest and during effort due to coronary spasm and myocardial bridging

    Institute of Scientific and Technical Information of China (English)

    Hiroki; Teragawa; Yuichi; Fujii; Tomohiro; Ueda; Daiki; Murata; Shuichi; Nomura

    2015-01-01

    We present a case of a 71-year-old male who hadchest symptoms at rest and during effort. He had felt chest oppression during effort for 1 year,and his chest symptoms had recently worsened. One month before admission he felt chest squeezing at rest in the early morning. He presented at our institution to evaluate his chest symptoms. Electrocardiography and echocardiography failed to show any specific changes. Because of the possibility that his chest symptoms were due to myocardial ischemia,he was admitted to our institution for coronary angiography(CAG). An initial CAG showed mild atherosclerotic changes in the proximal segment of the left anterior descending coronary artery(LAD) and mid-segment of the left circumflex coronary artery. Subsequent spasm provocation testing using acetylcholine revealed a bilateral coronary vasospasm,which was relieved after the intracoronary infusion of nitroglycerin. Finally,a CAG showed myocardial bridging(MB) of the mid-distal segments of the LAD. Fractional flow reserve using the intravenous administration of adenosine triphosphate was positive at 0.77,which jumped up to 0.90 through the myocardial bridging segments when the pressure wire was pulled back. Thus,coronary vasospasm and MB might have contributed to his chest symptoms at rest and during effort. Interventional cardiologists should consider the presence of MB as a potential cause of myocardial ischemia.

  13. Effect of compound danshen dropping pill on angina as well as serum c-reactive protein (CRP) and brain natriuretic peptide (BNP)

    Institute of Scientific and Technical Information of China (English)

    Jing Ye

    2016-01-01

    Objective:To study the effect of Compound Danshen Dropping Pill on angina as well as serum C-reactive protein (CRP) and brain natriuretic peptide (BNP) so as to provide reference for clinical treatment.Methods: Patients with angina treated in our hospital from February 2010 to August 2015 were enrolled in this research. The effect of Compound Danshen Dropping Pill on angina as well as serum C reaction protein (CRP) and brain natriuretic peptide (BNP) were analyzed. 110 cases of healthy subjects receiving physical examination in our hospital during the same period were taken as control.Results: After treatment, the duration of angina significantly decreased, the frequency of angina pectoris attack significantly decreased, and serum inflammatory factors IL1, IL2 and IL6 as well as Hcy, TG, TC and LDL levels significantly decreased while HDL, folic acid and vitamin B12 levels significantly increased, and compared with before treatment, differences were with notable statistical significance. Conclusion: Compound Danshen Dropping Pill can effectively treat angina, which is related to its regulation of serum C-reactive protein, brain natriuretic peptide and inflammatory factor levels.

  14. How Can Angina Be Prevented?

    Science.gov (United States)

    ... can help prevent or delay angina and heart disease. To adopt a healthy lifestyle, you can: Quit smoking and avoid secondhand smoke ... a healthy diet Be physically active Maintain a healthy ... and controlling heart disease risk factors, visit the Diseases and Conditions Index ...

  15. CLINICAL EFFECTIVENESS AND SAFETY OF IVABRADINE USE IN PATIENTS WITH UNSTABLE ANGINA AND DIABETES MELLITUS TYPE 2

    Directory of Open Access Journals (Sweden)

    A. I. Kondratiev

    2011-01-01

    Full Text Available Aim – to estimate the clinical and pharmacological effects of ivabradine in complex treatment of patients with acute coronary syndrome anddiabetes mellitus type 2 (DM 2.Materials and methods. The study included 36 patients with acute coronary insufficiency (unstable angina and acute left ventricular failure(Killip class I–III during concomitant type 2 diabetes.Results. Prescribing ivabradine in treatment of unstable angina pectoris complicated by type 2 diabetes led to decrease in clinical symptoms,heart rate and reduce in number of myocardial ischemia episodes. Patients treated with ivabradine, showed a significant tendency to increase left ventricular ejection fraction (12.3 %. Mo adverse reactions were recorded, including hypotensive complications.Conclusion. Ivabradine therapy was characterized by high ischemic and antianginal efficacy, good tolerability, did not lead to the developmentof tolerance and was not accompanied by the appearance of withdrawal syndrome.

  16. CLINICAL EFFECTIVENESS AND SAFETY OF IVABRADINE USE IN PATIENTS WITH UNSTABLE ANGINA AND DIABETES MELLITUS TYPE 2

    Directory of Open Access Journals (Sweden)

    A. I. Kondratiev

    2014-07-01

    Full Text Available Aim – to estimate the clinical and pharmacological effects of ivabradine in complex treatment of patients with acute coronary syndrome anddiabetes mellitus type 2 (DM 2.Materials and methods. The study included 36 patients with acute coronary insufficiency (unstable angina and acute left ventricular failure(Killip class I–III during concomitant type 2 diabetes.Results. Prescribing ivabradine in treatment of unstable angina pectoris complicated by type 2 diabetes led to decrease in clinical symptoms,heart rate and reduce in number of myocardial ischemia episodes. Patients treated with ivabradine, showed a significant tendency to increase left ventricular ejection fraction (12.3 %. Mo adverse reactions were recorded, including hypotensive complications.Conclusion. Ivabradine therapy was characterized by high ischemic and antianginal efficacy, good tolerability, did not lead to the developmentof tolerance and was not accompanied by the appearance of withdrawal syndrome.

  17. Current Indications for Coronary Arteriography

    OpenAIRE

    Dodek, Arthur

    1981-01-01

    Coronary arteriography is not necessary in all patients with angina pectoris. Angiography is indicated to define coronary anatomy in patients who have persistent angina despite full medication. It is also indicated in patients with a markedly positive stress test, unstable angina pectoris, positive stress test following myocardial infarction, variants of angina, ventricular aneurysm complications, and in the young coronary patient. Coronary arteriography may clarify the diagnosis in patients ...

  18. [Exercise tests in unstable angina suspects].

    Science.gov (United States)

    2012-01-01

    The review is devoted to exercise tests (ET) potential in patients with different forms of coronary heart disease (CHD) exacerbation and suspected unstable angina. It is well known that unstable angina untreated pharmacologically is a contraindication for ET. Of interest in clinical practice is diagnosis, risk assessment and treatment policy in patients with chest pain. The main focus is on ET conduction in unstable angina suspects with low and intermediate risk, on safety and validity of ET conduction in these patients.

  19. Combined analysis of six lipoprotein lipase genetic variants on triglycerides, high-density lipoprotein, and ischemic heart disease: cross-sectional, prospective, and case-control studies from the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Wittrup, HH; Andersen, RV; Tybjærg-Hansen, A

    2006-01-01

    . SETTING: The study was performed in the Danish general population (the Copenhagen City Heart Study). PARTICIPANTS: IHD was angina pectoris or myocardial infarction. MAIN OUTCOME MEASURES: Triglycerides, HDL, and IHD were the main outcome measures. RESULTS: Cross-sectionally, triglycerides varied...

  20. Unstable angina early after aortic valve replacement surgery in a female patient with normal coronary arteries preoperatively – a case report

    Directory of Open Access Journals (Sweden)

    Schwarz Christian

    2009-07-01

    Full Text Available Abstract Background Angina pectoris early after aortic valve replacement surgery in patients with previously normal coronary arteries may be life threatening and has to be assessed immediately. Case report 12 weeks after aortic valve replacement surgery, a 60-year-old female patient was referred for evaluation of recent onset of severe chest pain on mild exertion and at rest. Coronary angiography showed severe stenosis nvolving the left coronary ostium and the left main stem. The patient was urgently referred for bypass surgery and had an uneventful postoperative recovery. Conclusion A high degree of suspicion is needed for early recognition and aggressive management of this rare but serious complication.

  1. Valor preditivo da angina em detectar doença coronariana em pacientes com estenose aórtica grave a partir da quinta década de vida Predictive value of angina to detect coronary artery disease in patients with severe aortic stenosis aged 50 years or older

    Directory of Open Access Journals (Sweden)

    Aline Alves Vargas Gonçalves

    2006-12-01

    Full Text Available OBJETIVO: O objetivo deste estudo é verificar o valor de previsão da angina de peito no diagnóstico da DAC em pacientes portadores de EA, a partir da quinta década de vida. MÉTODOS: A população estudada foi constituída por 186 pacientes consecutivos com EA e idade e" 50 anos, referidos para cirurgia de troca valvar aórtica entre junho de 1989 e setembro de 2004. Cinecoronariografia de rotina foi realizada em todos os pacientes. Cento e um eram homens (54,3% e 85, mulheres (45,7%, com idade de 66±8 anos. Angina estava presente em 124 pacientes (66,7%. O gradiente máximo transvalvar aórtico foi de 89,4±27,6 mmHg e a área valvar aórtica de 0,59±0,17 cm2. Calculamos a sensibilidade, a especificidade, o valor de previsão positivo e negativo e a razão de verossimilhança positiva da angina na predição da presença de DAC. RESULTADOS: DAC estava presente em 93 pacientes (50%. Dos 124 pacientes com angina, 68 (54,8% apresentavam DAC; enquanto dos 62 sem angina, 25 apresentavam DAC (40,3%. Portanto, a sensibilidade da angina para DAC foi de 73,1%, a especificidade de 39,7%, valor preditivo positivo de 54,8%, valor preditivo negativo de 59,6% e razão de verossimilhança positiva de 1,6. CONCLUSÃO: A angina de peito não é bom preditor da presença de DAC em pacientes com EA a partir da quinta década de vida.OBJECTIVE: The objective of this study is to evaluate the value of angina pectoris as a predictor of CAD (coronary artery disease in patients with AS (aortic stenosis during and beyond the 5th decade of life. METHODS: The study population consisted of 186 consecutive patients with AS and e" 50 years of age, referred for surgical aortic valve replacement (AVR between June 1989 and September 2004. Routine coronary angiography was performed for all patients. One hundred and one patients were males (54.3% and 85 were females (45.7%, and the mean age was 66±8 years. One hundred and twenty-four patients (66.7% had angina. The maximum

  2. Angina

    Science.gov (United States)

    ... Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ... Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of ...

