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Sample records for angina pectoris

  1. 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.

  2. Management of refractory angina pectoris

    Directory of Open Access Journals (Sweden)

    Ristić Anđelka

    2004-01-01

    Full Text Available An increasing number of patients with coronary artery disease have ischemie symptoms that are unresponsive to both conventional medical therapy and revascularization techniques. The objective of this study was to define the population of patients with refractory angina pectoris and to present the therapeutic options currently available for this condition. Among many techniques, the enhanced external counterpulsation, transmyocardial laser revascularization and neurostimulation have been shown to reduce angina and to improve objective measures of myocardial ischemia in patients with refractory angina.

  3. Myocardial ischemia and angina pectoris

    International Nuclear Information System (INIS)

    Ambulatory monitoring of ST segment changes was performed in 60 patients presenting with angina, positive ECG stress tests and coronary artery disease, 85% of ischemic ECG events were asymptomatic, 37% occurred with no increase in heart rate and 15% of episodes either lasted 20 minutes or more or fluctuated in severity. A controlled pilot study in ten patients showed depression. Radionuclide studies in 50 patients with angina and coronary artery disease have shown that stress (i.e., atrial pacing) produced different patterns of disturbed regional myocardial perfusion related to the patient's exercise capacity and eventually leading to a decrease in regional myocardial perfusion during the ischemic episode. ST segment depression appeared only after the decrease in regional myocardial perfusion. These findings combined with past research suggest that patients with angina and coronary artery disease can suffer frequent asymptomatic disturbances of the regional myocardial perfusion. The frequency of these episodes and the time course for the recovery of the metabolic consequences mean that segments of ventricular myocardium may be constantly abnormal. The relative importance of changes in coronary tone and malfunction of platelets in the diseased coronary tree needs to be examined in clinical research. Pilot studies of antiplatelet agents have shown a significant beneficial effect on episodes of ischemia occurring at night and those occurring without any increase in heart rate. The techniques and observations in these patients with coronary artery disease all suggest that acute transient regional myocardial ischemia is caused by a variety of mechnisms. Further research using objective methods is required to discover the causes of ischemia and to rationalize treatment. (orig./MG)

  4. 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.

  5. NEBIVOLOL IN TREATMENT OF STABLE EXERTIONAL ANGINA PECTORIS

    OpenAIRE

    Gavrilov, Y V; V. A. Sulimov; V. I. Makolkin

    2015-01-01

    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 treat...

  6. Neurostimulation bei refraktärer Angina pectoris

    OpenAIRE

    Theres H; Baumann G; Eddicks S; Maier-Hauff K; Schenk M.; Spies C

    2005-01-01

    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 IIIIV), 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 b...

  7. Usefulness of hyperventilation myocardial SPECT for diagnosing vasospastic angina pectoris

    International Nuclear Information System (INIS)

    We evaluated the usefulness of hyperventilation myocardial scintigraphy (HV-SPECT) for diagnosing vasospastic angina pectoris. The subjects consisted of 11 patients with rest angina and 13 with rest and exertional angina in whom coronary spasm was demonstrated by coronary angiography, and 6 with exertional angina in whom a significant stenotic lesion was observed by coronary angiography. Hyperventilation was performed at a rate of 40/min for 5 minutes in all the patients. Ischemia was considered to be present when defect and redistribution were observed by SPECT. HV-SPECT revealed positive findings in 8 patients with rest angina (73%) and 9 with exertional and rest angina (69%) but only in 1 with exertional angina (17%). Ischemic ST changes on monitor ECG were observed in 13 of the 30 patients (43%); ST was enhanced in 4 patients and depressed in 9 patients. In the patients with rest angina, HV-SPECT induced ischemic findings more frequently than exercise SPECT (73% vs 55%). HV-SPECT seems to be useful as a non-invasive method for diagnosing angina pectoris resulting from coronary spasm. (author)

  8. Management Options in Chronic Stable Angina Pectoris: Focus on Ranolazine

    OpenAIRE

    Vadnais, David S; Wenger, Nanette K.

    2009-01-01

    Chronic stable angina pectoris results from a fixed coronary arterial obstruction causing an imbalance between myocardial oxygen supply and demand. Current therapy aims to reduce cardiovascular events (vasculoprotective) thereby improving survival, and/or relieve ischemic symptoms (antianginal) thereby improving the quality of life. Vasculoprotective therapy consists of lifestyle modification, antiplatelet agents, lipid lowering therapy and angiotensin-converting enzyme (ACE) inhibitors. Conv...

  9. 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.

  10. Epidural spinal electrical stimulation in severe angina pectoris.

    OpenAIRE

    Mannheimer, C; Augustinsson, L E; Carlsson, C A; Manhem, K; Wilhelmsson, C

    1988-01-01

    The short term effects of epidural spinal electrical stimulation were studied in 10 patients with angina pectoris of New York Heart Association functional class III or IV. The antianginal pharmacological treatment given at entry to the study was regarded as optimal and was not changed during the study. The effects of epidural spinal electrical stimulation were measured by repeated bicycle ergometer tests. Treatment with epidural spinal electrical stimulation increased the patients' working ca...

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

    DEFF Research Database (Denmark)

    Larsen, C T; Sørum, C; Rasmussen, V; Fischer Hansen, J

    1993-01-01

    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......The purpose of this study was to examine the 24-hour antiischemic efficacy of once-a-day anipamil compared to placebo in the treatment of patients with stable angina. The study was designed as a double-blind, placebo-controlled crossover study with an initial 3 week single-blind placebo period. The...... once a day is an effective 24-hour antiischemic drug in the treatment of transient myocardial ischemia....

  12. Physical Activitiea Associted with Angina Pectoris Before Myocardial Infarction and the Onset of Myocardial Infarction

    OpenAIRE

    Matsuda, Masako

    1984-01-01

    One hundred and ninety-seven patients with a history of myocardeal infarction were interviewed to evaluate the incidence of angina pectoris and the physical activity precipitating angina before myocardial infarction, and the mode of physical activity at the onset of myocardial infarction. Ninety-ewo patients had no angina before infarction, whereas 105 did, In 105 patients, 58 had a chronic stable angina without a change of pattern of angina before infarction, while 22 noticed worsening of th...

  13. Management Options in Chronic Stable Angina Pectoris: Focus on Ranolazine

    Directory of Open Access Journals (Sweden)

    David S. Vadnais

    2009-01-01

    Full Text Available Chronic stable angina pectoris results from a fixed coronary arterial obstruction causing an imbalance between myocardial oxygen supply and demand. Current therapy aims to reduce cardiovascular events (vasculoprotective thereby improving survival, and/or relieve ischemic symptoms (antianginal thereby improving the quality of life. Vasculoprotective therapy consists of lifestyle modification, antiplatelet agents, lipid lowering therapy and angiotensin-converting enzyme (ACE inhibitors. Conventional antianginal therapy for patients with chronic stable angina consists of beta-blockers, calcium channel blockers and nitrates, with surgical or percutaneous revascularization serving an adjunctive role. Despite the investigation of multiple novel therapies and medications over the past 25 years, arguably the most significant contribution to antianginal therapy during that time involved the recent introduction of ranolazine. Ranolazine acts via a distinctive pathway, inhibiting the late sodium current of the action potential in ischemic myocytes. Multiple studies have demonstrated that ranolazine significantly reduces anginal symptoms and improves exercise performance in patients with chronic stable angina but does not reduce mortality. Ranolazine does not affect either heart rate or blood pressure, a unique property among the current antianginal agents. Despite its QT prolongation, ranolazine has a proven safety profile and is not proarrhythmic. In fact, in a recent large randomized trial, ranolazine reduced the incidence of supraventricular tachycardia, ventricular tachycardia, new-onset atrial fibrillation and bradycardic events. Ranolazine may confer some additional benefits such as a reduction in HbA1c levels and improved left ventricular diastolic function. Ranolazine is now approved for use in chronic stable angina. Current guidelines recommend beta-blockers as the first line antianginal agent due to the proven mortality reduction. However, for

  14. 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. The...... therapeutic effect was good in 87% of the patients who experienced considerably reduced frequency of attacks and markedly reduced opioid consumption (p less than 0.00005). Nine of the patients could reduce opioid consumption and 14 out of 27 could cease their otherwise daily opioid consumption. In four...... patients, the therapeutic effect was unsatisfactory. In the first 22 patients in whom a unipolar electrode was introduced, displacement of the electrode and subsequent reoperation was a frequent problem. This problem disappeared after change to multipolar electrodes as slight changes in placing of the...

  15. Respiratory compromise: a rare complication of transcutaneous electrical nerve stimulation for angina pectoris.

    OpenAIRE

    Mann, C. J.

    1996-01-01

    Electrical stimulation of any muscle group may produce tetany. If the intercostal muscles are involved this may lead to respiratory embarrasment. A case is presented in which transcutaneous electrical nerve stimulation (TENS) treatment for angina pectoris resulted in respiratory arrest.

  16. Dental Calculus Links Statistically to Angina Pectoris: 26-Year Observational Study.

    Directory of Open Access Journals (Sweden)

    Birgitta Söder

    Full Text Available Dental infections, such as periodontitis, associate with atherosclerosis and its complications. We studied a cohort followed-up since 1985 for incidence of angina pectoris with the hypothesis that calculus accumulation, proxy for poor oral hygiene, links to this symptom.In our Swedish prospective cohort study of 1676 randomly selected subjects followed-up for 26 years. In 1985 all subjects underwent clinical oral examination and answered a questionnaire assessing background variables such as socio-economic status and pack-years of smoking. By using data from the Center of Epidemiology, Swedish National Board of Health and Welfare, Sweden we analyzed the association of oral health parameters with the prevalence of in-hospital verified angina pectoris classified according to the WHO International Classification of Diseases, using descriptive statistics and logistic regression analysis.Of the 1676 subjects, 51 (28 women/23 men had been diagnosed with angina pectoris at a mean age of 59.8 ± 2.9 years. No difference was observed in age and gender between patients with angina pectoris and subjects without. Neither was there any difference in education level and smoking habits (in pack years, Gingival index and Plaque index between the groups. Angina pectoris patients had significantly more often their first maxillary molar tooth extracted (d. 16 than the other subjects (p = 0.02. Patients also showed significantly higher dental calculus index values than the subjects without angina pectoris (p = 0.01. Multiple regression analysis showed odds ratio 2.21 (95% confidence interval 1.17-4.17 in the association between high calculus index and angina pectoris (p = 0.015.Our study hypothesis was confirmed by showing for the first time that high dental calculus score indeed associated with the incidence of angina pectoris in this cohort study.

  17. 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 cohor...... 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....

  18. Dental Calculus Links Statistically to Angina Pectoris: 26-Year Observational Study

    Science.gov (United States)

    2016-01-01

    Objectives Dental infections, such as periodontitis, associate with atherosclerosis and its complications. We studied a cohort followed-up since 1985 for incidence of angina pectoris with the hypothesis that calculus accumulation, proxy for poor oral hygiene, links to this symptom. Methods In our Swedish prospective cohort study of 1676 randomly selected subjects followed-up for 26 years. In 1985 all subjects underwent clinical oral examination and answered a questionnaire assessing background variables such as socio-economic status and pack-years of smoking. By using data from the Center of Epidemiology, Swedish National Board of Health and Welfare, Sweden we analyzed the association of oral health parameters with the prevalence of in-hospital verified angina pectoris classified according to the WHO International Classification of Diseases, using descriptive statistics and logistic regression analysis. Results Of the 1676 subjects, 51 (28 women/23 men) had been diagnosed with angina pectoris at a mean age of 59.8 ± 2.9 years. No difference was observed in age and gender between patients with angina pectoris and subjects without. Neither was there any difference in education level and smoking habits (in pack years), Gingival index and Plaque index between the groups. Angina pectoris patients had significantly more often their first maxillary molar tooth extracted (d. 16) than the other subjects (p = 0.02). Patients also showed significantly higher dental calculus index values than the subjects without angina pectoris (p = 0.01). Multiple regression analysis showed odds ratio 2.21 (95% confidence interval 1.17–4.17) in the association between high calculus index and angina pectoris (p = 0.015). Conclusion Our study hypothesis was confirmed by showing for the first time that high dental calculus score indeed associated with the incidence of angina pectoris in this cohort study. PMID:27336307

  19. One year follow-up of patients with refractory angina pectoris treated with enhanced external counterpulsation

    DEFF Research Database (Denmark)

    Pettersson, Thomas; Bondesson, Susanne; Cojocaru, Diodor; Ohlsson, Ola; Wackenfors, Angelica; Edvinsson, Lars

    2006-01-01

    the long-term outcome of EECP treatment at a Scandinavian centre, in relieving angina in patients with chronic refractory angina pectoris. METHODS: 55 patients were treated with EECP. Canadian cardiovascular society (CCS) class, antianginal medication and adverse clinical events were collected prior...

  20. 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.

  1. Neurostimulation as an adjuvant therapy for patients with intractable angina pectoris.

    OpenAIRE

    Jongste, Michel Johannes Leendert de

    2009-01-01

    In spite of tremendous improvement in treatment of patients with angina pectoris due to significant coronary artery disease, there remains a group of patients who cannot adequately be treated. These patients are considered as having ‘intractale angina’. Patients, suffering from intractable ischemic disease have never been defined as a separate group and no data are available regarding their morbidity and mortality. Furthermore, since their angina was 'intractable’, no therapy was offered to i...

  2. 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

  3. Spinal cord stimulation in chronic intractable angina pectoris : A randomized, controlled efficacy study

    NARCIS (Netherlands)

    Hautvast, RWM; DeJongste, MJL; Staal, MJ; van Gilst, WH; Lie, KI

    1998-01-01

    Background Spinel cord stimulation is known to be a successful treatment for chronic intractable angina pectoris. its effect may be anti-ischemic. It is uncertain if the clinical effect is partly caused by a placebo effect of surgery For implantation of a stimulator. In this study, clinical efficacy

  4. Angina pectoris refractory for conventional therapy - Is neurostimulation a possible alternative treatment?

    NARCIS (Netherlands)

    Hautvast, RWM; DeJongste, MJL; TerHorst, GJ; Blanksma, PK; Lie, KI

    1996-01-01

    The treatment of angina pectoris as a symptom of coronary artery disease usually is focused on restoring the balance between oxygen demand and supply of the myocardium by administration of drugs interfering in heart rate, cardiac pre- and afterload, and coronary vascular tone. For nonresponders to d

  5. 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.

  6. 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, Ptrimetazidine in the treatment of stable angina pectoris, in comparison with conventional antianginal agents, regardless of treatment duration. PMID:25466565

  7. Effects on blood pressure in patients with refractory angina pectoris after enhanced external counterpulsation

    DEFF Research Database (Denmark)

    Bondesson, Susanne; Pettersson, Thomas; Ohlsson, Børje Ola Mattias;

    2010-01-01

    OBJECTIVE: Enhanced external counterpulsation (EECP) is a non-invasive technique that has been shown to reduce the frequency and severity of angina pectoris. Little is known how EECP affects the blood pressure. METHODS: 153 patients with refractory angina were treated with either EECP or retained...... on their pharmacological treatment (reference group). Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP) and heart rate were measured pre- and post-treatment and at 12 months follow-up. RESULTS: EECP treatment altered the blood pressure in patients with...... refractory angina pectoris. A decrease in the blood pressure was more common in the EECP group compared with the reference group. In the reference group, an increase in the blood pressure was more common. A correlation between a decrease in blood pressure after EECP treatment and a higher baseline MAP, SBP...