  3. An Overview of Meta-Analyses of Danhong Injection for Unstable Angina

    Directory of Open Access Journals (Sweden)

    Xiaoxia Zhang

    2015-01-01

    Full Text Available Objective. To systematically collect evidence and evaluate the effects of Danhong injection (DHI for unstable angina (UA. Methods. A comprehensive search was conducted in seven electronic databases up to January 2015. The methodological and reporting quality of included studies was assessed by using AMSTAR and PRISMA. Result. Five articles were included. The conclusions suggest that DHI plus conventional medicine treatment was effective for UA pectoris treatment, could alleviate symptoms of angina and ameliorate electrocardiograms. Flaws of the original studies and systematic reviews weaken the strength of evidence. Limitations of the methodology quality include performing an incomprehensive literature search, lacking detailed characteristics, ignoring clinical heterogeneity, and not assessing publication bias and other forms of bias. The flaws of reporting systematic reviews included the following: not providing a structured summary, no standardized search strategy. For the pooled findings, researchers took statistical heterogeneity into consideration, but clinical and methodology heterogeneity were ignored. Conclusion. DHI plus conventional medicine treatment generally appears to be effective for UA treatment. However, the evidence is not hard enough due to methodological flaws in original clinical trials and systematic reviews. Furthermore, rigorous designed randomized controlled trials are also needed. The methodology and reporting quality of systematic reviews should be improved.

  4. Interpreting angina: symptoms along a gender continuum

    Science.gov (United States)

    Crea-Arsenio, Mary; Shannon, Harry S; Velianou, James L; Giacomini, Mita

    2016-01-01

    Background ‘Typical’ angina is often used to describe symptoms common among men, while ‘atypical’ angina is used to describe symptoms common among women, despite a higher prevalence of angina among women. This discrepancy is a source of controversy in cardiac care among women. Objectives To redefine angina by (1) qualitatively comparing angina symptoms and experiences in women and men and (2) to propose a more meaningful construct of angina that integrates a more gender-centred approach. Methods Patients were recruited between July and December 2010 from a tertiary cardiac care centre and interviewed immediately prior to their first angiogram. Symptoms were explored through in-depth semi-structured interviews, transcribed verbatim and analysed concurrently using a modified grounded theory approach. Angiographically significant disease was assessed at ≥70% stenosis of a major epicardial vessel. Results Among 31 total patients, 13 men and 14 women had angiograpically significant CAD. Patients describe angina symptoms according to 6 symptomatic subthemes that array along a ‘gender continuum’. Gender-specific symptoms are anchored at each end of the continuum. At the centre of the continuum, are a remarkably large number of symptoms commonly expressed by both men and women. Conclusions The ‘gender continuum’ offers new insights into angina experiences of angiography candidates. Notably, there is more overlap of shared experiences between men and women than conventionally thought. The gender continuum can help researchers and clinicians contextualise patient symptom reports, avoiding the conventional ‘typical’ versus ‘atypical’ distinction that can misrepresent gendered angina experiences. PMID:27158523

  5. Decreased Diagnostic Accuracy of Multislice Coronary Computed Tomographic Angiography in Women with Atypical Angina Symptoms

    Institute of Scientific and Technical Information of China (English)

    Wen-Ying Jin; Xiu-Juan Zhao; Hong Chen

    2016-01-01

    Background:Multislice computed tomography (MSCT) coronary angiography (CAG) is a noninvasive technique with a reported high diagnostic accuracy for coronary artery disease (CAD).Women,more frequently than men,are known to develop atypical angina symptoms.The purpose of this study was to investigate whether the diagnostic accuracy of MSCT in women with atypical presentation differs from that in men.Methods:We enrolled 396 in-hospital patients (141 women and 255 men) with suspected or proven CAD who successively underwent both MSCT and invasive CAG.CAD was defined as any coronary stenosis of≥50% on conventional invasive CAG,which was used as the reference standard.The patients were divided into typical and atypical groups based on their symptoms of angina pectoris.The diagnostic accuracy of MSCT,including its sensitivity,specificity,negative predictive value,and positive predictive value (PPV),was calculated to determine the usefulness of MSCT in assessing stenoses.The diagnostic performance of MSCT was also assessed by constructing receiver operating characteristic (ROC) curves.Results:The PPV (91% vs.97%,x2 =5.705,P < 0.05) and diagnostic accuracy (87% vs.93%,x2 =5.093,P < 0.05) of MSCT in detecting CAD were lower in women than in men.Atypical presentation was an independent influencing factor on the diagnostic accuracy of MSCT in women (odds ratio =4.94,95% confidence intervals:1.16-20.92,Walds =4.69,P < 0.05).Compared with those in the atypical group,women with typical angina pectoris had higher PPV (98% vs.74%,x2 =17.283.P < 0.001),diagnostic accuracy (93% vs.72%,x2 =9.571,P < 0.001),and area under the ROC curve (0.91 vs.0.64,Z =2.690,P < 0.01) in MSCT diagnosis.Conclusions:Although MSCT is a reliable diagnostic modality for the exclusion of significant coronary artery stenoses in all patients,gender and atypical symptoms might have some influence on its diagnostic accuracy.

  6. Microvascular angina in postmenopausal women.

    Directory of Open Access Journals (Sweden)

    Alexander Valdés Martín

    2011-10-01

    Full Text Available Fundamento: la angina microvascular es frecuente en mujeres posmenopáusicas. La isquemia miocárdica ha sido inducida mediante pruebas de estrés, en las que se ha comprobado una relación entre la disfunción endotelial y los defectos de perfusión miocárdica. Objetivo: determinar si la isquemia miocárdica puede evidenciarse por anormalidades de la perfusión y de la función detectadas por gammagrafía miocárdica en mujeres con angina típica, angiografía coronaria normal y disfunción endotelial. Métodos: estudio descriptivo realizado en el Instituto de Cardiología y Cirugía Cardiovascular de La Habana que incluyó 59 mujeres. Se les realizó lipidograma, se les midió función endotelial de la arteria braquial mediante ultrasonido, y estudio electrocardiográfico de 24 horas (Holter. Se aplicó un protocolo de estrés-reposo durante la gammagrafía. Las pacientes fueron divididas en dos grupos, acorde a la presencia (grupo I o ausencia (grupo II de defectos de perfusión miocárdica. Resultados: mostraron defectos de la perfusión 21 pacientes. El 57 % de las pacientes del grupo I exhibió más disfunción endotelial. Sólo doce pacientes mostraron defectos reversibles de la perfusión y en el 75 % de los casos se asoció a una reducción de la fracción de eyección ventricular izquierda postestrés mayor de un 5 % y a anormalidades regionales de la motilidad de la pared. Tres pacientes en el grupo I mostraron evidencia de isquemia comparado con cuatro en el grupo II. Conclusiones: la isquemia inducida por estrés se asocia a una reducción de la fracción de eyección ventricular izquierda postestrés y a una vasodilatación anormal dependiente del endotelio.

  7. Comparision of high sensitivity C-reactive protein and matrix metalloproteinase 9 in patients with unstable angina between with and without significant coronary artery plaques

    Institute of Scientific and Technical Information of China (English)

    WANG Li-xin; L(U) Shu-zheng; ZHANG Wei-jun; SONG Xian-tao; CHEN Hui; ZHANG Li-jie

    2011-01-01

    Background Inflammation within vulnerable coronary plaques may cause unstable angina by promoting rupture and erosion. C-reactive protein (CRP) is the most reliable and accessible test method for clinical use for identifying coronary artery disease event. Matrix metalloproteinase 9 (MMP-9) is highly over-expressed in the vulnerable regions of a plaque.Our aim was to evaluate the plasma levels of MMP-9 and hsCRP in subjects with both unstable angina and coronary plaques, as well as in those with unstable angina without coronary plaques.Methods Patients with newly diagnosed unstable angina pectoris from clinical presentation and ECG, who were undergoing coronary angiography from April 2007 to April 2009, were included in this study. A total of 170 subjects were enrolled in the study. Before angiography, the baseline clinical data (mainly including conventional risk factors) was collected.These patients were divided into two groups, a non-plaque group (G1) which included 55 patients with no significant stenosis or less than 20% stenosis in at least one of the major coronary artery branches, and a plaque group (G2) which included 115 patients with at least one of the major coronary artery branches unstable angina pectoris with at least 50% stenosis of one major coronary artery. The patients presenting with calcified nodules of a major coronary artery were excluded from this study.We examined the serum levels of MMP-9 for all cases by multi-effect enzyme-linked immunosorbent assay.Results There was a significant difference in the serum levels of MMP-9 between the two groups (P<0.001). The percentage of patients with hypertension, diabetes and current smokers were significantly different between the two groups (P=0.034, P=0.031, and P=0.044 respectively). The univariate Logistic regression analyses of risk factors showed that smoking was the main risk factor for angina in the non-plaque group with the OR being 1.95 (95% Cl 1.02-3.75).Hypertension, diabetes mellitus

  8. Bypass surgery versus stenting for the treatment of multivessel disease in patients with unstable angina compared with stable angina

    OpenAIRE

    de Feyter, Pim; Heuvel, P.; Unger, Felix; Beyar, R; Lindeboom, Wietze; de Valk, Vincent; Milo, S; Simon, Rudiger; Tyers, Frank; Regensburger, D.; Crean, Peter; Penn, Ian; McGovern, E; Cauwelaert, C.; Serruys, Patrick

    2002-01-01

    textabstractBACKGROUND: Earlier reports have shown that the outcome of balloon angioplasty or bypass surgery in unstable angina is less favorable than in stable angina. Recent improvements in percutaneous treatment (stent implantation) and bypass surgery (arterial grafts) warrant reevaluation of the relative merits of either technique in treatment of unstable angina. Methods and Results- Seven hundred fifty-five patients with stable angina were randomly assigned to coronary stenting (374) or ...

  9. Coronary angioplasty for early postinfarction unstable angina

    NARCIS (Netherlands)

    P.J. de Feyter (Pim); P.W.J.C. Serruys (Patrick); A. Soward; M.J.B.M. van den Brand (Marcel); E. Bos (Egbert); P.G. Hugenholtz (Paul)

    1986-01-01

    textabstractCoronary angioplasty was performed in 53 patients in whom unstable angina had reoccurred after 48 hr and within 30 days after sustained myocardial infarction. Single-vessel disease was present in 64% of the patients and multivessel disease in 36%. The preceding myocardial infarction had

  10. Effect of preinfarction angina on the prognosis of elderly patients with acute myocardial infarction and undergoing emergency PCI%梗死前心绞痛对行急诊PCI的老年急性心肌梗死患者预后的影响

    Institute of Scientific and Technical Information of China (English)

    张金艳; 周长钰

    2011-01-01

    目的:探讨老年首发急性心肌梗死(AMI)患者梗死前1周内心绞痛对其近期预后的影响.方法:87例年龄≥70岁的老年首发AMI且行急诊经皮冠状动脉介入(PCI)治疗的患者按AMI前1周内有无心绞痛发作分为心绞痛组(41例)和无心绞痛组(46例),观察其住院期间心律失常、心力衰竭、心源性休克、肺感染发生率,并比较两组间心功能Killip分级、左室结构、左室射血分数(LVEF)及冠脉病变程度.结果:心绞痛组左心室内径小于无心绞痛组,舒张末径分别为(47.50±6.17)mm及(51.88±5.96)mm(P<0.05),但两组间LVEF无统计学差异(P>0.05).心绞痛组住院期间严重心律失常、心力衰竭、心源性休克、肺感染的发生率与无心绞痛组比较,差异无统计学意义(P>0.05).结论:心肌梗死前心绞痛发作未显示对老年首发心肌梗死患者的保护作用,未能改善患者的近期预后.%Objective: To explore the effect of angina one week before the onset of acute myocardial infarction (AMI)on the short-term prognosis of initial AMI in elderly patients.Methods: Totally 87 initial AMI patients aged ≥ 70 years and undergoing emergency percutaneous coronary intervention (PCI) were divided into two groups: angina pectoris group (n=41)and no angina pectoris group (n=46).Their prevalence of arrhythmia, heart failure,eardiogenie shock and pulmonary infection during the period of hospitalization were observed.And Killip grading of heart functions, left ventricular structure,left ventrieular ejection fraction(LVEF)and the degree of coronary artery lesions of the two groups were compared.Results:Left ventricular demension in angina pectoris group was less than that in no angina pectoris group,left ventricular end-diastolic dimension was (47.50±6.17)mm and(51.88±5.96)mm respectively(P<0.05 ), but LVEF showed no significant difference in the two groups (P>0.05).The prevalence of arrhythmia,heart failure,eardiogenie shock and

  11. [Anesthetic management of coronary artery bypass grafting for unstable angina pectoris in a patient undergoing home oxygen therapy].

    Science.gov (United States)

    Arai, Takero; Enomoto, Yoshiro; Kuno, Yuichiro; Inoue, Hisashi; Okuda, Yasuhisa

    2008-04-01

    A 70-year-old man with pneumoconiosis receiving home oxygen therapy presented with chest pain. Coronary angiogram showed severe stenosis of his left main trunks and required emergency off-pump coronary artery bypass grafting. Anesthesia was induced and maintained with propofol, fentanyl and vecuronium. The trachea was intubated and the lungs were ventilated with oxygen and air maintaining the PaO2 between 80-100 mmHg and the PaCO2 between 55-65 mmHg. The operation was performed uneventfully. In the intensive care unit, the trachea was extubated after ensuring adequate respiratory function. The postoperative course was satisfactory.

  12. Coronary microvascular function and myocardial fibrosis in women with angina pectoris and no obstructive coronary artery disease

    DEFF Research Database (Denmark)

    Mygind, Naja Dam; Michelsen, Marie Mide; Pena, Adam

    2016-01-01

    using a modified Look-Locker pulse sequence measuring T1 and extracellular volume fraction (ECV). RESULTS: CFVR and CMR were performed in 64 women, mean (SD) age 62.5 (8.3) years. MBFR was performed in a subgroup of 54 (84 %) of these women. Mean native T1 was 1023 (86) and ECV (%) was 33.7 (3.5); none...

  13. The diagnostic accuracy and outcomes after coronary computed tomography angiography vs. conventional functional testing in patients with stable angina pectoris

    DEFF Research Database (Denmark)

    Nielsen, Lene H; Ortner, Nino; Nørgaard, Bjarne L

    2014-01-01

    AIMS: To systematically review and perform a meta-analysis of the diagnostic accuracy and post-test outcomes of conventional exercise electrocardiography (XECG) and single-photon emission computed tomography (SPECT) compared with coronary computed tomography angiography (coronary CTA) in patients...

  14. Prediction of clinical outcome by myocardial CT perfusion in patients with low-risk unstable angina pectoris

    DEFF Research Database (Denmark)

    Linde, Jesper J; Sørgaard, Mathias; Kühl, Jørgen T

    2017-01-01

    The prognostic implications of myocardial computed tomography perfusion (CTP) analyses are unknown. In this sub-study to the CATCH-trial we evaluate the ability of adenosine stress CTP findings to predict mid-term major adverse cardiac events (MACE). In 240 patients with acute-onset chest pain, y...

  15. Comparison of costs of percutaneous transluminal coronary angioplasty and coronary bypass surgery for patients with angina pectoris

    NARCIS (Netherlands)

    C. van Halem; F. van den Brink; P.J. de Feyter (Pim); P.W.J.C. Serruys (Patrick); H. Suryapranata (Harry); K.J. Meeter; E. Bos (Egbert); F.J. van Dalen (Frederik); M.J.B.M. van den Brand (Marcel)

    1990-01-01

    textabstractTo determine the costs of a procedure, the total costs of the department that provides the service must be considered and, in addition, the direct cost of the specific procedure. Applying this principle to the cost accounting of angioplasty and bypass surgery results in a direct, i.e. pr

  16. Two-dimentional speckle tracking strain imaging in the assessment of myocardial diastolic function in patients with stable angina pectoris

    Directory of Open Access Journals (Sweden)

    Somaye Farokhnejad

    2015-06-01

    Full Text Available Introduction: Ischemic heart disease is caused mainly by obstruction of coronary arteries. The ischemic assessment through echocardiography is dependent on wall motion abnormality detection during systole. In patients with ischemic heart disease the diastolic function is impaired before systolic function and measurement of regional diastolic dysfunction if possible will be most sensitive for assessment of obstructed coronary artery region. This study was designed to determine whether regional left ventricular delayed relaxation diagnosis could be detected with strain imaging derived from two-dimensional speckle-tracking echocardiography in patients with coronary artery disease.Methods: All the articles reviewed were obtained using MEDLINE & ScienceDirect (up to October 2014. All data extracted by speckle tracking echocardiography. The index which is used is strain imaging diastolic index which is calculated as: (A-B A×100  . A is the amount of strain at the time Aortic value closure and B is the amount of strain in first one-third point of diastolic duration.Result: Four articles were reviewed. Three articles assessed patients with echocardiography at rest and one with stress echocardiography. All articles showed the coronary artery tracking with significant stenosis is possible by regional deformation analysis through two-dimensional strain.Discussion: The usage of strain images obtained through two-dimensional speckle tracking has been validated for the quantitation assessment of regional dysfunction in ischemic heart disease. Regional LV delayed relaxation diagnosis with strain imaging is a reliable method after treadmill stress test.Conclusion:  Strain imaging is reasonable for evaluation of ischemia as a low cost noninvasive test with high accuracy.

  17. Myocardial Strain Analysis by 2-Dimensional Speckle Tracking Echocardiography Improves Diagnostics of Coronary Artery Stenosis in Stable Angina Pectoris

    DEFF Research Database (Denmark)

    Biering-Sørensen, Tor; Hoffmann, Soren; Mogelvang, Rasmus

    2014-01-01

    of the exercise test. Patients with an area stenosis≥70% in ≥1 epicardial coronary artery were categorized as having significant CAD (n=107). Global longitudinal peak systolic strain was significantly lower in patients with CAD compared with patients without (17.1±2.5% versus 18.8±2.6%; P... an independent predictor of CAD after multivariable adjustment for baseline data, exercise test, and conventional echocardiography (odds ratio, 1.25 [P=0.016] per 1% decrease). Area under receiver operating characteristic curve for exercise test and global longitudinal peak systolic strain in combination...

  18. Reduction of transient myocardial ischemia with pravastatin in addition to the conventional treatment in patients with angina pectoris

    NARCIS (Netherlands)

    vanBoven, AJ; Jukema, JW; Zwinderman, AH; Crijns, HJGM; Lie, KI; Bruschke, AVG

    1996-01-01

    Background Lipid-lowering therapy reduces cardiac mor bidity and mortality. Le Methods and Results In a 2-year prospective randomized placebo-controlled study, the effect of pravastatin 40 mg on transient myocardial ischemia was assessed. Forty-eight-hour ambulatory ECGs with continuous ST-segment a

  19. Impaired myocardial perfusion reserve in microvascular angina (syndrome X): Assessment by vasodilation {sup 99m}Tc-MIBI-SPECT; Einschraenkung der myokardialen Perfusionsreserve bei Mikrovaskular-Angina (Syndrom X): Nachweis durch {sup 99m}Tc-MIBI-SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Langes, K. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. fuer Kardiologie; Beuthien-Baumann, B. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. fuer Nuklearmedizin; Luebeck, M. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. fuer Nuklearmedizin; Fuchs, C. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. fuer Nuklearmedizin; Schneider, M.A. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. fuer Kardiologie; Volk, C. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. fuer Kardiologie; Nienaber, C.A. [Universitaetskrankenhaus Eppendorf, Hamburg (Germany). Abt. fuer Kardiologie