  8. Die Bedeutung der Kaliumkanalöffner für die Therapie der Angina pectoris

    Directory of Open Access Journals (Sweden)

    Auer J

    2003-01-01

    Full Text Available In der Behandlung der koronaren Herzkrankheit ist primär die Senkung der Ereignisrate (Mortalität, Koronarletalität, Myokardinfarkt, rezidivierende Angina, Insult, Herzinsuffizienz, Revaskularisationen anzustreben. Zusätzlich ist die Zielsetzung der antianginösen Therapie vor allem die Verbesserung der Belastungstoleranz sowie die Reduktion von ischämiebedingten Folgeerscheinungen. Für die antianginöse Therapie stehen vier Wirkstoffklassen zur Verfügung, die ein differenziertes Vorgehen erlauben und die wahlweise als Monotherapien oder in Kombination in der Therapie der stabilen Angina pectoris zur Anwendung kommen können: Betablocker, Nitrate, Kalziumantagonisten und Kaliumkanalöffner. Im Rahmen der IONA-Studie (Impact Of Nicorandil in Angina wurde rezent überprüft, ob unter einer Therapie mit Nicorandil bei Patienten mit chronisch stabiler Angina pectoris die Häufigkeit schwerwiegender koronarer Ereignisse verringert werden könnte. Mit dieser Studie konnte nun ein eindeutiger Hinweis für eine Reduktion ischämiebezogener klinischer Ereignisse unter Nicorandil bei Patienten mit Angina pectoris nachgewiesen werden. Während für die antianginöse Therapie bisher lediglich eine symptomlindernde Wirkung zweifelsfrei dokumentiert ist, verbessern Maßnahmen zur Verhinderung von Thrombose- und Atheromentwicklung die Prognose (Aspirin, Cumarine, ACE-Hemmer und Lipidsenker [Statine] sowie Lebensstilmodifikation einschließlich Nikotinkarenz. Grundsätzlich sollte darüber hinaus bei Patienten mit Angina-pectoris-Beschwerden immer die Option einer Koronarangiographie und Koronarintervention (PTCA, Stent, Bypass überlegt werden.

  9. 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

    pectoris experienced during the first month following discharge from AMI. METHODS: In all, 803 patients included in the placebo arm of the Danish Verapamil Infarction Trial II were followed up for 18 months in 20 coronary care units in Denmark. The patients were randomized to placebo and were still...... 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...

  10. Observations on the warm up phenomenon in angina pectoris.

    OpenAIRE

    Joy, M; Cairns, A W; Sprigings, D

    1987-01-01

    Adaptation to exercise was investigated in 14 men aged 34-69 years (mean 51) with stable exertional angina caused by occlusive coronary artery disease. All underwent exercise electrocardiography to symptom limitation according to the Bruce protocol (first effort), and exercise to the onset of angina (warm up) followed by four minutes' rest, followed by exercise to symptom limitation (second effort). This protocol was repeated after sequential treatment for one month each with nifedipine 10 mg...

  11. 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; Gillberg, L; Pehrsson, K; Hardy, I; Ståhle, A; Andersen, Claus; Mannheimer, C

    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....

  12. Chest pain and angina pectoris - or the ugly swan and the beautiful duckling

    Science.gov (United States)

    van Tellingen, C.

    2010-01-01

    The original description of Heberden’s angina pectoris is put forward to stress the importance of proper history-taking in identifying patients. In a market-driven approach to improve cost-effectiveness in healthcare, angina pectoris as an entity seems stripped to its bare minimum: chest and pain. The diagnostic yield of exercise testing, however, depends on the pre-test likelihood of disease and therefore knowledge of its clinical utility and pitfalls is essential to refine an initial and subjective diagnosis based on anamnesis. Nowadays chest pain units attempt to improve diagnostic accuracy by submitting all sorts of patients to the (stress) test. In the end protocol-driven policies like these may very well prove to be contraproductive when fundamentals are ignored. (Neth Heart J 2010;18:561–4.) PMID:21113382

  13. Reduced peripheral vascular reactivity in refractory angina pectoris

    DEFF Research Database (Denmark)

    Bondesson, Susanne M; Edvinsson, Marie-Louise; Pettersson, Thomas;

    2011-01-01

    compared to matched healthy subjects (n = 20). The cutaneous forearm microvascular blood flow was measured by Laser-Doppler flowmetry. The vascular responsiveness to iontophoretic administration of acetylcholine (ACh), sodium nitroprusside (SNP) and local skin warming were studied. Measurements of Canadian......AIMS: To examine if the skin microvascular bed is altered and can be modified by enhanced external counterpulsation (EECP) in patients with chronic refractory angina. METHODS: Twenty patients diagnosed with refractory angina were divided into EECP (n = 10) or no EECP (n = 10) groups. The data were...

  14. Combination treatment with trimetazidine and diltiazem in stable angina pectoris

    OpenAIRE

    Manchanda, S; Krishnaswami, S

    1997-01-01

    Objective—To assess antianginal efficacy and possible adverse haemodynamic effects of combination treatment with trimetazidine and diltiazem in patients with stable angina.
Design—Double blind, randomised, placebo controlled trial of four weeks duration.
Setting—Outpatient department of two Indian hospitals.
Subjects—64 male patients with stable angina, uncontrolled on diltiazem alone.
Interventions—Diltiazem 180 mg and trimetazidine 60 mg, or diltiazem 180 mg and placebo daily.
Main outcome ...

  15. Prognostic implications of exercise induced and ambulatory ischemia in patients with stable angina pectoris

    OpenAIRE

    Forslund, Lennart

    1999-01-01

    Results from exercise testing and ambulatory ECG registration were studied in 809 patients with stable angina pectoris; special attention was paid to signs of ischemia during both tests. Autonomic nervous system activity was investigated by measurements of heart rate variability (HRV) and catecholamines in plasma and urine. At baseline, the patients were compared with 50 age and sex matched controls. Prognostic implications of HRV, catecholamine levels, signs of ischemia dur...

  16. 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...

  17. 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. PMID:12686334

  18. 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

  19. 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 83...... %) with no prior cardiovascular disease who had a first-time coronary angiography (CAG) in 2008-2009 due to suspected stable angina to participate in a questionnaire survey in 2011 with the Seattle Angina Questionnaire and the Hospital Anxiety and Depression Scale as key elements. Long-term persistent...... angina (i.e., symptoms at least once a month) was present in 64 % of patients with diffuse non-obstructive CAD (1-49 % stenosis), 49 % of patients with normal coronary arteries (0 % stenosis), and 41 % of patients with obstructive CAD (a parts per thousand yen50 % stenosis) (P = 0.01). Depression and...

  20. 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; Maeng, Michael; Tilsted, Hans-Henrik; Bøtker, Hans E; Ravkilde, Jan; Madsen, Morten; Sørensen, Henrik T; Thuesen, Leif; Lassen, Jens F; Jensen, Lisette O

    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...

  1. 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...

  2. 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 be...

  3. Nitrate-Induced Headache in Patients with Stable Angina Pectoris: Beneficial Effect of Starting on a Low Dosage.

    Science.gov (United States)

    Cleophas, Ton J.M.; Niemeyer, Menco G.; van Der Wall, Ernst E.

    1996-12-01

    BACKGROUND: Nitrates, although important for the management of angina pectoris, cause significant headache in many patients. METHODS: In a randomized, double-blind crossover study, 89 patients with stable angina pectoris were used to compare two different dosage strategies of isosorbide-5-mononitrate (5-ISMN). Patients were randomized to either 60 mg 5-ISMN once daily (o.d.) for 2 weeks or 30 mg 5-ISMN o.d. for 1 week followed by 60 mg 5-ISMN o.d. for 1 week. A 2-week placebo wash-out ensued, after which the alternative treatment was given. We assessed the occurrence of angina pectoris and headache by diary cards while taking into account the numbers of isosorbide dinitrate sublingual puffs and paracetamole tables required. Data were assessed for carryover and time effects. RESULTS: The two dosage regimens were equally efficient for the relief of angina pectoris without development of tolerance. Thirty percent of the patients never experienced headache from the given dosages. The remainder showed a highly significant time-effect: The total numbers of headache attacks in the 1st period of active treatment were 2,380 vs 1,400 attacks is the 2nd period (p < 0.003), yet significantly fewer patients had headaches on low dosages than high ones (45 vs 57, p < 0.02). CONCLUSIONS: Starting on a low dosage was associated with reduced frequency and severity of headache and did not notably influence the beneficial effect of nitrates on angina pectoris. One in three patients never experienced headache from the given dosages. The overall number of headache attacks in the 1st period of active treatment was significantly higher than that of the 2nd period, irrespective of the dosages given. PMID:11862241

  4. 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.

  5. 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; 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

    2015-01-01

    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...... 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...

  6. 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. PMID:25360837

  7. 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

    microvascular dysfunction and the association with symptoms, cardiovascular risk factors, psychosocial factors, and results from diagnostic stress testing. METHODS AND RESULTS: After screening 3568 women, 963 women with angina-like chest pain and a diagnostic coronary angiogram without significant coronary....... 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 of...

  8. Arteriographic morphology and intracoronary thrombus in patients with unstable angina, non-Q wave myocardial infarction and stable angina pectoris.

    Science.gov (United States)

    Hussain, K M; Gould, L; Bharathan, T; Angirekula, M; Choubey, S; Karpov, Y

    1995-03-01

    Coronary artery lesions were compared in 71 patients with unstable angina, 15 patients with non-Q wave myocardial infarction (MI), and 40 patients with stable angina. In the unstable angina group, 29 patients had new-onset angina, 31 had crescendo angina, and 11 had rest angina. In a subgroup of patients with unstable angina, three-vessel disease was less frequently (P < 0.05) seen in patients with new-onset angina (10.3%) than in the patients with crescendo angina (51.6%) or rest angina (54.5%). An angina-producing artery could be identified in 59 patients with unstable angina, in 11 with non-Q wave MI, and in 30 with stable angina. Type II eccentric stenosis (asymmetric narrowing with narrow neck and overhanging irregular edges) was present in 31 patients (52.5%; P < 0.01) with unstable angina, in 7 (63.6%; P < 0.01) with non-Q wave MI, and in only 2 (6.7%) with stable angina. Abrupt occlusion of a vessel was observed in 7 patients (11.9%) with unstable angina and in 2 (18.2%) with non-Q wave MI. None of the patients with stable angina had this type of occlusion. In the group of unstable angina and non-Q wave MI, angiographic evidence of intracoronary thrombi was present in 16 (27.1%) and 3 patients (27.3%), respectively, but in stable angina in only 1 patient (3.3%; P < 0.05). Intracoronary thrombi were most frequently found in rest angina (88%; P < 0.001) and crescendo angina (33.3%; P < 0.01) compared with new-onset angina (3.7%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7879958

  9. Richtlinien zur Diagnostik und Therapie der instabilen Angina pectoris und des Non-Q-Wave-Myokardinfarktes: vorgeschlagene Revisionen

    OpenAIRE

    Huber K; Gaul G; Glogar HD; Kaliman J; Mlczoch J

    2000-01-01

    Die letzten Praxis-Empfehlungen der United States Agency for Health Care Policy and Research zum Thema "Diagnose und Behandlung der instabilen Angina Pectoris (IAP)" stammen aus dem Jahre 1994 und wurden trotz der rasanten Fortschritte auf diesem Gebiet in den vergangenen 5 Jahren nicht erneuert. Das International Cardiology Forum (ICF) hat Ende 1998 die existierenden Richtlinien diskutiert und Vorschläge gemacht, in welchen Bereichen die Diagnostik und die Therapie der IAP aufgrund der mittl...

  10. Periodontal disease in relation to selected parameters of the cardiovascular system in a group of patients with stable angina pectoris

    OpenAIRE

    Włosowicz, Monika; Wożakowska-Kapłon, Beata; Górska, Renata

    2014-01-01

    Introduction Periodontal diseases (PD), which are the cause of chronic inflammatory processes, can develop increased susceptibility to vascular diseases through atherosclerosis. Due to the raised inflammatory and thrombotic risk, PD can have a significant influence on the course and results of stable angina pectoris (SAP). Objectives The aim of the study is to evaluate the influence of chosen PD parameters on selected cardiovascular system parameters, and the correlation between chosen parame...

  11. A controlled comparison of oxyfedrine, isosorbide dinitrate and placebo in the treatment of patients suffering attacks of angina pectoris.

    OpenAIRE

    Whittington, J; Raftery, E B

    1980-01-01

    1 In a group of 23 patients with documented ischaemic heart disease who experienced angina pectoris, oral oxyfedrine (24 mg three times daily) was compared with isosorbide dinitrate (10 mg three times daily) and placebo in a double-blind double-crossover clinical trial. 2 Isosorbide dinitrate appeared no better than placebo, either in terms of symptomatic relief or ECG responses to exercise. Thirty eight per cent of patients complained of headaches and 28% had to cease taking the drug for thi...

  12. Drug efficacy in treating stable angina pectoris: a protocol for network meta-analysis of randomised controlled trials

    OpenAIRE

    Jia, Yongliang; Leung, Siu-wai

    2014-01-01

    Introduction There were 11 pairwise meta-analysis on the efficacy of β-blockers (including atenolol, propranolol, bisoprolol, metoprolol and nadolol), calcium channel blockers (including amlodipine, diltiazem, felodipine, nifedipine and verapamil), and nitrates (including isosorbide dinitrate, isosorbide mononitrate and nitroglycerin) in treating stable angina pectoris. No network meta-analytic study has been published to evaluate the efficacies of these antianginal drugs. Current clinical gu...

  13. Alterations in left ventricular function during therapy of unstable angina pectoris: relationship to clinical outcome

    International Nuclear Information System (INIS)

    We studied 30 consecutive patients with unstable angina during pain-free intervals with gated blood pool scintigraphy. The initial study was performed within 18 hours of admission to the coronary care unit. A second study was performed near the time of hospital discharge, after stabilization with medical therapy. Three months thereafter patients were categorized according to their worst anginal status following hospital discharge. Fifteen patients were New York Heart Association functional class I or II (group A); 15 patients were in functional class III or IV (group B). Left ventricular ejection fraction was similar at the time of initial study (55.9 +/- 2.18% and 56.0 +/- 3.55% for groups A and B respectively). At the time of hospital discharge the ejection fraction had risen to 60.3 +/- 1.85% (p less than 0.01) in group A and in group B it had fallen to 48.1 +/- 3.4% (p less than 0.005). End-systolic volume index in group B rose from 37 ml/m2 +/- 6.1 to 43 +/- 6.2 ml/m2 (p less than 0.005) at the time of the follow-up study. There were no significant intergroup patients during the two scintigraphic examinations. Eleven group B patients subsequently underwent coronary artery bypass surgery. A significant increase in ejection fraction and a significant decrease in end-systolic volume index were noted when these patients were restudied an average of 3.2 months after surgery. This study suggests that changes in left ventricular function during the course of unstable angina pectoris are common and may be detected by serial gated blood pool scintigraphy

  14. Typische Angina pectoris-Symptomatik bei normalem Koronarangiogramm: Gibt es geschlechtsspezifische Unterschiede?

    Directory of Open Access Journals (Sweden)

    Graf S

    2008-01-01

    Full Text Available 10–30 % aller Patientinnen und Patienten mit typischer Angina pectoris-Symptomatik und positivem Belastungstest weisen angiographisch unauffällige epikardiale Koronarien auf. Diese Befundkonstellation wird auch als Syndrom X bezeichnet. In der folgenden Übersicht soll auf geschlechtsspezifische Unterschiede sowie mögliche Ursachen dieses Krankheitsbildes eingegangen werden. So konnte gezeigt werden, dass die diagnostische Wertigkeit nicht-invasiver Tests wie Ergometrie und Myokardszintigraphie bei Frauen und Männern unterschiedlich ist und ein "falsch positiver" Test durch geschlechtsspezifische methodische Probleme hervorgerufen sein kann. Ein weiterer Grund für falsch positive Ergebnisse nicht-invasiver Tests kann das Vorliegen einer mikrovaskulären koronaren Herzkrankheit darstellen. Auf die Häufigkeit und Geschlechtsverteilung dieser Erkrankung und deren Prognose sowie mögliche Therapieansätze wird in der folgenden Übersicht eingegangen. Des Weiteren wird auf mögliche ursächliche Zusammenhänge, im Besonderen mit der Bedeutung des Risikofaktorenprofils, hingewiesen.

  15. Adaptation and validation of the Iranian version of Angina Pectoris characteristics questionnaire.

    Science.gov (United States)

    Najafi-Ghezeljeh, Tahereh; Ekman, Inger; Nikravesh, Mansoureh Yadavar; Emami, Azita

    2008-12-01

    Research aimed at evaluating Angina Pectoris (AP) symptoms in patients with Coronary Heart Disease (CHD) requires a comprehensive assessment tool applicable to this population. Because no single existing measure assessed the full range of symptom characteristics important to our study, we combined two measures (the modified Rose Questionnaire (MRQ), and the Short Form-McGill Pain Questionnaire (SF-MPQ) and added one item to examine specific aspects of AP symptoms (Accompanying Symptom Checklist). The purposes of this study are: (i) to describe the process of translating the SF-MPQ, MRQ and accompanying symptom checklist from English to the Farsi language; and (ii) to evaluate substantial psychometric works (content and construct validity) for the entire instrument and each part of it (SF-MPQ, MRQ and accompanying symptom checklist). A cross-cultural adaptation of the instrument was carried out before developing the final version of it. To these ends, one hundred and 10 CHD patients with AP were assessed by this hybrid measure in an initial study. An analysis of the results indicated that a content valid instrument had been developed. There was a significantly high correlation between scores in the SF-MPQ and there were associations between items in the MRQ. The Iranian version of AP characteristics questionnaire is valid; it is capable of describing characteristics of AP symptoms. However, the reliability of the instrument needs to be assessed through further research. PMID:19126076

  16. Therapeutic efficacy of a new transdermal system containing nitroglycerin in patients with angina pectoris.

    Science.gov (United States)

    Georgopoulos, A J; Markis, A; Georgiadis, H

    1982-01-01

    The results of a placebo-controlled, double-blind cross-over study in 13 patients with angina pectoris demonstrated that daily application of a newly developed, transdermal therapeutic system for the administration of nitroglycerin (NTG-TTS) over a period of 14 days reduced the daily frequency of anginal attacks by 67%, and the daily consumption of nitrates by 63%. Systolic and diastolic blood pressures were significantly lowered by 10 mmHg and 7.5 mmHg, respectively. The exercise-induced increase in blood pressure was not influenced by NTG-TTS, but it occurred at a lower level. Heart rate was not increased by NTG-TTS, either at rest or upon exercise. Exercise-induced depression of the ST segment diminished by about 50%, and anginal attacks were distinctly less severe and of shorter duration NTG application. Development of tolerance was not detected; on the contrary, the anti-anginal effect was more pronounced in the second than in the first week of medication. NTG had no effect on haematological parameters or blood chemistry, and methaemoglobin formation was not observed. Cutaneous tolerability of the system was good and its application posed no major problem. PMID:6813126

  17. 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).

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

    International Nuclear Information System (INIS)

    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)

  19. Comparison of percutaneous coronary intervention versus conservative treatment in unstable angina pectoris

    International Nuclear Information System (INIS)

    Objective: To evaluate the efficacies of percutaneous coronary intervention (PCI) and drug treatment in patients with unstable angina (UAP). Methods: 248 patients with UAP were divided into two groups: conservative group of 123 patients who received antiplatelet, anticoagulant and antianginal therapies only and invasive group of 125 patients who underwent additional PCI 4.4 days after admission. The occurrence of death, AMI, recurrent angina, readmission were assessed during the first hospitalization year. Results: There was no difference in the incidence of composite endpoint of death or AMI between the two groups during the hospitalization (0.8 % vs 1.6 %, P > 0.05 ), but hospitalization duration was shorter in the invasive group than in the conservative group (10.3 ± 5.6 days vs 14.6 ± 10.7 days, P < 0.01 ). In duration of one year, the incidence of AMI (2.4% vs 8.9%, P<0.03), death (1.6% vs 6.5%, P<0.05), composite endpoint of death or AMI (4.0 % vs 13.0 % P < 0.02), recurrent angina pectoris (26.4 % vs 48.7, P <0.001), CABG (1.6% vs 10.5%, P<0.01) and readmission (24.8% vs 45.5%, P<0.01) were also lower in the invasive group than in the conservative group. Survival rate free of composite death or AMI for 1 year was higher in the invasive group than in the conservative group(96.0 % vs 86.9 %, P < 0.02). There was a definite benefit of the invasive treatment in reducing the risk of composite endpoint of death or AMI in patients with chest pain at rest, troponin T positive and three vessel diseases. Old age, three vessel diseases, LAD disease, lower LVEF, ST-segment depression, diabetes and hypertension were the independent factors associated with composite of death or AMI. Conclusions: In patients with UAP, PCI associated with routine antiplatelet, anticoagulant and antiischemic treatment significantly decreases the incidence of adverse cardiac events and improves the survival rate in one year. Such beneficial effects can be more obvious for high-risk patients

  20. Excimer laser coronary angioplasty: experience with a prototype multifibre catheter in patients with stable angina pectoris.

    Science.gov (United States)

    Kochs, M; Haerer, W; Eggeling, T; Hoeher, M; Schmidt, A; Hombach, V

    1992-03-01

    Percutaneous excimer laser coronary angioplasty (ELCA) was performed in a first group of 20 patients with stable angina pectoris caused by significant coronary stenosis, and long-term follow-up was evaluated. Prototype 4 to 5.5 French multifibre catheters with 18-20 quartz fibres of 100 microns diameter, concentrically arranged around a central lumen for taking up a guide wire, were coupled to a commercial XeCl excimer laser. Energy was delivered at a wavelength of 308 nm with a pulse duration of 60 or 120 ns. Operating at a repetition rate of 20 Hz, mean energy transmission was 13.4 +/- 6.8 mJ per pulse. In all but one patient the lesion could be passed by the catheter. Percent diameter stenosis decreased from 77.1 +/- 10.8% to 53.1 +/- 11.8% after ELCA. Complications were frequently observed, intracoronary thrombus formation in eight instances, dissection in six patients and spasm in five cases, causing total vessel occlusion in five procedures. All complications could be managed efficaciously by thrombolytic and vasodilating drugs and/or balloon angioplasty. Subsequent PTCA was performed in case of complication or insufficient stenosis reduction after ELCA in 18 patients with adequate results (residual stenosis, 28.5 +/- 10.2%). Long-term follow-up angiography, which could be performed in 16 of 19 laser treatments, demonstrated significant restenosis in only three patients. Our preliminary results suggest that, using ELCA, ablation of atherosclerotic lesions is feasible in most cases. However, compared with PTCA, stenosis reduction is significantly less, and the acute complication rate is much higher. Thus, further improvements of the catheter system are necessary in order to realize the advantages of excimer laser ablation, which can be demonstrated by experimental studies. PMID:1597220

  1. 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.

  2. Decreased soluble cell adhesion molecules after tirofiban infusion in patients with unstable angina pectoris

    Directory of Open Access Journals (Sweden)

    Aliyev Emil

    2004-04-01

    Full Text Available Abstract Aim The inflammatory response, initiated by neutrophil and monocyte adhesion to endothelial cells, is important in the pathogenesis of acute coronary syndromes. Platelets play an important role in inflammatory process by interacting with monocytes and neutrophils. In this study, we investigated the effect of tirofiban on the levels of cell adhesion molecules (soluble intercellular adhesion molecule-1, sICAM-1, and vascular cell adhesion molecule-1, sVCAM-1 in patients with unstable angina pectoris (AP. Methods Thirty-five patients with unstable AP (Group I, ten patients with stable AP (Group II and ten subjects who had angiographycally normal coronary arteries (Group III were included the study. Group I was divided into two subgroups for the specific treatment regimens: Group IA (n = 15 received tirofiban and Group IB (n = 20 did not. Blood samples for investigating the cell adhesion molecules were drawn at zero time (baseline; 0 h in all patients and at 72 h in Group I. Results The baseline levels of sICAM-1 and sVCAM-1 were higher in Group I than in Groups II and III. They were higher in Group IA than in Group IB. However, the sICAM-1 and sVCAM-1 levels decreased significantly in Group IA after tirofiban infusion. In contrast, these levels remained unchanged or were increased above the baseline value in Group IB at 72 h. Conclusion The levels of cell adhesion molecules in patients with unstable AP decreased significantly after tirofiban infusion. Inhibition of platelet function by specific glycoprotein IIb/IIIa antagonists may decrease platelet-mediated inflammation and the ischemic end-point.

  3. Decreased soluble cell adhesion molecules after tirofiban infusion in patients with unstable angina pectoris

    Science.gov (United States)

    Ercan, Ertugrul; Bozdemir, Huseyin; Tengiz, Istemihan; Sekuri, Cevad; Aliyev, Emil; Akilli, Azem; Akin, Mustafa

    2004-01-01

    Aim The inflammatory response, initiated by neutrophil and monocyte adhesion to endothelial cells, is important in the pathogenesis of acute coronary syndromes. Platelets play an important role in inflammatory process by interacting with monocytes and neutrophils. In this study, we investigated the effect of tirofiban on the levels of cell adhesion molecules (soluble intercellular adhesion molecule-1, sICAM-1, and vascular cell adhesion molecule-1, sVCAM-1) in patients with unstable angina pectoris (AP). Methods Thirty-five patients with unstable AP (Group I), ten patients with stable AP (Group II) and ten subjects who had angiographycally normal coronary arteries (Group III) were included the study. Group I was divided into two subgroups for the specific treatment regimens: Group IA (n = 15) received tirofiban and Group IB (n = 20) did not. Blood samples for investigating the cell adhesion molecules were drawn at zero time (baseline; 0 h) in all patients and at 72 h in Group I. Results The baseline levels of sICAM-1 and sVCAM-1 were higher in Group I than in Groups II and III. They were higher in Group IA than in Group IB. However, the sICAM-1 and sVCAM-1 levels decreased significantly in Group IA after tirofiban infusion. In contrast, these levels remained unchanged or were increased above the baseline value in Group IB at 72 h. Conclusion The levels of cell adhesion molecules in patients with unstable AP decreased significantly after tirofiban infusion. Inhibition of platelet function by specific glycoprotein IIb/IIIa antagonists may decrease platelet-mediated inflammation and the ischemic end-point. PMID:15059285

  4. Angina pectoris-like pain provoked by intravenous adenosine in healthy volunteers.

    Science.gov (United States)

    Sylvén, C; Beermann, B; Jonzon, B; Brandt, R

    1986-07-26

    In a study to characterise the chest pain induced by adenosine this agent was given as a bolus into a peripheral vein to six healthy volunteers (five men) aged 30-44. On the first day the maximum tolerable dose was determined in each case. On the second day three doses of adenosine (one third, two thirds, and the full maximum tolerable dose) and three doses of saline were given single blind in randomised order. Thereafter aminophylline 5 mg/kg was given and the procedure repeated in a different randomised order. On the third day between two thirds and the full maximum tolerable dose was given followed by 10 mg dipyridamole intravenously and a second injection of the same dose of adenosine. Heart rate and atrioventricular blocks were recorded by electrocardiography. One minute after each dose of adenosine the chest pain was scored. The maximum tolerable dose of adenosine ranged from 10.6 to 37.1 mg. All subjects experienced uneasy central chest pain provoking anxiety. The pain radiated to the shoulders, ulnar aspect of the arms, epigastric area, back, and into the throat. The pain began about 20 seconds after the injection and lasted 10-15 seconds. Increasing the dose of adenosine increased the intensity of the pain. Administration of aminophylline reduced the pain significantly. Second degree heart block was recorded in five of the six subjects during the time that the pain was experienced. After aminophylline no block was observed. Dipyridamole increased the intensity of pain. The duration of second degree heart block increased in four of the subjects, and in two of these third degree heart block occurred. These findings suggest that adenosine released from the myocardium during ischaemia induces angina pectoris by stimulating theophylline sensitive receptors. PMID:3089465

  5. 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.

  6. 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

    BACKGROUND: Two-dimensional strain echocardiography detects early signs of left ventricular dysfunction; however, it is unknown whether myocardial strain analysis at rest in patients with suspected stable angina pectoris predicts the presence of coronary artery disease (CAD). METHODS AND RESULTS......<0.001) and remained 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...

  7. Relevance of 123I-BMIPP delayed scintigraphic imaging for patients with angina pectoris – a pilot study

    OpenAIRE

    Koyama, Kohei; Akashi, Yoshihiro J.; Kida, Keisuke; Suzuki, Kengo; Ishibashi, Yuki; Musha, Haruki; Banach, Maciej

    2011-01-01

    Introduction The study was designed to clarify the role of 123I-β-methyl-iodophenylpentadecanoic acid (123I-BMIPP) in the evaluation of myocardial fatty acid metabolism in patients with stable angina pectoris (AP) before and after percutaneous coronary intervention (PCI). Material and methods Ten controls (mean age: 70.4 ±10.5 years) and 12 patients with AP (mean age: 67.4 ±11.6 years) and single vessel coronary artery disease participated in the radionuclide cardiac study. Scintigraphic imag...

  8. 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

    (MACE), defined as cardiovascular death, myocardial infarction, stroke or heart failure, and all-cause mortality. Significantly more women (65%) than men (32%) had no obstructive CAD (P<0.001). In Cox's models adjusted for age, body mass index, diabetes, smoking, and use of lipid-lowering or...... 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.......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...

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

    OpenAIRE

    Alessandro Santoro; Vincenzo Schiano Lomoriello; Ciro Santoro; Riccardo Muscariello; Maurizio Galderisi

    2013-01-01

    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 pati...

  10. 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.

  11. The Impact of Remote Ischemic Preconditioning on Arterial Stiffness and Heart Rate Variability in Patients with Angina Pectoris.

    Science.gov (United States)

    Zagidullin, Naufal; Scherbakova, Elena; Safina, Yuliana; Zulkarneev, Rustem; Zagidullin, Shamil

    2016-01-01

    Remote ischemic preconditioning (RIPC) is the set of ischemia episodes that protects against subsequent periods of prolonged ischemia through the cascade of adaptive responses; however, the mechanisms of RIPC are not entirely clear. Here, we aimed to study the impact of RIPC in patients with stable angina pectoris and compare it with healthy individuals with respect to arterial stiffness and heart rate variability. In the randomized, sham-controlled, crossover blind design study, a group of 30 coronary heart disease (CHD) patients (63.9 ± 1.6 years) with stable angina pectoris NYHA II-III and a control group of 20 healthy individuals (58.2 ± 2.49) were both randomly allocated for remote RIPC or sham RIPC. Arterial stiffness, pulse wave velocity (Spygmacor, Australia), and heart rate variability (HRV) were recorded before and after the procedure followed by the crossover examination. In the group of healthy individuals, RIPC showed virtually no impact on the cardiovascular parameters, while, in the CHD group, the systolic and central systolic blood pressure, central pulse pressure, and augmentation decreased, and total power of HRV improved. We conclude that ischemic preconditioning reduces not only systolic blood pressure, but also reduces central systolic blood pressure and improves arterial compliance and heart rate modulation reserve, which may be associated with the antianginal effect of preconditioning. PMID:27348009

  12. 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.