    1996-12-01

    Aim: In 22 patients with typical chest pain and normal coronary arteries (microvascular angina, syndrome X) {sup 99m}Tc-MIBI-SPECT was examined in regard to assess impairment of myocardial perfusion reserve. Method: The study was performed with {sup 99m}Tc-MIBI-SPECT at rest and under vasodilation with dipyridamole. The findings were compared with a normal database. A normal perfusion reserve was said to be an increase >20% of the {sup 99m}Tc-MIBI-activity. Results: In 2/22 (9%) of the patients the perfusion reserve lay >20% i.e. 37%. In 91% of the patients a diminution or even decrease of the perfusion was to be seen. From these 9/22 (41%) of the patients showed a diminution of the {sup 99m}Tc-MIBI by 6%. 11/22 patients had a decrease of the perfusion under vasodilation with dipyridamole i.e. a lower activity of 99mTc-MIBI 13%. Conclusion: Vasodilation {sup 99m}Tc-MIBI-SPECT offers good imaging quality and enables semiquantitative assessment of myocardial perfusion reserve in patients with microvascular angina. (orig.) [Deutsch] Ziel: An 22 Patienten mit typischer Angina pectoris und normalen Koronararterien (Mikrovaskular-Angina, Syndrom X) wurde geprueft, ob mit {sup 99m}Tc-MIBI-SPECT eine Einschraenkung der myokardialen Perfusionsreserve nachweisbar ist. Methode: Die Untersuchung mit {sup 99m}Tc-MIBI-SPECT erfolgte in Ruhe und unter Vasodilatation nach einer Infusion mit Dipyridamol im Vergleich zu einer normalen Datenbank. Eine normale myokardiale Perfusionsreserve wurde bei einer differenziellen {sup 99m}Tc-MIBI-Aufnahme von {>=}20% angesehen. Ergebnisse: 2/22 (9%) der Patienten wiesen eine Perfusionsreserve >20% mit im Mittel 37% auf, 91% der Patienten wiesen eine relativ oder absolut verminderte {sup 99m}Tc-MIBI-Aufnahme unter Vasodilatation auf. Bei 9/22 (41%) Patienten war die Perfusionsreserve relativ gemindert mit einer Zunahme der {sup 99m}Tc-MIBI-Aktivitaet von 6%, bei 11/22 wurde eine Abnahme der {sup 99m}Tc-MIBI-Aktivitaet um 13% unter

  20. Confiabilidade de sintomas sugestivos de angina em pacientes com doença pulmonar obstrutiva crônica Confiabilidad de síntomas sugestivos de angina en pacientes con enfermedad pulmonar obstructiva crónica Reliability of symptoms suggestive of angina in patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Yilmaz Gunes

    2009-05-01

    baseline clinical characteristics who had undergone diagnostic coronary angiography for the first time were reviewed retrospectively. RESULTS: The frequency of significant CAD was significantly lower in COPD patients than in the control group (52.8% vs. 80.2%, p<0.001. Frequencies of CAD risk factors (older age, hypertension, diabetes, smoking history were significantly more frequent among COPD patients having significant CAD. Among patients reporting stable angina pectoris, significant CAD was detected in 32.7% of COPD patients and 71.0% of non-COPD patients (p<0.001. However, among the patients with a diagnosis of unstable angina pectoris, significant CAD was detected in 87.5% of COPD patients and 90.2% of non-COPD patients (p=0.755. CONCLUSION: Diagnosis of CAD in COPD patients by symptomatology may be difficult. However, clinical diagnosis of CAD in the setting of unstable angina is accurate in most of the COPD patients. Therefore, further noninvasive diagnostic methods or careful follow up may be more appropriate for COPD patients reporting stable angina pectoris.

  1. A rare cause of Ludwig's angina by Morganella morganii.

    Science.gov (United States)

    Ho, Min-Po; Tsai, Kuang-Chau; Yen, Szu-Lin; Lu, Cheng-Lin; Chen, Chia-Hung

    2006-10-01

    Ludwig's angina is a rapidly spreading and potentially lethal infection involving the floor of the mouth and neck. We present a rare case of Ludwig's angina caused by an unusual microorganism, Morganella morganii, and the group D alpha-hemolytic streptococcus. To our knowledge, this is the first case of Ludwig's angina and deep neck infection caused by Morganella morganii. Adequate airway maintenance, appropriate use of antibiotics and surgical drainage resulted in survival of the patient without complications.

  2. Extracorporeal Cardiac Shock Wave Therapy Ameliorates Clinical Symptoms and Improves Regional Myocardial Blood Flow in a Patient with Severe Coronary Artery Disease and Refractory Angina

    Directory of Open Access Journals (Sweden)

    Christian Prinz

    2009-01-01

    Full Text Available Different therapeutic options are being used for chronic coronary artery disease (CAD. We report about a 51-year-old female with CAD and refractory angina pectoris despite maximally tolerated medical therapy and after both percutaneous coronary intervention (PCI and coronary artery bypass grafting (CABG. The patient received cardiac shock wave therapy (CSWT over a period of 6 month. There was no arrhythmia during or after treatment; enzyme levels were normal at all times. PET imaging showed a substantial improvement of myocardial stress perfusion. Since the patient reported that she now was fully capable to deal with her everyday life, further treatment options were postponed. Our case report suggests that ultrasound-guided CSWT is able to improve symptoms and perfusion in ischemic myocardium.

  3. Angina de pecho en mujeres del departamento de Nariño Angina de peito em mulheres do departamento de Nariño Angina Pectoris in Women from the Department of Nariño

    Directory of Open Access Journals (Sweden)

    Carmen Ofelia Narváez Erazo

    2012-07-01

    Full Text Available El artículo describe el estado del conocimiento sobre la enfermedad coronaria en las mujeres en el departamento de Nariño. La consulta a expertos, las visitas institucionales y la revisión documental a nivel regional, permitieron estructurar una visión general de la enfermedad coronaria en las mujeres en comparación con los hallazgos encontrados en estudios nacionales e internacionales, además visualiza algunas concepciones culturales que condicionan los comportamientos. Se concluye que en Nariño comienza a esbozarse el intento de llenar el vacío investigativo respecto al tema desde el objeto de estudio del enfermero.O artigo descreve o estado de conhecimento sobre a doença coronária nas mulheres no departamento de Nariño. A consulta de especialistas, as visitas institucionais e a revisão documental a nível regional possibilitaram a estruturação de uma visão geral da doença coronária nas mulheres a respeito dos achados encontrados em estudos nacionais e internacionais, além de visualizar algumas concepções culturais que condicionam os comportamentos. Conclui-se que em Nariño começa a se manifestar a tentativa de fechar a brecha nas pesquisas relativas a este tópico desde o objeto de estudo do enfermeiro.This article describes the state of knowledge about the coronary disease in women from the Department of Nariño. Expert consultation, institutional visits and document review at regional level allowed structuring an overview of the coronary disease in women in contrast with the findings of national and international studies. Likewise, it considers some cultural conceptions conditioning behaviors. It was found that in Nariño an attempt to fill in the research void about the issue is originating from the nurse subject of study.

  4. Ludwig's angina after severe thrombocytopenic purpura associated with dengue fever

    Directory of Open Access Journals (Sweden)

    Maria Antonia Campos

    2014-01-01

    Full Text Available Here, we report a case of Ludwig's angina, which required surgery because of toothache. The patient had dengue and severe thrombocytopenia as confirmed by clinical and laboratory diagnoses. However, dengue is not included among the predisposing factors for Ludwig's angina.

  5. Necrotizing fasciitis in association with Ludwig's angina - A case report.

    Science.gov (United States)

    Kavarodi, A M

    2011-07-01

    A 28 year old male diabetic patient developed Ludwig's angina which subsequently evolved into cervicofacial necrotizing fasciitis. The differential characteristic of Ludwig's angina and cervicofacial necrotizing fasciitis, as it relates to this rare presentation is discussed. The clinical and radiological features, pathophysiology, diagnosis and the management that resulted in a successful outcome are presented.

  6. Angina de Ludwig. Reporte de 2 casos

    OpenAIRE

    Antonio Fabbio Gagliardi Lugo; María Gabriela Contreras Ravago; Ronar Alejandro Gudiño Martinez; Rafael José Zeballos Peltrini

    2014-01-01

    La angina de Ludwig (AL) es una entidad patológica, odontogénica e infecciosa que representa una situación de emergencia en la Cirugía Bucal y Maxilofacial por comprometer la vida del paciente debido a una progresiva oclusión de la vía aérea, producto del avance de la infección hacia los espacios submandibulares, sublinguales y submental, lo que trae como consecuencia el colapso de la misma. En el presente trabajo se hace una revisión de la literatura actualizada acerca de dicha entidad, orig...

  7. Preinfarction angina: old story initiates new attention

    Institute of Scientific and Technical Information of China (English)

    GE Jun-bo

    2012-01-01

    Since first report by Murry et al1 in 1986,the role of ischemia preconditioning before sustained coronary occlusion in protecting myocardium and reducing infarct size has been identified in animal studies.2-4 The mechanism underlying the endogenous cardioprotective effects of ischemia preconditioning is complex and may involve humoral,neural,or a combination of both,with different signaling pathwaysinvolving adenosine,bradykinin,protein kinases and K(ATP) channels.5,6 In humans,episodes of angina before acute myocardial infarction (AMI) may also confer a preconditioning or protective effect.

  8. Bypass surgery versus stenting for the treatment of multivessel disease in patients with unstable angina compared with stable angina

    NARCIS (Netherlands)

    P.J. de Feyter (Pim); P. van den Heuvel; F. Unger (Felix); R. Beyar; W.K. Lindeboom (Wietze); V. de Valk (Vincent); S. Milo; R. Simon (Rudiger); G.F.O. Tyers (Frank); D. Regensburger; P.A. Crean (Peter); I.M. Penn (Ian); E. McGovern; C. van Cauwelaert; P.W.J.C. Serruys (Patrick)

    2002-01-01

    textabstractBACKGROUND: Earlier reports have shown that the outcome of balloon angioplasty or bypass surgery in unstable angina is less favorable than in stable angina. Recent improvements in percutaneous treatment (stent implantation) and bypass surgery (arterial grafts) warrant reevaluation of the

  9. Angina de pecho con arterias angiográficamente normales: características epidemiológicas y clínicas

    Directory of Open Access Journals (Sweden)

    Oswaldo Gutiérrez Sotelo

    2002-12-01

    Full Text Available Introducción: Las lesiones obstructivas por arterioesclerosis coronaria genera diversos síndromes coronarios. Sin embargo, un subgrupo de pacientes con angina de pecho y alteraciones electrocardiográficas no presenta dichas lesiones, en el que se incluyen el vasoespasmo coronario, la angina microvascular, los puentes musculares y otras condiciones. En este estudio se evaluaron las principales características clínicas y electrocardiográficas de este grupo de pacientes. Material y métodos: Se incluyeron pacientes con cualquier síndrome coronario y angiografía coronaria sin lesiones obstructivas. Se consignaron los factores de riesgo cardiovascular, los síntomas de presentación, alteraciones electrocardiográficas y ecocardiográficas y los fármacos utilizados. Resultados: Se reclutaron 26 casos, 13 hombres y 13 mujeres con edad promedio de 56.6 años (rango 16 - 78. Se presentó angina microvascular en 16 casos, vasoespasmo coronario en 8, uno con un puente coronario y uno con flujo lento. Como síntomas se observó disnea en 18 pacientes, angor típico en 19 y angor atípico en 7. El electrocardiograma de reposo fue anormal en 18 pacientes, y el de esfuerzo en 13 casos. De 19 ecocardiogramas, 9 fueron anormales. Los fármacos más utilizados fueron los betabloqueadores, los bloqueadores de los canales del calcio y los nitratos. Conclusiones: Los pacientes con síndromes coronarios y angiografía coronaria sin lesiones obstructivas presentan frecuentemente factores de riesgo coronario, no hay diferencia de género y los exámenes auxiliares son anormales lo que motiva la realización de la angiografía.lntroduction: Coronary arteriosclerosis lesions induce several coronary syndromes. Some patients suffer angina pectoris with abnormal electrocardiograms with no obstructive plaques in the angiogram. This group includes coronary vasospasm, micro vascular angina, muscle bridges and others. This study evaluates the most important clinical

  10. Angina bullosa hemorrhagica: report of 11 cases

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    Julieta Ruiz Beguerie

    2014-05-01

    Full Text Available Angina bullosa hemorrhagica is a rare and benign disorder, usually localized in the subepithelial layer of the oral, pharyngeal and esophageal mucosa. The lesions are characterized by their sudden onset. They appear as a painless, tense, dark red and blood-filled blister in the mouth that rapidly expand and rupture spontaneously in 24-48 hours. The underlying etiopathology remains ill defined, although it may be a multifactorial phenomenon including diabetes, and steroid inhalers. The condition is not attributable to blood dyscrasias, nor other vesicular-bullous disorders. In this study, eleven patients with such blisters are described. Physical examination of the patients revealed a single blister with hemorrhagic content localized in the oral mucosa. Biopsy of the lesions showed sub epithelial blisters with a mild infiltrate. In general practice, dermatologists could face a blood-filled bullous lesion of the oral mucosa. Recognition is, therefore, of great importance for dermatologists.

  11. Unstable angina of crescendo pattern vs new onset: a clinical, coronary arteriographic and hemodynamic study.

    Science.gov (United States)

    Hussain, K M; Gould, L; Bharathan, T; Abdelsayed, G; Karpov, Y

    1995-06-01

    Unstable angina includes a variety of clinical presentations with a different level of risk for an unfavorable outcome. In this study the authors investigated the prognostic significance of crescendo angina and new-onset angina to discuss management strategies, paying attention to the relevance of baseline clinical characteristics, coronary artery lesions, and left ventricular function, as well as their alterations during atrial pacing. Accordingly coronary arteriographic anatomy and changes in left ventricular volumes and ejection fraction before and during atrial pacing were studied by means of digital subtraction ventriculography in 18 patients with crescendo angina and in 18 patients with new-onset angina. Triple-vessel disease was more frequently observed in crescendo angina (56%; P crescendo angina. The angiographic evidence of intracoronary thrombi was found in 33% (P crescendo angina and in 4% patients with new-onset angina. Compared with the patients with new-onset angina, patients with crescendo angina had higher end-diastolic and end-systolic volumes and lower ejection fraction at rest. At peak pacing, ejection fraction was significantly (P crescendo angina (0.48 +/- 0.06) than in new-onset angina (0.66 +/- 0.04). In crescendo angina, during pacing, the magnitude of velocity of circumferential fiber shortening was significantly decreased as compared with new-onset angina.(ABSTRACT TRUNCATED AT 250 WORDS)

  12. Side effects of using nitrates to treat heart failure and the acute coronary syndromes, unstable angina and acute myocardial infarction.

    Science.gov (United States)

    Thadani, Udho; Ripley, Toni L

    2007-07-01

    Nitrates are potent venous dilators and anti-ischemic agents. They are widely used for the relief of chest pain and pulmonary congestion in patients with acute coronary syndromes and heart failure. Nitrates, however, do not reduce mortality in patients with acute coronary syndromes. Combination of nitrates and hydralazine when given in addition to beta-blockers and angiotensin-converting enzyme (ACE) inhibitors reduce mortality and heart failure hospitalizations in patients with heart failure due to left ventricular systolic dysfunction who are of African-American origin. Side effects during nitrate therapy are common but are less well described in the literature compared with the reported side effects in patients with stable angina pectoris. The reported incidence of side effects varies highly among different studies and among various disease states. Headache is the most commonly reported side effect with an incidence of 12% in acute heart failure, 41-73% in chronic heart failure, 3-19% in unstable angina and 2-26% in acute myocardial infarction. The reported incidence of hypotension also differs: 5-10% in acute heart failure, 20% in chronic heart failure, 9% in unstable angina and < 1-48% in acute myocardial infarction, with the incidence being much higher with concomitant nitrate therapy plus angiotensin-converting enzyme inhibitors. Reported incidence of dizziness is as low as 1% in patients with acute myocardial infarction to as high as 29% in patients with heart failure. Severe headaches and/or symptomatic hypotension may necessitate discontinuation of nitrate therapy. Severe life threatening hypotension or even death may occur when nitrates are used in patients with acute inferior myocardial infarction associated with right ventricular dysfunction or infarction, or with concomitant use of phosphodiesterase-5 inhibitors or N-acetylcysteine. Despite the disturbing observational reports in the literature that continuous and prolonged use of nitrates may lead to

  13. Cellulase variants

    Energy Technology Data Exchange (ETDEWEB)

    Blazej, Robert; Toriello, Nicholas; Emrich, Charles; Cohen, Richard N.; Koppel, Nitzan

    2015-07-14

    This invention provides novel variant cellulolytic enzymes having improved activity and/or stability. In certain embodiments the variant cellulotyic enzymes comprise a glycoside hydrolase with or comprising a substitution at one or more positions corresponding to one or more of residues F64, A226, and/or E246 in Thermobifida fusca Cel9A enzyme. In certain embodiments the glycoside hydrolase is a variant of a family 9 glycoside hydrolase. In certain embodiments the glycoside hydrolase is a variant of a theme B family 9 glycoside hydrolase.

  14. Angina de Ludwig. Reporte de 2 casos

    Directory of Open Access Journals (Sweden)

    Antonio Fabbio Gagliardi Lugo

    2014-10-01

    Full Text Available La angina de Ludwig (AL es una entidad patológica, odontogénica e infecciosa que representa una situación de emergencia en la Cirugía Bucal y Maxilofacial por comprometer la vida del paciente debido a una progresiva oclusión de la vía aérea, producto del avance de la infección hacia los espacios submandibulares, sublinguales y submental, lo que trae como consecuencia el colapso de la misma. En el presente trabajo se hace una revisión de la literatura actualizada acerca de dicha entidad, origen, vías de diseminación, manejo terapéutico y posibles complicaciones. Se reportan 2 casos que acuden a Emergencias del Hospital General del Oeste «Dr. José Gregorio Hernández» (HGO en Los Magallanes de Catia (Caracas, Venezuela con diagnóstico de AL. Se presenta el manejo clínico y la relevancia del rol que adquiere el cirujano maxilofacial en el diagnóstico en aras de la preservación de la vida del paciente.

  15. Analysis of Plasma Homocysteine Levels in Patients with Unstable Angina

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    José Roberto Tavares

    2002-08-01

    Full Text Available OBJECTIVE - To determine the prevalence of hyperhomocystinemia in patients with acute ischemic syndrome of the unstable angina type. METHODS - We prospectively studied 46 patients (24 females with unstable angina and 46 control patients (19 males, paired by sex and age, blinded to the laboratory data. Details of diets, smoking habits, medication used, body mass index, and the presence of hypertension and diabetes were recorded, as were plasma lipid and glucose levels, C-reactive protein, and lipoperoxidation in all participants. Patients with renal disease were excluded. Plasma homocysteine was estimated using high-pressure liquid chromatography. RESULTS - Plasma homocysteine levels were significantly higher in the group of patients with unstable angina (12.7±6.7 µmol/L than in the control group (8.7±4.4 µmol/L (p<0.05. Among males, homocystinemia was higher in the group with unstable angina than in the control group, but this difference was not statistically significant (14.1±5.9 µmol/L versus 11.9±4.2 µmol/L. Among females, however, a statistically significant difference was observed between the 2 groups: 11.0±7.4 µmol/L versus 6.4±2.9 µmol/L (p<0.05 in the unstable angina and control groups, respectively. Approximately 24% of the patients had unstable angina at homocysteine levels above 15 µmol/L. CONCLUSION - High homocysteine levels seem to be a relevant prevalent factor in the population with unstable angina, particularly among females.

  16. Pharmacological Management of Chronic Stable Angina: Focus on Ranolazine.

    Science.gov (United States)

    Rosano, Giuseppe M C; Vitale, Cristiana; Volterrani, Maurizio

    2016-08-01

    Percutaneous coronary intervention and anti-anginal medications have similar prognostic effectiveness in patients with chronic stable angina. The choice of optimal medical therapy for the management of chronic angina is of pivotal importance in patients with stable ischemic heart disease. The most commonly used anti-anginal agents have demonstrated equivalent efficacy in improving patient reported ischemic symptoms and quantitative exercise parameters. With regards to mortality, beta-blockers are beneficial only in the setting of depressed left ventricular systolic function after a recent myocardial infarction. Recent evidence suggests the lack of any benefit of beta-blockers in patients with preserved systolic function, even in the setting of prior myocardial infarction.Ranolazine is a non-haemodynamic anti-anginal agent. It is effective as adjunctive therapy in patients with chronic stable angina whose symptoms are un-adequately controlled by conventional treatment. The clinical development program of ranolazine has shown that the drug improves exercise performance, decreases angina and use of sublingual nitrates, compared to placebo. Ranolazine is well tolerated with neutral effect on haemodynamics. Besides its role in chronic stable angina, ranolazine has the potential for development in a number of other cardiovascular and non-cardiovascular conditions in the future.

  17. ["Persistent" angina: rationale for a metabolic approach].