  13. Sequential comparison of therapy with beta-blockers and calcium channel blockers with celiprolol therapy in patients with angina pectoris, hypertension, or both

    NARCIS (Netherlands)

    Cleophas, TJM; Niemeyer, MG; Bernink, PJLM; Zwinderman, KH; Wijk, AV; Wall, EEVD

    1996-01-01

    Unlike patients with either hypertension (HT) of angina pectoris (AP) alone, patients with both HT and AP usually have a reduced left ventricular compliance and may, therefore, have an impaired capability to cope with acute hemodynamic changes generated by standard beta-blockers or calcium channel b

  14. Incidence and impact on prognosis of peri-procedural myocardial infarction in 2760 elective patients with stable angina pectoris in a historical prospective follow-up study

    DEFF Research Database (Denmark)

    Christensen, Martin Kirk; Huang, Hui; Torp-Pedersen, Christian;

    2016-01-01

    elevated biomarkers after elective PCI in patients with stable angina pectoris using the defined cut-off (>5 x URL) was 15.2 % using cTnT and 4.1 % using CK-MBmass. The independent prognostic value for both cardiac biomarkers of any cut-off showed no statistical significance for all-cause mortality...

  15. Comparison of patients undergoing enhanced external counterpulsation and spinal cord stimulation for refractory angina pectoris

    DEFF Research Database (Denmark)

    Bondesson, Susanne; Pettersson, Thomas; Erdling, André;

    2008-01-01

    with refractory angina. METHODS: 153 patients with refractory angina were treated with either EECP, SCS, or were retained on their pharmacological treatment (control). Glyceryl trinitrate usage and Canadian Cardiovascular Society classification were registered at baseline, 6 and 12 months after therapy. RESULTS...

  16. 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

    coherence tomography have been applied to study the coronary pathology in patients with vasospastic angina. Patients with vasospastic angina represent a heterogeneous cohort of patients with regard to the extent of concomitant coronary atherosclerosis. They share the common pathophysiological phenomenon of...

  17. A controlled comparison of oxyfedrine, isosorbide dinitrate and placebo in the treatment of patients suffering attacks of angina pectoris.

    Science.gov (United States)

    Whittington, J; Raftery, E B

    1980-09-01

    1 In a group of 23 patients with documented ischaemic heart disease who experienced angina pectoris, oral oxyfedrine (24 mg three times daily) was compared with isosorbide dinitrate (10 mg three times daily) and placebo in a double-blind double-crossover clinical trial. 2 Isosorbide dinitrate appeared no better than placebo, either in terms of symptomatic relief or ECG responses to exercise. Thirty eight per cent of patients complained of headaches and 28% had to cease taking the drug for this reason. 3 Oxyfedrine produced statistically significant improvements in both symptom level (P exercise (P effect noted was a reversible loss of taste sensation by one patient. 4 Neither drug produced any adverse changes in any haematological or biochemical parameters. 5 Oxyfedrine is, therefore, to be preferred to isosorbide dinitrate, being both much better tolerated and more efficacious. PMID:7002181

  18. 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.

  19. Safety and Efficacy of Ranolazine for the Treatment of Chronic Angina Pectoris

    OpenAIRE

    Mohammed Aldakkak; Stowe, David F; Camara, Amadou K.S.

    2013-01-01

    Coronary heart disease is a global malady and it is the leading cause of death in the United States. Chronic stable angina is the most common manifestation of coronary heart disease and it results from the imbalance between myocardial oxygen supply and demand due to reduction in coronary blood flow. Therefore, in addition to lifestyle changes, commonly used pharmaceutical treatments for angina (nitrates, β-blockers, Ca2+ channel blockers) are aimed at increasing blood flow or decreasing O2 de...

  20. 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.

  1. The effects of lidoflazine on exercise performance and thallium stress scintigraphy in patients with stable angina pectoris

    International Nuclear Information System (INIS)

    Lidoflazine is a synthetic drug with calcium-channel blocking effects. In a 7-month study, 36 patients with stable angina pectoris were tested during a 3-month single-blind placebo phase. Nineteen were then randomized by double-blind methods to lidoflazine and 17 to placebo therapy. The lidoflazine group had a significant (p < 0.01) reduction in anginal attacks; the placebo group did not. Exercise testing demonstrated that lidoflazine therapy was associated with a 34% increase in total work performance and a 15.6% increase in peak calculated oxygen uptake during double-blind treatment (both p < 0.004 compared with the placebo group). Heart rate was significantly reduced at submaximal levels of exercise during lidoflazine therapy (p < 0.04). Nitroglycerin consumption and electrocardiographic changes at the end of exercise did not change during the double-blind phase. In a second study of six similar patients, single-blind administration of lidoflazine was associated with improved myocardial perfusion during exercise as determined by thallium-201 stress scintigraphy. These studies demonstrate that lidoflazine therapy is associated with relief of angina, an increased physical work capacity, and improved regional myocardial perfusion during exercise

  2. [Thiotriazoline in the Treatment of Stable Angina Pectoris of II-III Functional Class].

    Science.gov (United States)

    Kadin, D V; Chumak, B A; Filippov, A E; Shustov, S B

    2015-01-01

    Trimetazidine is a metabolic agent of proven efficacy in improving myocardial ischemia and angina. A comparative international multicenter randomized trial, assessed anti-anginal anti ischemic efficacy and safety of Trimetazidine (60 mg/d) and Thiotriazoline (600 mg/d) in symptomatic patients with chronic ischemic heart disease receiving the first line therapy. The study assessed the efficacy of the two drugs on total exercise duration, time to 1-mm ST segment depression, the number of angina attacks and nitroglycerin tablets consumed amount. Both drugs have demonstrated clinical efficacy equal for all primary and secondary endpoints. PMID:26761968

  3. 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

  4. Reduced peripheral vascular reactivity in refractory angina pectoris: Effect of enhanced external counterpulsation

    Institute of Scientific and Technical Information of China (English)

    Susanne M Bondesson; Marie-Louise Edvinsson; Thomas Pettersson; Lars Edvinsson

    2011-01-01

    Objective To examine if the skin microvascular bed is altered and can be modified by enhanced external counterpulsation (EECP) in patients with chronic refractory angina.Methods Twenty patients diagnosed with refractory angina were divided into EECP (n =10) or no EECP (n =10) groups.The data were compared to matched healthy subjects (n =20).The cutaneous forearm microvascular blood flow was measured by Laser-Doppler flowmetry.The vascular responsiveness to iontophoretic administration of acetylcholine (ACh),sodium nitroprusside (SNP) and local skin warming were studied.Measurements of Canadian Cardiovascular Society (CCS)-class,blood pressure and plasma samples were registered.Results EECP patients showed reduced CCS-class compared to no EECP (P < 0.05).Both EECP and no EECP (P < 0.05) groups had decreased systolic blood pressure (SBP) as compared to SBP at baseline (P < 0.05).There was no difference in resting blood flow between the two refractory groups at baseline as well as after EECP and seven weeks of follow-up.Responses to heating,the responses to ACh and SNP in the cutaneous microcirculation were lower in both groups of refractory angina patients as compared to healthy subjects (P < 0.05).EECP patients corresponded positively to the treatment shown by reduced plasma level of soluble interleukin-2 receptor and CCS-class.Conclusions Refractory angina patients have reduced responsiveness in their cutaneous microcirculation to ACh,SNP and heat compared to healthy subjects.Although EECP reduced the CCS-class,this effect was not associated with improvements in responsiveness of the cutaneous microcirculation.

  5. Patterns of disturbed myocardial perfusion in patients with coronary artery disease. Regional myocardial perfusion in angina pectoris

    International Nuclear Information System (INIS)

    Fifty patients who presented with angina pectoris were studied to examine the disturbances of regional myocardial perfusion during stress. Each patient underwent 16-point precordial mapping of the ECG during an exercise test, and coronary and left ventricular angiography. Regional myocardial perfusion was assessed using an atrial pacing test and a short-lived radionuclide, krypton-81m. Eleven patients had negative exercise tests and uniform increases in myocardial activity of krypton-81m of 98 +/- 18.0% during pacing. Ten patients performed 30,000-43,000 J in positive exercise tests. These patients showed abnormal coronary anatomy and increases in myocardial activity of krypton-81m to remote and jeopardized myocardium at the onset of pacing. However, further pacing produced a decrease in activity in the affected segment of 68.0 +/- 9.0% accompanied by ST-segment depression and angina. Twelve patients achieved 26,000-32,000 J in positive exercise tests and had significant coronary artery disease. Atrial pacing produced increased activity of krypton-81m to remote myocardium. The jeopardized segment at first showed no change and then a decrease in regional activity of krypton-81m (89.0 +/- 17%) accompanied by ST-segment depression and chest pain. Seventeen patients achieved only 7000-22,000 J in positive exercise tests. These patients showed abnormal coronary anatomy and developed decreases in regional activity of krypton-81m to the affected segment of myocardium starting at the onset of atrial pacing and decreasing by 88 +/- 0 7.0% below control. We conclude that different patterns of disturbed myocardial distribution of krypton-81m are present during stress-induced ischemia in patients with coronary artery disease. There was a close temporal relationship between these disturbances and ST-segment depression

  6. 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......, cohabitation status or depression in terms of angina. Conclusion Excessive demands and serious worries from significant others seem to be important risk factors for development of angina pectoris....

  7. Changes of dendritic cells and fractalkine in type 2 diabetic patients with unstable angina pectoris: a preliminary report

    Directory of Open Access Journals (Sweden)

    Qian Juying

    2011-06-01

    Full Text Available Abstract Background It has been shown that dendritic cells (DCs and fractalkine play a role in accelerating progression of the inflamed atherosclerotic lesions and plaque rupture. We evaluated the numbers and functional changes of DCs and its subsets in human type 2 diabetes with or without unstable angina pectoris (UAP. Methods The study population consisted of 39 diabetic patients (DM:18 without CAD; DM + UAP: 21 with UAP, 18 non-diabetic UAP patients (UAP, and 15 healthy control (Normal. Peripheral blood DCs and its subsets were measured by three color flow cytometry. Serum levels of fractalkine, IL-12, and IFN-α were also measured. The functional status of the monocyte-derived DCs was analyzed by flow cytometry and allogeneic mixed T lymphocytes reaction. Results The percent and absolute numbers of DCs and mDC within the total leukocyte population was similar for Normal and DM, while significantly lower in DM + UAP. pDC numbers were not significantly altered. Serum fractalkine in DM + UAP was highest among the four groups (p = 0.04 vs. UAP, p = 0.0003 vs. DM, p p = 0.01 level. Compared with DM and UAP, the costimulatory molecules CD86 and proliferation of T cells stimulated by DCs were significantly increased in DM + UAP group. Conclusions Our study suggested that increases in the fractalkine level and the number and functional changes of blood DCs might contribute to diabetic coronary atherosclerosis and plaque destabilization.

  8. Richtlinien zur Diagnostik und Therapie der instabilen Angina pectoris und des Non-Q-Wave-Myokardinfarktes: vorgeschlagene Revisionen

    Directory of Open Access Journals (Sweden)

    Huber K

    2000-01-01

    Full Text Available Die letzten Praxis-Empfehlungen der United States Agency for Health Care Policy and Research zum Thema "Diagnose und Behandlung der instabilen Angina Pectoris (IAP" stammen aus dem Jahre 1994 und wurden trotz der rasanten Fortschritte auf diesem Gebiet in den vergangenen 5 Jahren nicht erneuert. Das International Cardiology Forum (ICF hat Ende 1998 die existierenden Richtlinien diskutiert und Vorschläge gemacht, in welchen Bereichen die Diagnostik und die Therapie der IAP aufgrund der mittlerweile vorliegenden Daten modifiziert werden sollten. Es wurde übereinstimmend beschlossen, daß folgende Änderungen empfohlen werden: 1. Troponin T und Troponin I sollten die Palette der Myokardmarker im Serum für diagnostische und prognostische Zwecke erweitern; 2. niedermolekulere Heparine sollten Standard-Heparin als Antikoagulantium ersetzen; 3. neue thrombozyten-inhibierende Substanzen sollten zusätzlich zu Aspirin zur Anwendung kommen; 4. die Verwendung von cholesterinsenkenden Medikamenten in der Langzeitbehandlung dieser Patienten ist sinnvoll. In der vorliegenden Arbeit wurden die Hintergründe für die vorgerschlagenen Revisionen diskutiert, und es wird auf rezente wissenschaftliche Publikationen Bezug genommen.

  9. Left ventricular dysfunction during exercise in patients with angina pectoris and angiographically normal coronary arteries (syndrome X)

    International Nuclear Information System (INIS)

    Left ventricular function during exercise and recovery was investigated in patients with angina pectoris, ST segment depression during exercise and angiographically normal coronary arteries (syndrome X) using a continuous left ventricular function monitor with cadmium telluride detector (CdTe-VEST). Fourteen patients with syndrome X and 14 patients with atypical chest pain without ST segment depression during exercise and normal coronary arteries (control group) performed supine ergometric exercise after administration of 740-925 MBq of technetium-99m labelled red blood cells, and left ventricular function was monitored every 20 s using CdTe-VEST. Left ventricular ejection fraction (EF) response was impaired (≤ 5% increase from rest to peak exercise) in 11 or 14 patients with syndrome X but in none of the control patients. Resting EF was similar in the two groups (62.1% ± 6.7% in patients with syndrome X, 61.9% ± 6.2% in controls); however, EF increase from rest to peak exercise was lower in syndrome X (-3.1 ± 9.5% vs 14.7% ± 7.4%). After cessation of exercise, all patients showed rapid EF increase over baseline and this EF overshoot was lower (19.3% ± 8.3% vs 26.4% ± 7.3%) with the time to EF overshoot longer (114 ± 43 s vs 74 ± 43 s, P < 0.05) in patients with syndrome X. (orig./MG)

  10. 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.)

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

    International Nuclear Information System (INIS)

    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.)

  12. Long-Term Preservation of Left Ventricular Systolic Function in Patients With Refractory Angina Pectoris and Inducible Myocardial Ischemia on Optimal Medical Therapy.

    Science.gov (United States)

    Slavich, Massimo; Maranta, Francesco; Fumero, Andrea; Godino, Cosmo; Giannini, Francesco; Oppizzi, Michele; Colombo, Antonio; Fragasso, Gabriele; Margonato, Alberto

    2016-05-15

    Refractory angina pectoris (RAP) represents a clinical condition characterized by frequent episodes of chest pain despite therapy optimization. According to myocardial stunning and myocardial hibernation definitions, RAP should represent the ideal condition for systolic dysfunction development. We aim to investigate the evolution of left ventricular (LV) function in patients with RAP. A retrospective study which encompasses 144 patients with RAP referred to our institution from 1999 to December 2014 was performed. Of them, 88 met the inclusion criteria, and LV function was assessed by echocardiography. All of them had persistent angina episodes on top of optimal medical therapy and evidence of significant inducible myocardial ischemia and no further revascularization options. Nitrates consumption rate, time of angina duration, and the number of angina attacks were evaluated. In the whole population, ejection fraction (EF) was 44% ± 2. EF was significantly lower in patients with previous myocardial infarction (41% ± 1.5 vs 51% ± 1.8, p 5 years (5 years 44% ± 2 [n = 44]; p 0.02). Long-term LV function in patients with RAP is generally preserved. A previous history of myocardial infarction is the only determinant in the development of systolic dysfunction. In conclusion, frequent angina attacks and a long-term history of angina are not apparently associated to worse LV function. PMID:27055755

  13. Comparative study of left ventricular function in patients with unstable angina, non-Q wave myocardial infarction and stable angina pectoris: assessment with atrial pacing and digital ventriculography.