    Science.gov (United States)

    Marzilli, Mario

    2004-03-01

    Despite increasing pharmacological and mechanical treatment options, ischemic heart disease continues to be associated with considerable patient mortality and morbidity. The estimates of the direct and indirect costs associated with chronic stable angina amount to billions of dollars. Given the epidemiological and economic magnitude of the problem, the need for more effective therapies is self-evident. Based on current guidelines, the management of ischemic heart disease has progressively broadened to include risk factor modification, patient education, and pharmacological therapy. The latter includes i) classic antianginal agents such as beta-blockers, calcium antagonists, and nitrates, and ii) drugs for secondary prevention, such as aspirin, clopidogrel, statins, and angiotensin-converting enzyme inhibitors. Tailoring therapy to individual needs has become even more challenging because of the marked changes in the clinical profile of patients with chronic ischemic heart disease. Compared with the past, today's patients tend to be older, to have undergone revascularization procedures, and to frequently have associated illnesses, including heart failure and diabetes. Significant progress has been made in recent years in understanding the role of cardiac energy metabolism in the pathogenesis of myocardial ischemia. A better understanding of metabolic derangements associated with ischemia and reperfusion is translating into innovative therapeutic approaches. Optimization of cardiac energy metabolism is based on promoting cardiac glucose oxidation. This has been proved to enhance cardiac function and protect myocardial tissue against ischemia-reperfusion injury. A new class of metabolic agents, known as the 3-ketoacyl coenzyme A thiolase inhibitors (trimetazidine), is able to elicit an increase in glucose and lactate combustion secondary to partial inhibition of fatty acid oxidation, producing clinical benefits in patients with ischemic heart disease.

  18. Blood blisters of the oral mucosa (angina bullosa haemorrhagica).

    Science.gov (United States)

    Deblauwe, B M; van der Waal, I

    1994-08-01

    Angina bullosa haemorrhagica is a benign phenomenon that is characterized by the sudden appearance of a blood blister on the oral mucosa in the absence of an identifiable cause or systemic disorder; local trauma has been suggested to be the most likely contributory factor. No treatment is required. Angina bullosa haemorrhagica affects mainly middle-aged and elderly people. There is no strong predilection for either men or women. In this article nine patients with such blisters are described. Blood blisters apparently are more common than has been suggested in the literature.

  19. LUDWIG’S ANGINA AND ANAESTHETIC DIFFICULTIES: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Sarda Devi

    2015-04-01

    Full Text Available Patients with deep neck infections present challenging airways for an anesthesiologist . Ludwig’s angina is potentially lethal, rapidly spreading cellulitis involving the floor of the mouth and neck. Without aggressive management it often results in life th reatening upper airway obstruction. Securing the airway remains the top priority in treatment of Ludwig’s angina. Although awake fibreoptic intubation remains the ideal method for securing the airway, but it is not available in every set up, so all feasibl e options of securing the airway should be prepared. We present a case successfully managed at our hospital with a brief review of airway management options.

  20. The prevalence and management of angina among patients with chronic coronary artery disease across US outpatient cardiology practices: insights from the Angina Prevalence and Provider Evaluation of Angina Relief (APPEAR) study.

    Science.gov (United States)

    Kureshi, Faraz; Shafiq, Ali; Arnold, Suzanne V; Gosch, Kensey; Breeding, Tracie; Kumar, Ashwath S; Jones, Philip G; Spertus, John A

    2017-01-01

    Although eliminating angina is a primary goal in treating patients with chronic coronary artery disease (CAD), few contemporary data quantify prevalence and severity of angina across US cardiology practices. The authors hypothesized that angina among outpatients with CAD managed by US cardiologists is low and its prevalence varies by site. Among 25 US outpatient cardiology clinics enrolled in the American College of Cardiology Practice Innovation and Clinical Excellence (PINNACLE) registry, we prospectively recruited a consecutive sample of patients with chronic CAD over a 1- to 2-week period at each site between April 2013 and July 2015, irrespective of the reason for their appointment. Eligible patients had documented history of CAD (prior acute coronary syndrome, prior coronary revascularization procedure, or diagnosis of stable angina) and ≥1 prior office visit at the practice site. Angina was assessed directly from patients using the Seattle Angina Questionnaire Angina Frequency score. Among 1257 patients from 25 sites, 7.6% (n = 96) reported daily/weekly, 25.1% (n = 315) monthly, and 67.3% (n = 846) no angina. The proportion of patients with daily/weekly angina at each site ranged from 2.0% to 24.0%, but just over half (56.3%) were on ≥2 antianginal medications, with wide variability across sites (0%-100%). One-third of outpatients with chronic CAD managed by cardiologists report having angina in the prior month, and 7.6% have frequent symptoms. Among those with frequent angina, just over half were on ≥2 antianginal medications, with wide variability across sites. These findings suggest an opportunity to improve symptom control.

  1. [Microvascular angina in women: a diagnostic and therapeutic challenge

    NARCIS (Netherlands)

    Elias-Smale, S.E.; Boer, M.J. de; Maas, A.H.E.M.

    2014-01-01

    Gender differences play an important role in coronary heart disease (CHD). Not only in the presentation of symptoms, but also in their underlying pathophysiology. Women with persistent angina without obstructive coronary artery disease (CAD) pose a diagnostic and therapeutic challenge. Half of these

  2. Unstable angina following intracavernous injection of alprostadil: a case study

    OpenAIRE

    Delongchamps, Nicolas Barry; Legrand, Guillaume; Zerbib, Marc; Peyromaure, Michael

    2009-01-01

    Intracavernous injection of alprostadil is the gold standard treatment for erectile dysfunction following radical prostatectomy. After surgery, low doses of alprostadil can be delivered for the sole purpose of penile rehabilitation. The only reported systemic side effects of such injections are arterial hypotension and headache. In the current report, a case of unstable angina immediately following an intracavernous injection of alprostadil is described.

  3. Emerging clinical role of ranolazine in the management of angina

    Directory of Open Access Journals (Sweden)

    David S Vadnais

    2010-10-01

    Full Text Available David S Vadnais, Nanette K WengerDivision of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USAAbstract: Chronic stable angina is an exceedingly prevalent condition with tremendous clinical, social, and financial implications. Traditional medical therapy for angina consists of beta-blockers, calcium channel blockers, and nitrates. These agents decrease myocardial oxygen demand and ischemia by reducing heart rate, lowering blood pressure, and/or optimizing ventricular loading characteristics. Unique in its mechanism of action, ranolazine is the first new antianginal agent approved for use in the US for chronic angina in over 25 years. By inhibiting the late inward sodium current (INa, ranolazine prevents pathologic intracellular calcium accumulation that leads to ischemia, myocardial dysfunction, and electrical instability. Ranolazine has been proven in multiple clinical trials to reduce the symptoms of angina safely and effectively and to improve exercise tolerance in patients with symptomatic coronary heart disease. These benefits occur without reduction in heart rate and blood pressure or increased mortality. Although ranolazine prolongs the QTc, experimental data indicate that ranolazine may actually be antiarrhythmic. In a large acute coronary syndrome clinical trial, ranolazine reduced the incidence of supraventricular tachycardia, ventricular tachycardia, new-onset atrial fibrillation, and bradycardic events. Additional benefits of ranolazine under investigation include reductions in glycosylated hemoglobin levels and improved left ventricular function. Ranolazine is a proven antianginal medication in patients with symptomatic coronary heart disease, and should be considered as an initial antianginal agent for those with hypotension or bradycardia.Keywords: chronic angina, myocardial ischemia, ranolazine, pharmacotherapy, antianginal, sodium current

  4. 脑钠肽检测预测心绞痛复发的临床价值%Clinical value of BNP testing to predict recurrence of angina

    Institute of Scientific and Technical Information of China (English)

    刘建修; 杨粟毅; 邹园枚

    2015-01-01

    目的:探讨脑钠肽(BNP)检测预测心绞痛复发的临床价值。方法选取我科2011年1月至2013年1月收治的82例稳定性心绞痛患者,所有患者均随访至2014年8月,以心绞痛再发为随访终点,按照是否再发分为未再发组72例和再发组10例。比较两组患者治疗前后的BNP水平、成功治疗后的基本特点,采用受试者工作特征(ROC)曲线计算BNP成功治疗后预测心绞痛的截断值,同时预测心绞痛再发的敏感性和特异性。结果未再发组成功治疗后的BNP水平显著低于治疗前与再发组治疗后,再发组成功治疗后的BNP水平显著高于治疗前(P<0.01)。未再发组的收缩压(SBP)、舒张压(DBP)、总甘油三酯(TG)和总胆固醇(TC)水平水平明显低于再发组(P<0.05)。BNP在成功治疗后缓解期的截断值为58.20 pg/ml,其ROC曲线的敏感性为71.09%,特异性为96.97%。结论稳定性心绞痛患者在其治疗前后测定其BNP水平,对于预测心绞痛再发有一定临床价值。%Objective To analyze the clinical value of brain natriuretic peptide (BNP) detection in predicting recurrence of angina. Methods Eighty-two patients of unstable angina in our department from January 2011 to Janu-ary 2013 were enrolled in the study. The patients were followed up to August 2014, with angina recurrence as the end of follow-up. According to the recurrence status, the patients were divided into non-recurrence group (n=72) and recur-rence group (n=10). BNP levels before and after treatment and the basic characteristics of successful treatment were compared in two groups of patients. Receiver operating characteristic (ROC) curve was used to calculate BNP cutoff value to predict angina pectoris after successful treatment and predict the sensitivity and specificity. Results BNP levels in non-recurrence group after treatment were significantly lower than those before treatment, and the levels was also significantly lower than those in

  5. Predicting prognosis in stable angina--results from the Euro heart survey of stable angina: prospective observational study.

    NARCIS (Netherlands)

    Daly, C.A.; Stavola, B. De; Lopez Sendon, J.L.; Tavazzi, L.; Boersma, E.; Clemens, F.; Danchin, N.; Delahaye, F.; Gitt, A.; Julian, D.; Mulcahy, D.; Ruzyllo, W.; Thygesen, K.; Verheugt, F.W.A.; Fox, K.M.

    2006-01-01

    OBJECTIVES: To investigate the prognosis associated with stable angina in a contemporary population as seen in clinical practice, to identify the key prognostic features, and from this to construct a simple score to assist risk prediction. DESIGN: Prospective observational cohort study. SETTING: Pan

  6. Clinical Experience of Beta Blocker Therapy in Unstable Angina%β受体阻滞剂治疗不稳定型心绞痛的临床体会

    Institute of Scientific and Technical Information of China (English)

    许志茹

    2015-01-01

    目的:针对β受体阻滞剂治疗不稳定型心绞痛的临床体会进行分析。方法选择我院在2013年6月~2014年6月期间,收治的80例不稳定型心绞痛患者,分为对照组和观察组。对照组常规心绞痛治疗,观察组常规治疗+β受体阻滞剂治疗。观察两组患者的临床治疗效果、不良反应、心绞痛发作情况。结果观察组与对照组患者的临床治疗总有效率分别为95.00%、65.00%,P<0.05,具有统计学意义。观察组与对照组患者的不良反应发生率分别为2.50%、15.00%,P<0.05,具有统计学意义。观察组与对照组患者的心绞痛发作次数和持续时间均有显著差异,P<0.05,具有统计学意义。结论在不稳定型心绞痛治疗中,β受体阻滞剂发挥重要作用,可以改善患者临床症状,降低不良反应,提高患者生活质量。%Objective To analysis Beta blockers in the treatment of unstable angina clinical experience. Methods Selected 80 patients with unstable angina treated in June 2013~June 2014, divided into control group and observation group. The control group conventional treatment angina pectoris, observation group conventional treatment+beta blockers. Observed the clinical therapeutic effect of two groups of patients, adverse reactions, angina pectoris attack Situation. Results Observation group and control group in patients with the clinical total effective rate respectively were 95.00%, 65.00%, P<0.05, there was statistical significance. Observation group and control group patients the incidence of adverse reactions were 2.50%, 15.00%, P<0.05, there was statistical significance. Observation group and control group in patients with angina frequency and duration were signiifcantly different, P<0.05, there was statistical signiifcance. Conclusion In the treatment of unstable angina, β-blockers play an important role, can improve the clinical symptoms and reduce adverse reactions and improve the

  7. Usefulness of positive troponin-T and negative creatine kinase levels in identifying high-risk patients with unstable angina pectoris.

    Science.gov (United States)

    Pettijohn, T L; Doyle, T; Spiekerman, A M; Watson, L E; Riggs, M W; Lawrence, M E

    1997-08-15

    Troponin-T was measured in patients with chest pain and negative creatine phosphokinase-MB isoenzymes. Patients with elevated troponin-T had a significantly greater risk of cardiac events over the next 6 months than patients with normal troponin-T.

  8. The low molecule heparin treats unstable angina pectoris clinical research%低分子肝素治疗不稳定心绞痛临床研究

    Institute of Scientific and Technical Information of China (English)

    卢海崧; 曾紫英; 梁中华; 张伟华

    2005-01-01

    目的:探讨低分子肝素(速避凝)治疗不稳定型心绞痛(UAP)的疗效及安全性.方法:将116例UAP患者随机单盲分为对照组(常规治疗)和治疗组(常规治疗+低分子肝素)分别为58例.结果:4周后总有效率:治疗组为91.38%,对照组为68.97%(P<0.05);观察4周治疗组无1例发生心肌梗死,无1例死亡;对照组发生心肌梗死5例(占8.62%),死亡4例.治疗组未发生明显不良反应.结论:在常规抗凝治疗基础上加用低分子肝素能更有效的控制并预防心绞痛发作频率,并能减低心肌梗死的发生率.

  9. Effect of Diltiazem on Coronary Artery Flow and Myocardial Perfusion in Patients With Isolated Coronary Artery Ectasia and Either Stable Angina Pectoris or Positive Myocardial Ischemic Stress Test.

    Science.gov (United States)

    Ozcan, Ozgur Ulas; Atmaca, Yusuf; Goksuluk, Huseyin; Akbulut, Irem Muge; Ozyuncu, Nil; Ersoy, Nedret; Erol, Cetin

    2015-10-15

    Isolated coronary artery ectasia (CAE) may be associated with stable or unstable coronary events despite the absence of epicardial coronary stenosis. Impaired coronary flow dynamics and myocardial perfusion have been demonstrated in stable patients with ectatic coronary arteries. We aimed to assess whether epicardial flow and tissue-level perfusion would be improved by diltiazem in myocardial regions subtended by the ectatic coronary arteries in patients with isolated CAE. A total of 60 patients with isolated CAE were identified of 9,780 patients who underwent elective coronary angiography. Patients were randomized to 5 mg of intracoronary diltiazem or saline. Coronary blood flow of the microvascular network was assessed using myocardial blush grade (MBG) technique. The thrombolysis in myocardial infarction (TIMI) flow grade and TIMI frame count (TFC) were used to assess epicardial coronary flow. MBG (from 2.4 to 2.6, p = 0.02), TIMI flow grades (from 2.4 to 2.8, p flow grade; and from 35 to 33, p = 0.43 for TFC). Diltiazem provided amelioration of the altered coronary flow dynamics, which was suggested as the pathophysiological influence of CAE. In conclusion, the favorable effects of the diltiazem on myocardial perfusion were observed at both epicardial and tissue levels.

  10. Assessment of myocardial fatty acid metabolism in patients with angina pectoris and diabetes mellitus using {sup 123}I-BMIPP myocardial scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Kazuki; Tanabe, Takuji; Yuba, Tatsuya; Doue, Tomoki; Adachi, Yoshihiko; Katoh, Shuuji [Asahi Univ., Gifu (Japan). Murakami Memorial Hospital; Sugihara, Hiroki; Azuma, Akihiro; Nakagawa, Masao

    2001-11-01

    We studied the effect of myocardial ischemia and diabetes mellitus (DM) on the myocardial fatty acid metabolism using {sup 123}I-BMIPP myocardial scintigraphy. We performed {sup 123}I-BMIPP myocardial scintigraphy in 50 patients with myocardial ischemia and without DM (AP), in 30 patients with myocardial ischemia and DM (AP+DM), 12 patients with DM and without myocardial ischemia (DM), and in 10 normal subjects (N). Myocardial uptake rate of {sup 123}I-BMIPP was obtained using the time activity curve. Myocardial washout rate of {sup 123}I-BMIPP was calculated using the polar images of early and delayed SPECT images. Myocardial uptake rate of {sup 123}I-BMIPP (%) were AP: 4.9{+-}0.6, AP+DM: 5.5{+-}0.5, DM 5.7{+-}0.5 and N: 5.0{+-}0.4. {sup 123}I-BMIPP myocardial uptake rate was increased in AP+DM and DM. {sup 123}I-BMIPP myocardial washout rate (%) were AP: 30.2{+-}4.3, AP+DM: 24.5{+-}3.9, DM: 16.1{+-}2.8 and N: 19.4{+-}3.2. {sup 123}I-BMIPP myocardial washout rate was increased in AP and AP+DM. {sup 123}I-BMIPP myocardial washout rate was increased particularly in patients with multi-vessels disease. {sup 123}I-BMIPP myocardial washout rate was decreased in DM. The present study suggested that diabetes mellitus increased myocardial fatty acid uptake and decreased myocardial fatty acid washout, and that myocardial ischemia increased myocardial fatty acid washout. (author)

  11. 对主动脉瓣狭窄病人发生心绞痛的认识%Current Recognition of Angina Pectoris in Patients with Aortic Stenosis

    Institute of Scientific and Technical Information of China (English)

    刘大治; 李贺; 姚民

    2004-01-01

    主动脉瓣狭窄(aortic stenosis,AS)和冠心病是老年人常见的心血管疾病,AS常伴发冠心病,心绞痛是这两种疾病的常见症状.不伴冠心病的AS发生心绞痛可能与心肌供氧及氧耗不平衡及冠脉血流储备下降有关.AS病程呈慢性进展.由于AS是否合并冠心病其治疗对策亦不同,因此决策外科治疗AS的同时是否对冠心病给予干预是临床常见的重要问题,对AS手术死亡率和长期生存率有重要影响.除冠脉造影外,超声心动图对评估是否合并冠心病及严重程度有一定意义.他汀类药物治疗对AS进展有一定延缓作用.

  12. [A surgical case of angina pectoris with a severe stenosis of Lt. mid-cerebral artery: the usefulness of the monitoring of cerebral blood flow].

    Science.gov (United States)

    Ayusawa, Y; Endo, M; Nishida, H; Tomizawa, Y; Uwabe, K; Maeda, T; Tei, I; Takiguchi, M; Ishida, T; Koyanagi, H

    1998-08-01

    A 64-year-old male patient had two episodes of transient ischemic attack and a cerebral infarction. Cerebral angiography showed 50% stenosis at the junction of left internal carotid artery and 90% stenosis at left mid-cerebral artery (MCA). Coronary angiography showed two vessel disease with arteriosclerotic change and underwent coronary artery bypass grafting. To prevent intraoperative cerebral infarction, we used brain protect solution just before starting ECC, set perfusion flow around 3 l/min/m2, monitored the flow of left MCA using Transcranial Doppler (TCD) and the saturation of left internal jugular vein (SjO2) continuously. PaCO2 was controlled around 45 mmHg. TCD showed good pulsatile flow, and SjO2 was kept over 60%. The patient recovered consciousness 2 hours after operation in the intensive care unit without paresthesia. We thought the number of open-heart cases with cerebrovascular disease increased, and pulsatile low of ECC by intraaortic balloon pumping and the monitoring of SjO2 are useful for the cases.

  13. The clinical characteristics and investigations planned in patients with stable angina presenting to cardiologists in Europe: from the Euro Heart Survey of Stable Angina.

    NARCIS (Netherlands)

    Daly, C.A.; Clemens, F.; Lopez-Sendon, J.; Tavazzi, L.; Boersma, E.; Danchin, N.; Delahaye, F.; Gitt, A.; Julian, D.; Mulcahy, D.; Ruzyllo, W.; Thygesen, K.; Verheugt, F.W.A.; Fox, K.M.