    Science.gov (United States)

    Hussain, K M; Gould, L; Pomerantsev, E V; Angirekula, M; Bharathan, T

    1995-10-01

    To compare left ventricular global and segmental function at rest and during right atrial pacing in patients with unstable angina, non-Q wave myocardial infarction, and stable angina (class III angina), low-dose digital subtraction ventriculography was performed at rest and after abrupt cessation of pacing in 42 patients with unstable angina, 8 patients with non-Q wave myocardial infarction and 15 patients with stable angina during selective coronary arteriography. Left ventricular ejection fraction was significantly lower at rest in patients with unstable angina (P < 0.01) and non-Q wave myocardial infarction (P < 0.05) and during pacing (P < 0.01). These two groups of patients had significantly higher values of left ventricular end-diastolic and end-systolic volumes at rest and during pacing as compared with stable angina group. In comparing various clinical patterns of unstable angina, ejection fraction was significantly (P < 0.05) lower during pacing in patients with crescendo angina than in new-onset angina. However, ejection fraction was significantly (P < 0.01) lower in crescendo angina only at rest as compared with rest angina. The length of zone of severe hypokinesia was greater in unstable angina (P < 0.01) as well as in non-Q wave myocardial infarction (P < 0.05) both at rest and during pacing as compared with stable angina. Contractility of region of hypokinesia during pacing was higher (P < 0.01) in stable angina than in unstable angina and non-Q wave myocardial infarction. In analyzing segmental function in various subgroups of unstable angina, the authors found that the length of total hypokinesia was significantly higher (P < 0.05) during pacing in crescendo angina than in new-onset angina. Contractility of region of hypokinesia was lowest at rest and during pacing in patients with crescendo angina. This study demonstrates that patients with unstable angina as well as non-Q wave myocardial infarction were characterized by more pronounced global and

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

    International Nuclear Information System (INIS)

    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

  15. 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.

  16. The diagnostic value of mean platelet volume in males with premature atherosclerotic coronary artery disease having stable angina pectoris

    Directory of Open Access Journals (Sweden)

    Özgül Malçok Gürel

    2014-09-01

    Full Text Available Objective: In this study, we aimed to investigate whether platelet count and mean platelet volume (MPV could be new biomarkers addition to classical risk factors in premature coronary artery disease (CAD. Methods: Totally 124 male patients (mean age: 45.8±13.0 year; range of age: 27-78 year, with stable angina pectoris, were included. Clinical and laboratory findings (whole blood cell count, glucose, creatinine, lipid profile were recorded. Automatic blood counter was used for hematological parameters. Conventional coronary angiography was performed. Patients having acute coronary syndrome within the last six months, with severe valvular, structural or congenital heart disease, thyroid and hepatic dysfunction or signs of any infection were excluded. Results: The study population were separated into three groups by coronary angiography: 51 with stable CAD aged ≤40 years (premature CAD, 38 with stable CAD older than 40 (mature CAD and 35 with the normal coronary arteries (NCA. No significant difference was found in MPV values between premature CAD and mature CAD and also between premature CAD and NCA (p>0.05. A significant negative correlation was found between MPV and platelet count in premature CAD (r=-0.419, p=0.002. Both in premature CAD and mature CAD groups, higher MPV values was found in critical CAD subgroup than noncritical CAD subgroup, but the difference was not statistically significant (p>0.05. Conclusion: There was no significant difference in MPV between premature and mature male CAD patients compared to NCA group. A positive but non-significant correlation was found between the MPV values and the severity of CAD. J Clin Exp Invest 2014; 5 (3: 381-385

  17. Comparison of nifedipine gastrointestinal therapeutic system and atenolol on antianginal efficacies and exercise hemodynamic responses in stable angina pectoris.

    Science.gov (United States)

    Wallace, W A; Wellington, K L; Chess, M A; Liang, C S

    1994-01-01

    A gastrointestinal therapeutic system (GITS) of nifedipine has been developed to provide a once-daily dosing, and predictable, relatively constant plasma concentrations. This study compared the antianginal efficacy of nifedipine GITS with a once-a-day beta-receptor blocker, atenolol. Seventeen patients with documented coronary artery disease and stable stress-induced angina pectoris were studied during a 2-week, single-blind, placebo baseline phase and a 12-week randomized, double-blind, active drug crossover efficacy phase, using the bicycle exercise test and ambulatory electrocardiographic recordings. Patients exercised significantly longer with nifedipine GITS (883 +/- 47 seconds) and atenolol (908 +/- 44 seconds) than with placebo (794 +/- 41 seconds). Nifedipine GITS reduced systolic blood pressure at all stages of exercise compared with placebo but, because heart rate tended to increase more during nifedipine therapy, there was no difference in rate-pressure products between the placebo and nifedipine GITS periods. In contrast, atenolol reduced heart rate, systolic blood pressure and rate-pressure product during exercise compared with placebo. Whereas left ventricular ejection fractions (by radionuclide angiocardiography) increased with exercise, the maximal increase was smaller with atenolol than with placebo and nifedipine. The net increase in left ventricular ejection fraction at the end of exercise was greater with nifedipine than with placebo or atenolol. Ambulatory electrocardiograms showed only a small number of ischemic events. Neither nifedipine GITS nor atenolol reduced the number of ischemic events or total duration of ST-segment deviations significantly. It is concluded that nifedipine GITS is as effective an antianginal agent as atenolol, but the hemodynamic effects of the 2 agents differ.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:8279372

  18. 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.

  19. Der Einsatz von niedermolekularen Heparinen bei instabiler Angina pectoris und nicht-transmuralem Myokardinfarkt

    Directory of Open Access Journals (Sweden)

    Huber K

    1999-01-01

    Full Text Available Im vorliegenden Artikel wird die Anwendung unterschiedlicher niedermolekularer Heparine bei instabiler Angina und nicht-transmuralem Infarkt auf dem neuesten Stand der internationalen Datenlage besprochen. Dabei scheint Enoxaparin die höchste Effektivität unter den getesteten LMW-Heparinen in der Akutphase der Erkrankung zu besitzen, da zwei durchgeführte Studien (ESSENCE, TIMI-11B signifikante Vorteile gegenüber Standard-Heparin nachgewiesen haben. Demgegenüber scheint Dalteparin Vorteile in der längerdauernden Anwendung nach der Akutphase zu haben (FRISC-II. Da die Patientenpopulationen in den bisher durchgeführten Studien aber nicht sicher vergleichbar sind, da zu wenig Daten über die mögliche klinische Bedeutung pharmakologischer Unterschiede der verschiedenen LMW-Heparine vorliegen, und vor allem, weil es keine prospektiven, randomisierten Vergleichsstudien zwischen verschiedenen LMW-Heparinen gibt, kann derzeit nicht, durch wissenschaftliche Daten abgesichert, einem der untersuchten LMW-Heparine der Vorteil gegenüber einem anderen in dieser Indikation gegeben werden.

  20. Vasospastic angina pectoris complicated by acute myocardial infarction and complete atrioventricular block

    Directory of Open Access Journals (Sweden)

    Pavlović Milan

    2011-01-01

    Full Text Available Background. A prolonged coronary artery spasm with interruption of coronary blood flow can lead to myocardial necrosis and increase of cardiospecific enzymes and can be complicated with cardiac rhythm disturbances, syncopc, or even sudden cardiac death. Case report. A 55-year old male felt a severe retrosternal pain when exposing himself to cold weather. The pain lasted for 20 minutes and was followed by the loss of conscience. Electrocardiogram (ECG showed a complete antrioventricular (AV block with nodal rhythm and marked elevation of ST segment in inferior leads. Electrocardiogram was soon normalized, but serum activities of cardiospecific enzymes were increased. Coronarography showed normal findings for the left coronary artery and a narrowing at the middle part of the right coronary artery, which disappeared after intracoronary application of nitroglycerine. The following therapy was prescribed: Diltiazem, Amlodipin, Isosorbid mononitrate, Molisdomin, Atrovastatin, Aspirin and Nitroglycerine spray. After 7 months medicaments were abandoned and the patient experienced again reccurent chest pain episodes at rest. Transitory ST segment elevation was recorded in inferior leads of ECG, but without increase of cardiospecific enzymes serum activities. After restoration of the medicament therapy anginal episodes ceased. Conclusion. Coronary dilators in maximal doses can prevent attacks of vasospastic angina.

  1. 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.

  2. 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.

  3. 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

    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...

  4. 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.

  5. Multiple Coronary–Cameral Fistulae in the Left Anterior Descending Coronary Artery Causing Angina Pectoris: A Clinical Case and the State of the Art

    Directory of Open Access Journals (Sweden)

    Musuraca G

    2014-02-01

    Full Text Available CLINICAL CASE A 82-year-old man with hypercholesterolemia, hypertension and glucidic intolerance, presented with angina pectoris upon exertion. The vital signs were normal. Echocardiography showed normal left ventricular (LV ejection fraction, non-critical aortic valvular stenosis and LV diastolic dysfunction. Rest and stress myocardial echocardiography showed a reversible abnormal septal-wall motion. Therefore, an initial diagnosis of possible coronary artery disease was made. Coronary arteriography showed no atherosclerotic lesions in the 3 major coronary arteries; however, in the anterior descending artery a communication with the right ventricle (RV cavity through ve small, di use stulae was detected (Figure 1 and 2, resulting in complete RV contrast opaci cation. The patient was stabilised on medical therapy because he refused any further invasive therapy.

  6. 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

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

    International Nuclear Information System (INIS)

    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.)

  8. 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.)

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

    OpenAIRE

    Xiaochen Yang; Xingjiang Xiong; Heran Wang; Guoyan Yang; Jie Wang

    2013-01-01

    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 ...

  10. Comparative Effectiveness of Ranolazine Versus Traditional Therapies in Chronic Stable Angina Pectoris and Concomitant Diabetes Mellitus and Impact on Health Care Resource Utilization and Cardiac Interventions.

    Science.gov (United States)

    Page, Robert L; Ghushchyan, Vahram; Read, Richard A; Hartsfield, Cynthia L; Koch, Bruce R; Nair, Kavita V

    2015-11-01

    Comparative studies evaluating traditional versus newer antianginal (AA) medications in chronic stable angina pectoris (CSA) on cardiovascular (CV) outcomes and utilization are limited, particularly in patients with diabetes mellitus (DM). Claims data (2008 to 2012) were analyzed using a commercial database. Patients with CSA receiving a β blocker (BB), calcium channel blocker (CCB), long-acting nitrate (LAN), or ranolazine were identified and followed for 12 months after a change in AA therapy. Patients on traditional AA medications were required to have concurrent sublingual nitroglycerin. Therapy change was defined as adding or switching to another traditional AA medication or ranolazine to identify patients whose angina was inadequately controlled with previous therapy. Four groups were identified (BB, CCB, LAN, or ranolazine users) and matched on relevant characteristics. A DM subset was identified. Logistic regression compared revascularization at 30, 60, 90, 180, and 360 days. Negative binomial regression compared all-cause, CV-, and DM-related (in the DM cohort) health care utilization. A total of 8,008 patients were identified with 2,002 patients in each matched group. Majority were men (mean age 66 years). A subset of 3,724 patients with DM (BB, n = 933; CCB, n = 940; LAN, n = 937; and ranolazine, n = 914) resulted from this cohort. Compared to ranolazine in the overall cohort, traditional AA medication exhibited greater odds for revascularization and higher rates in all-cause outpatient, emergency room visits, inpatient length of stay, and CV-related emergency room visits. In the DM cohort, ranolazine demonstrated similar benefits over traditional AA medication. In conclusion, ranolazine use in patients with inadequately controlled chronic angina is associated with less revascularization and all-cause and CV-related health care utilization compared to traditional AA medication. PMID:26358510

  11. 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.

  12. Xuesaitong soft capsule (chinese patent medicine) for the treatment of unstable angina pectoris: a meta-analysis and systematic review.

    Science.gov (United States)

    Yang, Xiaochen; Xiong, Xingjiang; Wang, Heran; Yang, Guoyan; Wang, Jie

    2013-01-01

    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. PMID:24489594

  13. 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.

  14. Investigation of the Relationship between Myocardial Infarction, Angina Pectoris, and Venous Thrombosis and Some Risk Factors in the Women Suffering from Cardiovascular Diseases with a History of Contraceptive Pills Consumption

    OpenAIRE

    Marzieh Akbarzade; Nasrin Sharifi; Najaf Zare

    2016-01-01

    Background: Cardiovascular diseases have various etiologies. Previous studies have come to contradictory results regarding the effects of Oral Contraceptive Pills (OCPs) on the risk of myocardial infarction, angina pectoris, and venous thrombosis. Thus, further investigation is required in this area. Objectives: This study aimed to determine the relationship between cardiovascular diseases and some risk factors in the women with a history of contraceptive pills consumption. Patients a...

  15. 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.

  16. Ranolazine for the symptomatic treatment of patients with chronic angina pectoris in Greece: a cost-utility study

    OpenAIRE

    Kourlaba, Georgia; Vlachopoulos, Charalambos; Parissis, John; Kanakakis, John; Gourzoulidis, George; Maniadakis, Nikos

    2015-01-01

    Background To conduct an economic evaluation comparing ranolazine as add-on therapy to standard-of-care (SoC) with SoC alone in patients with stable angina who did not respond adequately to first line therapy, in Greece. Methods A decision tree model was locally adapted in the Greek setting to evaluate the cost-utility of ranolazine during a 6-month period. The analysis was conducted from a third-party payer perspective. The clinical inputs were extracted from the published literature. The co...

  17. 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. PMID:26994453

  18. 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.

  19. 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.

  20. Clinical Effects Observation of Compound Danseng Dripping Pills in Treating Unsteady Angina Pectoris Patients%复方丹参滴丸治疗不稳定性心绞痛疗效观察

    Institute of Scientific and Technical Information of China (English)

    王昕

    2001-01-01

    Aim To observe the clinical effects of treatment for curing the unsteady angina pectoris(belonging to the blood blocked heart vessels symptoms) by taking advantage of the Chinese medicine called compound Danseng dripping pills.Methods By means of randomization control and on the basis of regular treatments,38 cases of the treated group adopt the dripping pills for treatment,meanwhile,35 cases of the control group adopt the Isosorbide dinitrate.Either of the treatments takes four weeks.Observing the changes of the two groups in symptoms,classified angina pectoris,ECG,the blood-flowing power and so on.Results The effect rate of the treated group is 92.1%.Compared with the control group,it has remarkable differences in classified angina pectoris,improving the heart vessels and the character of blood blowing(P<0.05,P<0.001) without any adverse reaction.Conclusion The compound danseng dripping pills have remarkable effects on the unsteady angina pectoris.%目的观察中成药复方丹参滴丸治疗冠心病不稳定性心绞痛(属心血瘀阻证)的临床疗效。方法采用随机对照法,在常规治疗基础上,治疗组38例使用复方丹参滴丸治疗,对照组35例使用硝酸异山梨醇酯片治疗,疗程均为4周。观察两组症状,治疗前后心绞痛分级,心电图,血流动力学等变化。结果治疗组总有效率为92.1%,对心绞痛分级,改善缺血心电图以及改善血液流变性等,与对照组比较,均有显著性差异(P<0.05,P<0.001),无不良反应。结论复方丹参滴丸对不稳定性心绞痛有较显著疗效。

  1. 逐瘀还五解毒颗粒治疗冠心病心绞痛临床研究%Clinical Research of Zhuyu Huanwu Jiedu Granule in Treating Coronary Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    李凯文; 史佃磊; 王凤红; 唐海莲

    2012-01-01

    Objective:To explore the influence of Zhuyu Huanwu Jiedu granule on coronary angina pectoris on clinical symptoms and e-lectrocardiogram changes and evaluate the clinical effects of zhuyu huanwu jiedu granule in treating coronary angina pectoris. Methods: 94 cases of coronary angina pectoris were randomly divided into two groups. The control group was treated by basic western medicine. The treatment group was orally given Zhuyu Huanwu Jiedu granule (composition:peach kernel 12 g,safflower 9 g, Angelica 9 g,dried rehmannia root 9 g,hemlock parsley 4. 5 g.red peony root 6 g, Achyranthes bidentata 9 g.Platycodon grandiflorum 4. 5 g,Chinese thoro-wax 3 g,fructus 6 g,licorice root 6 g,Astragalus membranaceus 18 g,Earthworm 9 g,honeysuckle 12 g,dandelionl2 g) based on the control group. 2 weeks were one treatment course for both groups. Results: Patients' clinical symptoms and the improvement of electrocardiogram in the treatment group were obviously superior to the control group. Conclusion: Zhuyu Huanwu Jiedu granule has a satisfactory therapeutic effect in treating coronary angina pectoris.%目的:探讨逐瘀还五解毒颗粒对冠心痛心绞痛的症状及心电图变化的影响,评估逐瘀还五解毒颗粒治疗冠心病心绞痛的临床疗效.方法:将94例冠心病心绞痛患者随机分为两组,对照组给予基础西药治疗,治疗组在对照组治疗基础上加用逐瘀还五解毒颗粒(方药组成:桃仁12 g,红花9 g,当归9 g,生地黄9 g,川芎4.5g,赤芍6 g,牛膝9 g,桔梗4.5g,柴胡3 g,枳壳6 g,甘草6 g,黄芪18 g,地龙9 g,金银花12 g,蒲公英12 g)治疗,2周为1个疗程.结果:治疗组患者的症状及心电图的改善明显优于对照组.结论:逐瘀还五解毒颗粒治疗冠心病心绞痛疗效满意.

  2. A Study on Syndrome of Angina Pectoris of Coronary Heart Disease Based on Feature Weighted Cluster Analysis%基于特征加权的冠心病心绞痛证候聚类研究

    Institute of Scientific and Technical Information of China (English)

    邹演梅; 张天奉

    2011-01-01

    目的:探讨冠心病心绞痛中医证候分型及分布规律.方法:根据收集符合纳入标准的冠心病心绞痛患者证候信息,并利用Access软件建立冠心病心绞痛证候信息数据库,然后将录入的证候信息导入SPSS进行聚类分析,归纳符合临床的合理证型.结果:通过聚类分析认为冠心痛心绞痛证候聚成气虚血瘀证、痰浊内阻证、阴虚痰瘀证、气滞痰热证、寒凝血瘀证、气阴两虚证、阴虚痰瘀证7类比较合理.结论:基于特征加权的聚类分析所得的冠心痛心绞痛证候分型与临床有较高的符合度,该方法可以在疾病证候分型研究领域进一步推广.%Objective: To discuss the syndrome-types and syndrome distribution of angina pectoris of coronary heart disease. Method: According to “coronary heart disease syndromes information collection form" to collect the angina pectoris of coronary heart disease syndromes information, and use the Access software to establish coronary syndromes database, then input the information into SPSS to cluster analysis,sum up a reasonable clinical syndromes. Result: It is more reasonable that the syndrome of angina pectoris of coronary heart disease are divided into seven types by cluster analysis, they are Qi-deficiency and blood stasis syndrome, phlegm-dampness syndrome, Yin-deficiency and phlegm-blood stasis syndrome, Qistagnation and phlegm-heat syndrome, Harning blood stasis syndrome, Qi and Yin-deficiency syndrome,Yin-deficiency and phlegm-heat syndrome. Conclusion: The syndrome-types of angina pectoris of coronary heart disease based on feature weighted cluster analysis have a higher accordance with clinical, this method can be further extended to syndrome classification research field of disease.

  3. 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.

  4. 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

  5. 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

  6. Serial thallium-201 imaging at rest in patients with unstable and stable angina pectoris: relationship of myocardial perfusion at rest to presenting clinical syndrome

    International Nuclear Information System (INIS)

    In order to determine whether there are differences in myocardial perfusion at rest among patients with various unstable and stable angina syndromes, serial thallium-201 imaging was performed at rest in 19 patients presenting with rapidly worsening exertional angina (unstable angina, group A), 12 patients with rest angina alone without exertional symptoms (unstable angina, group B), and 34 patients with chronic stable angina. No patient had an episode of angina within 4 hours of study. Nineteen of 19 (100%) patients in group A demonstrated transient defects compared to only 3 of 12 (25%) patients in group B (p less than 0.0001) and 4 of 34 (12%) stable angina patients (p less than 0.0001). The majority of zones demonstrating transient defects in group A were associated with hypokinesis of the corresponding left ventriculogram segment without associated ECG evidence of previous infarction. There were no significant differences in the frequency of persistent thallium defects, severity of angiographic coronary artery disease, or frequency of regional wall motion abnormalities of myocardial segments supplied by stenotic coronary arteries among the three groups of patients. Transient defects have been shown to reflect reduction in regional coronary blood flow to viable myocardium. Therefore, we conclude that regional resting hypoperfusion of viable myocardium is far more common in patients with exertional unstable angina symptoms than in patients with rest angina alone or chronic stable angina

  7. 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

    left anterior descending and left circumflex artery vascular territories (kappa = 0.85 and 0.82, respectively). However, in the right coronary artery territory, agreement was excellent in men (kappa = 0.83) but moderate in women (kappa = 0.57). CONCLUSIONS: In a relatively large group of men and women...... with stable angina pectoris, interpretive reproducibility (overall and individual vessel diagnosis) was excellent, except in the right coronary artery territory of women, in which it was moderate....... 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...

  8. 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

  9. 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

    prognosis. From 2002 through 2009 all elderly patients treated with PCI were identified in a population of 3.0 million based on the Western Denmark Heart Registry. Cox regression analysis was used to compare mortality rates according to clinical indications controlling for potential confounding. In total 3......,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 29.7%, and......Patients ≥ 80 years old with coronary artery disease constitute a particular risk group in relation to percutaneous coronary intervention (PCI). From 2002 through 2008 we examined the annual proportion of patients ≥ 80 years old undergoing PCI in western Denmark, their indications for PCI, and...

  10. Detection of coronary microembolization by Doppler ultrasound in patients with stable angina pectoris during percutaneous coronary interventions under an adjunctive antithrombotic therapy with abciximab: design and rationale of the High Intensity Transient Signals ReoPro (HITS-RP study

    Directory of Open Access Journals (Sweden)

    Kretzschmar Daniel

    2012-05-01

    Full Text Available Abstract Background Embolization of atherosclerotic debris from the rupture of a vulnerable atherosclerotic plaque occurs iatrogenically during percutaneous coronary interventions (PCI and can induce myocardial necrosis. These microembolizations are detected as high intensity transient signals (HITS using intracoronary Doppler technology. Presentation of the hypothesis In the presented study we will test if abciximab (ReoPro® infusion reduces high intensity transient signals in patients with stable angina pectoris undergoing PCI in comparison to standard therapy alone. Testing the hypothesis The High Intensity Transient Signals ReoPro® (HITS-RP study will enroll 60 patients. It is a prospective, single center, randomized, double-blinded, controlled trial. The study is designed to compare the efficacy of intravenous abciximab administration for reduction of microembolization during elective PCI. Patients will be randomized in a 1:1 fashion to abciximab or placebo infusion. The primary end point of the HITS-RP-Study is the number of HITS during PCI measured by intracoronary Doppler wire. Secondary endpoints are bleeding complications, elevation of cardiac biomarkers or ECG changes after percutaneous coronary interventions, changes in coronary flow velocity reserve, hs-CRP elevation, any major adverse cardio-vascular event during one month follow-up. Implications of the hypothesis The HITS-RP-Study addresses important questions regarding the efficacy of intravenous abciximab administration in reducing microembolization and periprocedural complications in stable angina pectoris patients undergoing PCI. Trial registration The trial is registered under http://www.drks-neu.uniklinik-freiburg.de/drks_web/:DRKS00000603.

  11. 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....

  12. The analysis anxiety/depression score and treatment of patients with angina pectoris%冠心病心绞痛患者焦虑/抑郁情绪测定评分的分析及治疗

    Institute of Scientific and Technical Information of China (English)

    姚涛; 吴达军

    2012-01-01

    Objective To investigate the level of anxiety and depression cores in patients with coronary heart disease and the efficacy of anti-anxiety depression treatment. Methods The Hospital Anxiety and Depression Scale(HADS) were measured in 120 patients with angina pectoris and 20 healthy volunteers between March 2010 and February 2012. Patients with anxiety and/or depression were treated by deanxit.The level of Hospital anxiety and depression scores and Seattle Angina scale (SAQ) were compared between pre- and post-treatment. Results The level of Hospital anxiety and depression scores of patients were higher than of the contral. The level of Hospital anxiety and depression scores and quality of life of patients of patients were improved after treatment. After treatment, the degree of anxiety and depression scores and physical activity limitation, angina stability status, onset of angina, treatment satisfaction, knowledge of the disease severity score was negatively correlated. The statistics were significant differences. (P<0.05). Conclusion The patients with angina pectoris have significant symptoms of anxiety and depression.After jointed anti-anxiety depression treatment, the patients felt the quality of life improved, stress relieved, living healthy and relaxed.%目的:探讨冠心痛心绞痛患者焦虑抑郁评分的高低及抗焦虑抑郁治疗的疗效.方法:2010年3月~2012年2月于本院心内科治疗的冠心痛心绞痛患者120例,对照组为健康志愿者20例,行焦虑抑郁评分.有焦虑抑郁患者行黛力新抗焦虑抑郁治疗,治疗前后行焦虑抑郁评分及采用西雅图心绞痛量表(SAQ)对患者治疗前后生活质量评估.结果:冠心病心绞痛患者焦虑评分及抑郁评分均高于对照组.治疗后患者焦虑抑郁评分较治疗前明显改善.治疗后患者生活质量较前明显好转.治疗后焦虑抑郁评分与躯体活动受限程度、心绞痛稳定状态、心绞痛发作情况、治疗满意程度、

  13. Clinical Trial Study on Effect of Yangxinshi Tablets in Treatment of Angina Pectoris of Coronary Heart Disease%养心氏片治疗心绞痛及冠心病临床试验资料研究

    Institute of Scientific and Technical Information of China (English)

    崔燕; 张辉; 庄婕

    2013-01-01

    Through searching the clinical trial data of Yangxinshi Tablets, the total of 1281 cases were summed up for the effects of Yangxinshi Tablets on the treatment of angina pectoris, diabetes angina, stable angina, coronary heart disease. The clinical effects of Yangxinshi Tablets were as follows:the curative effect on angina was approximately 72.00%-95.30%, the curative effect on traditional Chinese medicine symptoms was 78.90%-95.00%, the curative effect on electrocardiogram was 42.90%-81.30%, and nitroglycerin stop reduction rate is generally determined to be valid for more than 50%. Compared with the chosen control drugs, clinical efficacy of Yangxinshi Tablets was better than isosorbide dinitrate and isosorbide mononitrate, which were western medicines. Clinical efficacy of the combination of isosorbide dinitrate and Yangxinshi Tablets was superior to Compound Danshen Tablets and Compound Danshen Granales, and equivalent to Musk Heart-saving Drop Pill. Combined application of Yangxinshi Tablets and hypoglycemic agents was effective in the treatment on diabetes angina. Consequently, Yangxinshi Tablets could reduce cardiac stress, increase coronary blood flow, resist myocardial ischemia, prolong antianoxia time, and lower blood pressure and blood lipids to a certain extent. Yangxinshi Tablets had good effects on coronary heart disease and angina, especially on Qi deficiency and blood stasis type angina and myocardial infarction. What is more, Yangxinshi Tablets could be used in a long time without toxic effect.%  检索养心氏片临床试验的文献,总结养心氏片治疗心绞痛、糖尿病性心绞痛、稳定型心绞痛、冠心病,共1281例。养心氏片临床疗效:心绞痛疗效总有效率72.0%~95.30%,中医症状疗效总有效率78.90%~95.00%,心电图疗效42.90%~81.30%;硝酸甘油停减率一般在50%以上判定为有效。与所选择的对照药相比,养心氏片的临床疗效优于所对照的西药硝酸异山梨酯(

  14. Percutaneous coronary excimer laser angioplasty in patients with stable and unstable angina pectoris. Acute results and incidence of restenosis during 6-month follow-up.

    Science.gov (United States)

    Karsch, K R; Haase, K K; Voelker, W; Baumbach, A; Mauser, M; Seipel, L

    1990-06-01

    A clinical study was conducted to evaluate the efficacy and safety of percutaneous coronary excimer laser angioplasty in 60 patients with coronary artery disease. Forty-nine patients had stable exertional angina, and 11 patients had unstable angina despite medical therapy. A novel 1.4-mm diameter catheter with 20 quartz fibers of 100-microns diameter each arranged concentrically around a central lumen suitable for a 0.014-in. flexible guide wire was coupled to an excimer laser. A commercial excimer laser emitting energy at a wavelength of 308 nm with a pulse duration of 60 nsec was used. The laser was operated at 20 Hz. Mean energy transmission was 30 +/- 5 mJ/mm2. In five of the 60 patients, laser angioplasty was not attempted. In 23 patients with laser ablation alone, percent stenosis decreased from 76 +/- 14% before to 27 +/- 17% after ablation and was 34 +/- 15% at the early follow-up angiogram. In 32 patients, additional balloon angioplasty was performed because of vessel closure after laser ablation in 11 and an insufficient qualitative result in 21 patients. Of the 11 patients with unstable angina, one patient died due to vessel closure 3 hours after intervention, and two patients developed a myocardial infarction. In 22 of 47 patients with late follow-up angiography, restenosis within the 6-month follow-up period occurred. Rate of restenosis was higher in patients treated with laser ablation and balloon angioplasty (16 of 28) than in patients treated with laser ablation alone (six of 19). These results suggest that coronary excimer laser angioplasty for ablation of obstructive lesions is feasible and safe in patients with stable angina. However, development of new catheter systems is necessary for an improved success rate. PMID:2344680

  15. 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.

  16. Sensitivity and related factors in iodine-123-β-methyl-p-iodophenyl-pentadecanoic acid myocardial scintigraphy to detect stable effort angina pectoris

    International Nuclear Information System (INIS)

    This study evaluated the sensitivity and the related factors in iodine-123-β-methyl-p-iodophenyl-pentadecanoic acid (BMIPP) scintigraphy to detect stable angina. The subjects were 198 patients with stable angina who underwent BMIPP before percutaneous coronary intervention or coronary bypass graft surgery. Patients with unstable angina, myocardial infarction, congestive heart failure, cardiomyopathy and vasospastic angina were excluded. After investigation of the sensitivity of BMIPP, the patients with single-vessel disease without collateral flow were classified into the normal 123I-BMIPP uptake group (normal group) or decreased 123I-BMIPP uptake group (decreased group), and various factors were compared between the two groups. Sensitivity was 61% overall, 58% in single-vessel disease, 69% in double-vessel disease, 53% in triple-vessel disease, 43% in only left main vessel disease, and 89% in left main and other vessel disease (NS). In single-vessel disease, the sensitivity was 40% in 75% coronary artery stenosis, 58% in 90% stenosis, 89% in 99% stenosis, and 69% in total occlusion (p=0.003). Comparing the decreased and normal groups, diabetes mellitus was more frequent in the normal group (14.6% vs 39.5%), minimal lumen diameter was smaller (0.75±0.37 vs 0.98±0.49 mm) and lesion length was longer in the decreased group (15.4±4.9 vs 11.6±5.5 mm). Logistic multivariate analysis showed that the independent factors were diabetes mellitus [odds ratio 0.20, 95% confidence interval (CI) 0.04-0.87, p=0.03], minimal lumen diameter (odds ratio 0.10, 95% CI 0.02-0.48, p=0.003) and lesion length (odds ratio 1.12, 95% CI 1.00-1.25, p=0.03). BMIPP is useful in stable angina patients because of the acceptable sensitivity. Diabetes mellitus, minimal lumen diameter and lesion length were independent factors associated with decreased BMIPP uptake. (author)

  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. 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.