    2005-01-01

    AIMS: The Euro Heart Survey of Stable Angina set out to prospectively study the presentation and management of patients with stable angina as first seen by a cardiologist in Europe, with particular reference to adherence to existing guidelines and regional variability in patient presentation and ini

  14. Update on ranolazine in the management of angina

    Directory of Open Access Journals (Sweden)

    Codolosa JN

    2014-06-01

    Full Text Available J Nicolás Codolosa,1 Subroto Acharjee,1 Vincent M Figueredo1,2 1Einstein Center for Heart and Vascular Health, Einstein Medical Center, 2Jefferson Medical College, Philadelphia, PA, USA Abstract: Mortality rates attributable to coronary heart disease have declined in recent years, possibly related to changes in clinical presentation patterns and use of proven secondary prevention strategies. Chronic stable angina (CSA remains prevalent, and the goal of treatment is control of symptoms and reduction in cardiovascular events. Ranolazine is a selective inhibitor of the late sodium current in myocytes with anti-ischemic and metabolic properties. It was approved by the US Food and Drug Administration in 2006 for use in patients with CSA. Multiple, randomized, placebo-controlled trials have shown that ranolazine improves functional capacity and decreases anginal episodes in CSA patients, despite a lack of a significant hemodynamic effect. Ranolazine did not improve cardiovascular mortality or affect incidence of myocardial infarction in the MERLIN (Metabolic Efficiency with Ranolazine for Less Ischemia in Non-ST-Elevation Acute Coronary Syndrome-TIMI (Thrombolysis In Myocardial Infarction 36 trial, but significantly decreased the incidence of recurrent angina. More recently, ranolazine has been shown to have beneficial and potent antiarrhythmic effects, both on supraventricular and ventricular tachyarrhythmias, largely due to its inhibition of the late sodium current. Randomized controlled trials testing these effects are underway. Lastly, ranolazine appears to be cost-effective due to its ability to decrease angina-related hospitalizations and improve quality of life. Keywords: ranolazine, chronic stable angina, coronary artery disease

  15. Update on ranolazine in the management of angina

    OpenAIRE

    Codolosa JN; Acharjee S; Figueredo VM

    2014-01-01

    J Nicolás Codolosa,1 Subroto Acharjee,1 Vincent M Figueredo1,2 1Einstein Center for Heart and Vascular Health, Einstein Medical Center, 2Jefferson Medical College, Philadelphia, PA, USA Abstract: Mortality rates attributable to coronary heart disease have declined in recent years, possibly related to changes in clinical presentation patterns and use of proven secondary prevention strategies. Chronic stable angina (CSA) remains prevalent, and the goal of treatment is control of sym...

  16. Update on ranolazine in the management of angina

    Science.gov (United States)

    Codolosa, J Nicolás; Acharjee, Subroto; Figueredo, Vincent M

    2014-01-01

    Mortality rates attributable to coronary heart disease have declined in recent years, possibly related to changes in clinical presentation patterns and use of proven secondary prevention strategies. Chronic stable angina (CSA) remains prevalent, and the goal of treatment is control of symptoms and reduction in cardiovascular events. Ranolazine is a selective inhibitor of the late sodium current in myocytes with anti-ischemic and metabolic properties. It was approved by the US Food and Drug Administration in 2006 for use in patients with CSA. Multiple, randomized, placebo-controlled trials have shown that ranolazine improves functional capacity and decreases anginal episodes in CSA patients, despite a lack of a significant hemodynamic effect. Ranolazine did not improve cardiovascular mortality or affect incidence of myocardial infarction in the MERLIN (Metabolic Efficiency with Ranolazine for Less Ischemia in Non-ST-Elevation Acute Coronary Syndrome)-TIMI (Thrombolysis In Myocardial Infarction) 36 trial, but significantly decreased the incidence of recurrent angina. More recently, ranolazine has been shown to have beneficial and potent antiarrhythmic effects, both on supraventricular and ventricular tachyarrhythmias, largely due to its inhibition of the late sodium current. Randomized controlled trials testing these effects are underway. Lastly, ranolazine appears to be cost-effective due to its ability to decrease angina-related hospitalizations and improve quality of life. PMID:25028555

  17. ENHANCED PLATELET AGGREGABILITY UNDER HIGH SHEAR STRESS IN CORONARY CIRCULATION OF PATIENTS WITH UNSTABLE ANGINA

    OpenAIRE

    Doi, Naofumi

    2000-01-01

    Mechanical forces, including high shear stress, have been found to cause platelet aggregation. Although increased platelet aggregation is also associated with the pathophysiology of unstable angina, it is not known whether platelet aggregation induced by high shear stress occurs in the coronary circulation of patients with unstable angina. We assayed high shear stress induced platelet aggregation (h-SIPA) in each of 25 patients with unstable angina and a severe stenotic lesion of the left cor...

  18. Effect of Glucose - Insulin - Potassium (Gik) Solution on Short Term Prognosis of Unstable Angina

    OpenAIRE

    A Azimi; Azimi; M Motafakker; M Sadr-Bafghi; A Andishmand

    2007-01-01

    Introduction: Unstable angina as a clinical condition includes a major group of patients manifested with acute coronary syndrome. Misdiagnosis of this clinical syndrome causes myocardial infarction (MI) and death. Conventional and advanced forms of treatment are used with the aim of rapid stabilization of unstable angina. Although infusion of glucose - insulin - potassium (GIK) solution has had good results in acute MI, no major trial has studied its effect in unstable angina. The main goal o...

  19. Predicting prognosis in stable angina - results from the Euro heart survey of stable angina: prospective observational study

    DEFF Research Database (Denmark)

    Daly, Caroline A.; De Stavola, Bianca; Sendon, Jose L. Lopez

    2006-01-01

    -European survey in 156 outpatient cardiology clinics. Participants 3031 patients were included on the basis of a new clinical diagnosis by a cardiologist of stable angina with follow-up at one year. Main outcome measure Death or non-fatal myocardial infarction. Results The rate of death and non-fatal myocardial...... of outcome to estimate the probability of death or myocardial infarction within one year of presentation with stable angina. Conclusions A score based on the presence of simple, objective clinical and investigative variables makes it possible to discriminate effectively between very low risk and very high...... risk patients and to estimate the probability of death or non-fatal myocardial infarction over one year....

  20. Bisphosphonate-related osteonecrosis of the jaw complicated by Ludwig's angina.

    Science.gov (United States)

    Yang, Rong-Hsin; Shen, Shu-Huei; Li, Wing-Yin; Chu, Yum-Kung

    2015-01-01

    Ludwig's angina is a life-threatening cellulitis that involves the submandibular and sublingual spaces. It often occurs after an infection of the roots of the teeth. However, modern dental care and use of antibiotics for oral infections have made Ludwig's angina rare. We present here a cancer patient exhibiting the sequential features of bisphosphonate related osteonecrosis of the jaw on bone scan complicating with Ludwig's angina. This report highlights the need for medical practitioners to be alert to these rare combinations in the compromised patient after bisphosphonate therapy. To the best of our knowledge, no case of Ludwig's angina secondary to osteonecrosis of the jaw has been reported.

  1. Gender differences in the management and clinical outcome of stable angina.

    NARCIS (Netherlands)

    Daly, C.A.; Clemens, F.; Lopez Sendon, J.L.; Tavazzi, L.; Boersma, E.; Danchin, N.; Delahaye, F.; Gitt, A.; Julian, D.; Mulcahy, D.; Ruzyllo, W.; Thygesen, K.; Verheugt, F.W.A.; Fox, K.M.

    2006-01-01

    BACKGROUND: We sought to examine the impact of gender on the investigation and subsequent management of stable angina and to assess gender differences in clinical outcome at 1 year. METHODS AND RESULTS: The Euro Heart Survey of Stable Angina enrolled patients with a clinical diagnosis of stable angi

  2. Clinical course of isolated stable angina due to coronary heart disease

    NARCIS (Netherlands)

    Poole-Wilson, Philip A.; Voko, Zoltan; Kirwan, Bridget-Anne; de Brouwer, Sophie; Dunselman, Peter H. J. M.; Lubsen, Jacobus

    2007-01-01

    Aims To describe the clinical course of patients with stable angina due to coronary heart disease without a history of cardiovascular (CV) events or revascutarization (isolated angina). Methods and results Of 7665 patients in a trial comparing long-acting nifedipine with placebo, 2170 (28%) had isol

  3. Muscle Fibre Types, Ubiquinone Content and Exercise Capacity in Hypertension and Effort Angina

    DEFF Research Database (Denmark)

    Karlsson, Jan; Diamant, Bertil; Folkers, Karl;

    1991-01-01

    Farmakologi, hypertension, IHD, skeletal muscle fibre composition, muscle coenzyme Q10, ischaemic heart disease, effort angina, muscle fibre lesion, muscle ubiquinone......Farmakologi, hypertension, IHD, skeletal muscle fibre composition, muscle coenzyme Q10, ischaemic heart disease, effort angina, muscle fibre lesion, muscle ubiquinone...

  4. Necrotizing fasciitis in association with Ludwig’s angina – A case report

    OpenAIRE

    Kavarodi, A.M.

    2011-01-01

    A 28 year old male diabetic patient developed Ludwig’s angina which subsequently evolved into cervicofacial necrotizing fasciitis. The differential characteristic of Ludwig’s angina and cervicofacial necrotizing fasciitis, as it relates to this rare presentation is discussed. The clinical and radiological features, pathophysiology, diagnosis and the management that resulted in a successful outcome are presented.

  5. Necrotizing fasciitis in association with Ludwig’s angina – A case report

    Science.gov (United States)

    Kavarodi, A.M.

    2011-01-01

    A 28 year old male diabetic patient developed Ludwig’s angina which subsequently evolved into cervicofacial necrotizing fasciitis. The differential characteristic of Ludwig’s angina and cervicofacial necrotizing fasciitis, as it relates to this rare presentation is discussed. The clinical and radiological features, pathophysiology, diagnosis and the management that resulted in a successful outcome are presented. PMID:24151421

  6. 丹蛭胶囊治疗阿司匹林抵抗心血瘀阻型冠心病心绞痛临床观察%Effective observation on treating Aspirin resistance in patients with angina pectois of the Xinxue Yuzu type with the Danzhi capsule

    Institute of Scientific and Technical Information of China (English)

    齐锋; 宋柏奇; 邓悦

    2016-01-01

    Objective: To investigate clinical effcacy of the Danzhi capsule on Aspirin resistance in patients with angina pectoris of the Xinxue Yuzu type. Methods: 100 patients were randomly divided into two groups. The control group was given the Aspirin; and the treatment group was given the Danzhi capsule more. In 2 weeks, experimental index of platelet aggregation rate, the clinical effcacy of angina pectoris, duration of angina, the clinical