  19. 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

  20. 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.

  1. 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

  2. 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

  3. Influence of preinfarction angina pectoris on patients with primary ST elevation acute myocardial in-farction%梗死前心绞痛对初发ST段抬高的急性心肌梗死的影响

    Institute of Scientific and Technical Information of China (English)

    夏树涛; 赵施竹

    2014-01-01

    Objective:To observe influence of preinfarction angina pectoris (PAP)on primary ST elevation acute my-ocardial infarction (AMI).Methods:A total of 280 patients with primary ST elevation AMI received coronary angi-ography (CAG)within 24h after symptoms occurred,and they received ECG and QRS scoring on hospitalization. According to PAP or not,patients were divided into PAP group (n=102)and non PAP group (n=178).According to attack to CAG time,patients were divided into early stage group (<2h,n=60),mid-term group (2~6h,n=150)and advanced stage group (6~24h,n=70).Results:QRS score of PAP patients [(2.4±2.4)scores]was sig-nificantly lower than that of non PAP patients [(3.2±3.0)scores],percentage of high QRS score in PAP group (8.0%)was also significantly lower than that of non PAP group (18.4%),P<0.05 both.In early stage group, there was no significant difference in QRS score [(2.0±1.8)scores vs.(2.6±2.8)scores,P=0.35]between PAP and non PAP patients;The QRS score of PAP patients [(2.0±2.1)scores]was significantly lower than that of non PAP group [(3.0 ±3.0)scores]in mid-term group,P=0.03;in advanced stage group,the QRS score all signifi-cantly rose in PAP patients [(4.1 ±3.3)scores]and non PAP patients [(5.5±2.9)scores],P=0.13;QRS score gradually rose along with onset time prolonged in non PAP group.Conclusion:Preinfarction angina pectoris can de-lay progress of acute myocardial infarction and expand therapeutic window of reperfusion.%目的:观察梗死前心绞痛(PAP)对初发 ST段抬高急性心肌梗死(AMI)进展的影响。方法:280例初发ST段抬高 AMI患者,发病后24h内进行冠脉造影,心电图检查并作 QRS记分。根据有无PAP,患者被分为 PAP (102例)和非PAP组(178例)。根据发病至造影时间患者被分为:早期组(<2h,60例)、中期组(2~6h,150例)和晚期组(6~24h,70例)。结果:伴有PAP患者较无PAP患者 QRS记分显著降低[(2.4±2.4)分比(3.2±3

  4. 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.

  5. PROTECTIVE EFFECTS OF NICORANDIL ON PATIENTS WITH UNSTABLE ANGINA PECTORIS UNDERGOING PERCUTANEOUS CORONARY INTERVENTION%尼可地尔对行PCI不稳定型心绞痛病人心肌保护作用

    Institute of Scientific and Technical Information of China (English)

    张彦; 孙道媛; 田建会

    2012-01-01

    Objective To observe the myocardial protective effect of oral Nicorandil on patients with unstable angina pec-toris (UAP) undergoing percutaneous coronary intervention (PCI) therapy. Methods Sixty patients with UAP needed PCI were equally randomized to Nicorandil group and control group. The patients in control group were given a conventional iherapy, those in Nicorandil group were added Nicorandil, 5 mg, three times a day, 48 hours prior to PCI, in addition to routine therapy. The medication was continued for eight weeks after PCI. Serum concentrations of creatine kinase-MB (CK-MB) and cardiac tropo-nin I (cTnl) were measured in both of the groups before and 6, 12, and 24 h after PCI. The electrocardiogram (ECG) and left ventricular ejection fraction (LVEF) were observed eight weeks after the procedure. Results The serum levels of CK-MB and cTnl were significantly lower in the Nicorandil group than that in the control group 24 h after PCI 1,1=2. 040,2. 241 ;P<0. OS). Post-PCI serum CK-MB and cTnl elevated were noted in five patients (16. 7%) in Nicorandil group and 13(43. 3%) in the control group, the difference being significant between the two groups (P=0. 047). Follow-up ECG and echocardiography conducted eight weeks after PCI revealed that the ECG and LEVF improved better in Nicorandil group than the control (u = 2.475,t = 2.061 ;P< C. 05). Conclusion Oral administration of Nicorandil has a definite myocardial protection in patients with UAP undergoing PCI.%目的 探讨口服尼可地尔对行经皮冠状动脉介入治疗(PCI)不稳定型心绞痛病人的心肌保护作用.方法 以在我科住院需行PCI的不稳定型心绞痛病人60例作为研究对象,随机分为2组,各30例.对照组入院后给予不稳定型心绞痛常规治疗;尼可地尔组在常规治疗的基础上,术前48 h给予尼可地尔每次5 mg,每天3次,术后继续以相同剂量口服尼可地尔8周.比较两组PCI治疗前及治疗后6、12、24 h血清肌酸激酶同

  6. 黄芪注射液治疗不稳定型心绞痛的系统评价%Systematic Review on HuangQi Injection in Treating Unstable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    王晓怀; 潘文; 康开彪; 柳树英; 袁仁智

    2013-01-01

    目的:评价黄芪注射液治疗不稳定型心绞痛的疗效与安全性。方法:计算机检索MEDLINE、EMbase、Cochrane图书馆、CNKI、VIP和万方数据库,按照纳入与排除标准由两位研究者独立筛选和提取资料,采用Cochrane协作网随机对照试验的质量评价标准评价纳入文献质量,使用RevMan 5.2软件进行Meta分析。结果:共纳入6篇文献,714例患者。Meta分析结果显示:黄芪注射液组的临床疗效[RR=1.21,95%CI(1.12,1.30)]和心电图改善情况[RR=1.30,95%CI(1.15,1.46)]均优于对照组,2组相比差异有统计学意义。纳入的6篇文献中,4篇文献报道未见明显不良反应,2篇未提及安全性或不良反应。结论:黄芪注射液治疗不稳定型心绞痛,较其他常规西药和中药,可以提高其治疗效果。但由于本系统评价纳入研究质量低且样本量小,药物安全性不明确,尚需高质量随机对照试验进一步验证。%Objective:To evaluate therapeutic effects and the safety of HuangQi injection in treating unstable angina pectoris (UAP). Method:MEDLINE, EMbase, Cochrane library, CNKI, VIP and Wangfang database were searched;data was screened and abstracted by two investigators according to the standard of inclusion and exclusion, the quality of included literature was assessed by quality assessment of randomized controlled trial from Cochrane net and Meta analysis was performed by RevMan 5.2 software. Result:Six pieces of writing were included and 714 patients were involved. The results of Meta analysis showed: HuangQi injection group was superior to the control group in clinical effects [RR=1.21,95%CI (1.12,1.30)] and the improvements of ECG [RR=1.30,95%CI (1.15,1.46)], the difference had statistical meaning. Among six pieces of writing, there was no obvious adverse reac-tion in four articles, there was no safety and adverse reaction mentioned in two articles. Conclusion:HuangQi injec-tion in

  7. 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

  8. Symptoms of Anxiety and Depression Are Correlates of Angina Pectoris by Recent History and an Ischemia-Positive Treadmill Test in Patients with Documented Coronary Artery Disease in the Pimi Study

    Directory of Open Access Journals (Sweden)

    Mark W. Ketterer

    2011-01-01

    Full Text Available Objective. We tested the association of specific psychological characteristics in patients having stable coronary disease with the reporting of anginal symptoms during daily activities, and positive exercise testing. Methods. One hundred and ninety-six patients with documented CAD enrolled in the Psychophysiological Investigations of Myocardial Ischemia (PIMI Study completed an anginal history questionnaire and a battery of psychometric tests. They also underwent standardized exercise treadmill tests. Results. Patients with a recent history of angina were more likely to be female, and had higher Beck Depression (P=.002, State Anxiety (P=.001, Trait Anxiety (P=.03, Harm Avoidance (P=.04 and Muscle Tension (P=.004 scores than patients who had no recent history of angina. Along with several treadmill variables indicating more severe disease state and reduced exercise tolerance, patients who developed angina on a positive treadmill test also displayed higher scores on the Beck Depression Inventory (P=.003 and State Anxiety (P=.004 scales. Conclusions. Several psychological characteristics, and most notably anxiety and depression, are strong correlates of recent angina and angina in the presence of ischemia provoked by treadmill testing.

  9. Impaired myocardial fatty acid metabolism detected by {sup 123}I-BMIPP in patients with unstable angina pectoris. Comparison with perfusion imaging by {sup 99m}Tc-sestamibi

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    Takeishi, Yasuchika; Sukekawa, Hiroyasu; Saito, Haruo; Nishimura, Shozo; Shibu, Takayuki; Sasaki, Yasuhiko; Tomoike, Hitonobu [Yamagata Univ. (Japan). School of Medicine

    1995-08-01

    The present study was undertaken to determine the potential diagnostic value of {sup 123}I-BMIPP scintigraphy for the detection of altered myocardial fatty acid metabolism in patients with unstable angina. Both myocardial metabolic imaging with {sup 123}I-BMIPP and perfusion imaging with {sup 99m}Tc-sestamibi were performed at rest in 28 patients with unstable angina in the pain-free state. The regional uptakes of {sup 123}I-BMIPP or {sup 99m}Tc-sestamibi were scored semiquantitatively (0=normal, 4=no activity) and compared with the coronary arteriographic findings. Decreased uptakes of {sup 123}I-BMIPP were observed in 18 patients, and 11 patients had abnormal {sup 99m}Tc-sestamibi images. Defect scores of {sup 123}I-BMIPP were larger than those of {sup 99m}Tc-sestamibi (7.8{+-}2.1 vs. 5.2{+-}1.9, p<0.01). The sensitivity for the detection of patients with unstable angina was higher in {sup 123}I-BMIPP than in {sup 99m}Tc-sestamibi (77% vs. 45%, p<0.01). The site of the decreased {sup 123}I-BMIPP uptake corresponded to the most stenotic coronary artery lesion in all patients. Fatty acid metabolic imaging with {sup 123}I-BMIPP was more sensitive for detecting myocardial ischemia than perfusion imaging with {sup 99m}Tc-sestamibi. {sup 123}I-BMIPP may be a clue to define the culprit lesion in unstable angina and be helpful to decide the best treatment and guide coronary angioplasty. (author).

  10. Comparative Study on the Effects of Small Dose of Aspirin Combined with Ginkgo-damole Injection(银杏达莫注射液) and the Effects of Conventional Dose of Aspirin in Treating Senile Unstable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    陈学林; 张劲农; 袁杰; 杨彬; 江凌; 刘承云

    2004-01-01

    Objective: To evaluate the therapeutic and adverse effect of small dose of aspirin (Asp) (UA). Methods: One hundred and twenty old in-patients of coronary heart disease with UA were randomly divided into two groups. The 60 patients in the treated group were treated with oral administration of enteric soluble 50 mg Asp once a day and GDI 20 ml per day by intravenous dripping, with 14 days as one therapeutic course, while the other 60 in the control group were treated with enteric soluble Asp 100 mg alone once a day orally. Besides, isosorbide-5-mononitrate 20 mg twice a day was applied to both groups, and the β-adrenoceptor blocker, blood lipids regulatory agents and nitroglycerin (10 mg by intravenous dripping) were given accordingly. The angina total improving rate, hemorrheologic indexes (whole blood viscosity, plasma viscosity, fibrinogen, platelet aggregation rate), comprehensive clinical terminal event and the total occurrence rate of adverse reaction in the two groups were observed. Results: After treatment, comparison between the two groups showed insignificant difference in aspects of angina total improving rate (75.00% vs 65.00 % ), hemorrheological indexes and comprehensive clinical terminal event rate (25.00 % vs 31. 67 % ),P>0.05, and the hemorrheological indexes were improved in both groups ( P<0.05), but the total occurrence rate of adverse reaction in the treated group was lower than that in the control group (6. 67% vs 25.00%), showing significant difference (P<0.05). Conclusion: In treatment of senile UA, small dose of Asp combined with GDI showed therapeutic effect similar to that of conventional dose of Asp, but it has lower adverse reaction.

  11. Stable angina

    Science.gov (United States)

    ... include: Coronary angiography Blood cholesterol profile ECG Exercise tolerance test (stress test or treadmill test) Nuclear medicine ( ... PhD, and the A.D.A.M. Editorial team. Related MedlinePlus Health Topics Angina Browse the Encyclopedia ...

  12. Unstable angina

    Science.gov (United States)

    ... pressure High LDL cholesterol Low HDL cholesterol Male gender Sedentary lifestyle (not getting enough exercise) Obesity Older ... Seek medical attention if you have new, unexplained chest pain or pressure. If you have had angina before, call your health ...

  13. 冠心病心绞痛合并糖尿病患者病变冠脉参照节段血管血管内超声的特点%Intravascular ultrasound characteristics of reference segmental vessels for coronary artery with lesion in coronary artery disease patients with angina pectoris complicated diabetes mellitus

    Institute of Scientific and Technical Information of China (English)

    祁建成; 曹晶茗; 万镇; 欧昌元; 刘锐

    2012-01-01

    Objective: To evaluate size and form of atherosclerosis lesion in reference segments vessels (they were "normal" by angiography) for coronary artery with lesion in coronary artery disease patients with angina pectoris complicated diabetes mellitus (DM) using intravascular ultrasound imaging (IVUS) and its relationship with clinic. Methods; According to complicated with DM or not, a total of 82 patients with angina pectoris were selected and divided into DM group (n = 32) and non-DM group (n = 50). IVUS was used to examine reference segments vessels in two groups. Results: Atherosclerosis existed in all 84 reference segmental vessels of 82 cases was measured by IVUS. Compared with non-DM group, there were significant decrease in flow area of reference segments vessel [ (8. 03 ± 1. 86) mm2 vs. (7. 79 ± 1. 27) mm2], and significant increase in external elastic membrane area [ (14. 09 ± 3. 86) mm2 vs. (15. 29 ± 2. 51) mm2], plaque burden [ (41. 9 ±8. 58)% vs. (48. 69 ± 6. 86)%], eccentricity index [ (3. 76 ± 2. 49) vs. (8. 13 ± 6. 77)] and lesion length [ (6. 66 ± 4. 73) mm vs. (10. 58 ± 5. 74) mm] of reference segments in DM group, P<0. 01 all. Linear correlation analysis indicated that plaque burden of reference segment vessel was positively correlated with plaque burden of target lesion (r = 0. 880, P<0. 001). Conclusion: Atherosclerosis also exists in "normal" reference segment vessel by angiography and it's more diffuse in diabetic patients.%目的:应用血管内超声成像(IVUS)评估冠心病心绞痛合并糖尿病患者冠脉造影示“正常”的病变冠脉参照节段的动脉粥样硬化病变大小,形态以及其与临床的相关性.方法:入选确诊心绞痛的患者82例,按是否合并DM分为:DM组(32例)和非DM组(50例).应用IVUS对两组的84支参照节段血管进行检查.结果:所有82例84支血管参照节段血管内超声检测均存在动脉粥样硬化病变.与非DM组比较,DM组参照节段血

  14. What Causes Angina?

    Science.gov (United States)

    ... this page from the NHLBI on Twitter. What Causes Angina? Underlying Causes Angina usually is a symptom of coronary heart ... and cause angina or a heart attack . Immediate Causes Many factors can trigger angina pain, depending on ...

  15. 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.

  16. 'Variant' angina: Evidence for small vessel coronary artery spasm

    International Nuclear Information System (INIS)

    A unique case of 'variant' angina pectoris has been observed in a patient with normal coronary arteries and typical chest pain appearing spontaneously at rest, and repeatedly provoked by ergonovine maleate (0.1 mg iv) associated with large transmural perfusion defects on 201TI-imaging (after ergonovine) and a marked increase in T wave voltage despite no demonstrable spasm of a major coronary artery after the same doses of ergonovine. While saline solution could not provoke chest pain and treatment with a beta-blocking agent increased the frequency of ischemic attacks, a calcium antangonist therapy reduced and eventually eliminated the attacks. Thus, this case provides evidence for yet another aspect of a 'variant' form of angina pectoris: small vessel coronary artery spasm. (orig.)

  17. Enhanced external counter pulsation in treatment of refractory angina pectoris

    DEFF Research Database (Denmark)

    Erdling, André; Bondesson, Susanne; Pettersson, Thomas; Edvinsson, Lars

    2008-01-01

    to therapy by improving at least one CCS class. In general, the CCS class improved by one class after EECP treatment (3.05 before versus 2.14 after treatment). A total of 61.5% of the initial responders showed sustained improvement at the 12 month follow-up while 29% presented sustained improvement...

  18. High probability of disease in angina pectoris patients

    DEFF Research Database (Denmark)

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

    2007-01-01

    Cardiovascular Society grade 2 pain or higher (n=176) or high (higher than 85%) estimated pretest likelihood of disease (n=142). RESULTS: In the three groups, 34% to 39% of male patients and 65% to 69% of female patients had normal MPS, while 37% to 38% and 60% to 71%, respectively, had insignificant findings on...... CA. Of the patients who had also an abnormal at-rest ECG, 14% to 21% of men and 42% to 57% of women had normal MPS. Sex-related differences were statistically significant. CONCLUSIONS: Clinical prediction appears to be unreliable. Addition of at-rest ECG data results in some improvement, particularly...... in male patients, but it makes the high probability groups so small that the addition appears to be of limited clinical relevance....

  19. 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

  20. 不稳定性心绞痛患者心理社会因素与血小板聚集功能关系的研究%Relationship between Psychosocial Factors end Platelet Aggregation Function inPatients with Unstable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    夏大胜; 刘书坤; 高陆; 曹燕然; 菅练

    2001-01-01

    目的:探讨不稳定性心绞痛(UAP)患者心理社会因素与血小板聚集功能的关系。方法:采用6个心理量表对46例UAP患者和46例健康人进行评定,并测定ADP诱导的血小板聚集率。结果:UAP组负性生活事件刺激量、消极应对、CH、焦虑和抑郁积分及血小板聚集率均高于对照组(均P<0.01),社会支持总分和积极应对分低于对照组(均P<0.01),UAP组A型行为、焦虑及抑郁分别占73.91%、82.6%和71.4%,高于对照组36.96%、34.8%和21.7%(均P<0.01)。UAP患者焦虑、抑郁程度与负性生活事件刺激量、消极应对分、CH分及血小板聚集率正相关(P<0.05或P<0.01),与社会支持总分负相关(均P<0.05),血小板聚集率与负性生活事件刺激量、CH分亦显著正相关(均P<0.01)。结论:UAP患者由于处于心理应激状态,表现焦虑、抑郁情绪障碍,血小板聚集功能增强,对疾病的发展和预后可能产生不利影响。%Objective:To explore the relationship between psychosocial factors and platelet aggregation function in patients withunstable angina pectoris(UAP). Methods:Forty-six UAP patients and 46 healthy subjects were evaluated with 6 psychologi-cal scales,and their adenosine diphosphate(ADP)-induced platelet aggregation function was determined. Results: The scoresof negative life event stimuli,negative coping,CH, anxiety, depression and the rate of platelet aggregation function in UAPgroup were significantly higher than controls, whereas the scores of total social support and positive coping were markedlylower than controls(all P<0.01). The prevalence of type A behavior, anxiety and depression in UAP group(73.91%,82.60% and 71.40% respectively)was higher than controls(36.96% ,34.80% and 21.70%respectively)(all P<0.01).The scores of anxiety or depression in UAP group had a positive correlation with the scores of negative life event stimuli,negative coping

  1. 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

    Patients implanted with a cardioverter defibrillator (ICD) who are suffering from refractory angina pectoris could benefit from spinal cord stimulation (SCS) due to the well-documented pain relieving effect. However, the combined treatment remains controversial. The aim of the study is to report ...

  2. Pharmacotherapy of Vasospastic Angina.

    Science.gov (United States)

    Harris, Justin R; Hale, Genevieve M; Dasari, Tarun W; Schwier, Nicholas C

    2016-09-01

    Vasospastic angina is a diagnosis of exclusion that manifests with signs and symptoms, which overlap with obstructive coronary artery disease, most often ST-segment elevation myocardial infarction. The pharmacotherapy that is available to treat vasospastic angina can help ameliorate angina symptoms. However, the etiology of vasospastic angina is ill-defined, making targeted pharmacotherapy difficult. Most patients receive pharmacotherapy that includes calcium channel blockers and/or long-acting nitrates. This article reviews the efficacy and safety of the pharmacotherapy used to treat vasospastic angina. High-dose calcium channel blockers possess the most evidence, with respect to decreasing angina incidence, frequency, and duration. However, not all patients respond to calcium channel blockers. Nitrates and/or alpha1-adrenergic receptor antagonists can be used in patients who respond poorly to calcium channel blockers. Albeit, evidence for use of nitrates and alpha1-adrenergic receptor antagonists in vasospastic angina is not as robust as calcium channel blockers and can exacerbate adverse effects when added to calcium channel blocker therapy. Despite having a clear benefit in patients with obstructive coronary artery disease, the benefit of beta-adrenergic receptor antagonists, statins, and aspirin remains unclear. More data are needed to elucidate whether or not these agents are beneficial or harmful to patients being treated for vasospastic angina. Overall, the use of pharmacotherapy for the treatment of vasospastic angina should be guided by patient-specific factors, such as tolerability, adverse effects, drug-drug, and drug-disease interactions. PMID:27081186

  3. 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.

  4. Extended-release ranolazine: critical evaluation of its use in stable angina

    OpenAIRE

    Melloni C; Newby LK; Truffa AAM

    2011-01-01

    Adriano AM Truffa, L Kristin Newby, Chiara MelloniDuke Clinical Research Institute and Department of Medicine, Duke University Medical Center, Durham, NC, USAAbstract: Coronary heart disease is the major cause of morbidity and mortality throughout the world, and is responsible for approximately one of every six deaths in the US. Angina pectoris is a clinical syndrome characterized by discomfort, typically in the chest, neck, chin, or left arm, induced by physical exertion, emotional stress, o...

  5. How Is Angina Treated?

    Science.gov (United States)

    ... may be advised to get annual flu shots. Medical Procedures If lifestyle changes and medicines don't control angina, you may need a medical procedure to treat the underlying heart disease. Both angioplasty ( ...

  6. Increased expression and plasma levels of myeloperoxidase are closely related to the presence of angiographically-detected complex lesion morphology in unstable angina

    NARCIS (Netherlands)

    T. Naruko; A. Furukawa; K. Yunoki; R. Komatsu; M. Nakagawa; Y. Matsumura; N. Shirai; K. Sugioka; M. Takagi; T. Hozumi; A. Itoh; K. Haze; M. Yoshiyama; A.E. Becker; M. Ueda

    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

  7. Stable Angina Pectoris : Evaluation of Ultrasonography in Detetion of Carotid Atherosclerosis and Flow-Mediated Dilation of Brachial Artery%超声检查颈动脉粥样硬化情况和肱动脉FMD对稳定性心绞痛的价值

    Institute of Scientific and Technical Information of China (English)

    田敏; 韩晓云; 王丽丽; 王小艳

    2011-01-01

    Objective: To explore the value of brachial artery FMD and common carotid arterial IMT in patients with stable angina evaluated by ultrasonography. Methods: We divided 65 patients with stable angina into mild stenosis, moderate stenosis and severe stenosis group. In all of cases, the IMT of common carotid artery and the FMD in the brachial artery were measured by ultrasouography. And their relationship were analyzed. Results: Califf risk score and As integral were obviously increased, aggravating with coronary artery stenosis, and there were positive correlation (P<0.05). Common carotid arterial IMT was obviously increased and brachial artery FMD was obviously reduced, aggravating with coronary artery stenosis. The two were negative correlation(P<0.05). Conclusion: It can control the clinical risk in SAP patients by noninvasive ultrasouography monitoring of brachial artery FMD and common carotid arterial IMT.%目的:探讨无创超声检查颈动脉粥样硬化情况和肱动脉FMD对SAP的价值.方法:将选取的65例SAP患者分为轻度狭窄组、中度狭窄组和重度狭窄组,超声检测所有病例的肱动脉FMD和颈总动脉IMT,并作Califf危险评分和As积分,分析观察指标间的关系.结果:Califf危险评分和As积分都随着冠脉狭窄程度的加深而增大,且二者呈正相关(P<0.05);颈总动脉IMT随着狭窄程度的加深而增大,肱动脉FMD则随着狭窄程度的加深而降低,二者呈负相关(P<0.05).结论:无创监测颈总动脉IMT和肱动脉FMD,可指导SAP临床风险的控制.

  8. 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

  9. Comparison of the Effect of Rosuvastatin 2.5 mg vs 20 mg on Coronary Plaque Determined by Angioscopy and Intravascular Ultrasound in Japanese With Stable Angina Pectoris (from the Aggressive Lipid-Lowering Treatment Approach Using Intensive Rosuvastatin for Vulnerable Coronary Artery Plaque [ALTAIR] Randomized Trial).

    Science.gov (United States)

    Takayama, Tadateru; Komatsu, Sei; Ueda, Yasunori; Fukushima, Seiji; Hiro, Takafumi; Hirayama, Atsushi; Saito, Satoshi

    2016-04-15

    Diminishing yellow color, evaluated by coronary angioscopy, is associated with plaque stabilization and regression. Our aim was to assess the effect of aggressive lipid-lowering therapy with rosuvastatin on plaque regression and instability. Thirty-seven patients with stable angina or silent myocardial ischemia who planned to undergo elective percutaneous coronary intervention and had angioscopic yellow plaques of grade 2 or more were randomized to high-dose (group H, 20 mg/day, n = 18) or low-dose (group L, 2.5 mg/day, n = 19) rosuvastatin therapy for 48 weeks. Yellow plaque was graded on a 4-point scale of 0 (white) to 3 (bright yellow) by angioscopy, and plaque volume was determined by intravascular ultrasound for plaques with a length of 5 to 15 mm. Color and volume were assessed at baseline and after 48 weeks by the investigators blinded to the rosuvastatin dosage, and were compared between the 2 dosing groups. The level of low-density lipoprotein-cholesterol decreased from 130.3 ± 25.5 mg/dl to 61.7 ± 16.5 mg/dl (-50 ± 19%: high intensity) in group H (p change in plaque volume was significantly larger in group H than in group L (p = 0.005). In conclusion, both high-dose and low-dose rosuvastatin increased plaque stability. However, high-dose rosuvastatin was more effective than low-dose rosuvastatin in inducing plaque volume regression. Clinical Trial Registration No: UMIN-CTR, UMIN000003276. PMID:26879069

  10. Effects of Omega-3 polyunsaturated fatty acids on serum inflammatory factors in patients with unstable angina pectoris%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

    Institute of Scientific and Technical Information of China (English)

    臧书文; 王开成

    2015-01-01

    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(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。

  11. Predictors of coronary intervention-related myocardial infarction in stable angina patients pre-treated with statins

    OpenAIRE

    Veselka, Josef; Hájek, Petr; Malý, Martin; Zemánek, David; Adlová, Radka; Tomašov, Pavol; Martinkovičová, Lucie; Tesař, David; Červinka, Pavel

    2011-01-01

    Introduction Peri-procedural myocardial infarction (PMI) is a frequent and prognostically important complication of percutaneous coronary intervention (PCI). This study was designed to determine the predictors of PMI in patients pre-treated with statins. Material and methods A total of 418 stable angina pectoris patients taking statins and aspirin were included. All the patients underwent PCI. Serum concentrations of creatine kinase (CK-MB mass) and troponin I (TnI) were measured prior to and...

  12. Extended-release ranolazine: critical evaluation of its use in stable angina

    Directory of Open Access Journals (Sweden)

    Melloni C

    2011-08-01

    Full Text Available Adriano AM Truffa, L Kristin Newby, Chiara MelloniDuke Clinical Research Institute and Department of Medicine, Duke University Medical Center, Durham, NC, USAAbstract: Coronary heart disease is the major cause of morbidity and mortality throughout the world, and is responsible for approximately one of every six deaths in the US. Angina pectoris is a clinical syndrome characterized by discomfort, typically in the chest, neck, chin, or left arm, induced by physical exertion, emotional stress, or cold, and relieved by rest or nitroglycerin. The main goals of treatment of stable angina pectoris are to improve quality of life by reducing the severity and/or frequency of symptoms, to increase functional capacity, and to improve prognosis. Ranolazine is a recently developed antianginal with unique methods of action. In this paper, we review the pharmacology of ranolazine, clinical trials supporting its approval for clinical use, and studies of its quality of life benefits. We conclude that ranolazine has been shown to be a reasonable and safe option for patients who have refractory ischemic symptoms despite the use of standard medications (for example, nitrates, beta-adrenergic receptor antagonists, and calcium channel antagonists for treatment of anginal symptoms, and also provides a modestly improved quality of life.Keywords: ranolazine, coronary heart disease, angina, treatment

  13. 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

  14. 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.

  15. Chronic Kidney Disease Stage Is a Modulator on the Association between High-Sensitivity C-Reactive Protein and Coronary Vasospastic Angina

    OpenAIRE

    Heng-Jung Hsu; Chiung-Hui Yen; Kuang-Hung Hsu; I-Wen Wu; Chin-Chan Lee; Chiao-Yin Sun; Chia-Chi Chou; Chun-Yu Chen; Shih-Ying Yang; Chi-Jen Tsai; Mai-Szu Wu; Ming-Jui Hung

    2014-01-01

    The prevalence of coronary vasospasm and also the factors associated with coronary vasospasm in CKD is still unclear. In this cross-sectional study of 859 consecutive CKD patients with angina pectoris received coronary catheterization, we evaluated the factors associated with coronary vasospasm. Patients with vasospasm were older and had higher peripheral blood white cell counts, higher peripheral blood monocyte cell counts, higher haemoglobin levels, higher hs-CRP levels, and lower levels of...

  16. How Can Angina Be Prevented?

    Science.gov (United States)

    ... changes and treating related conditions. Making Lifestyle Changes Healthy lifestyle choices can help prevent or delay angina and heart disease. To adopt a healthy lifestyle, you can: Quit smoking and avoid secondhand ...

  17. Management of stable angina: A commentary on the European Society of Cardiology guidelines.

    Science.gov (United States)

    Ambrosio, Giuseppe; Komajda, Michel; Mugelli, Alessandro; Lopez-Sendón, José; Tamargo, Juan; Camm, John

    2016-09-01

    In 2013 the European Society of Cardiology (ESC) released new guidelines on the management of stable coronary artery disease. These guidelines update and replace the previous ESC guidelines on the management of stable angina pectoris, issued in 2006. There are several new aspects in the 2013 ESC guidelines compared with the 2006 version. This opinion paper provides an in-depth interpretation of the ESC guidelines with regard to these issues, to help physicians in making evidence-based therapeutic choices in their routine clinical practice. The first new element is the definition of stable coronary artery disease itself, which has now broadened from a 'simple' symptom, angina pectoris, to a more complex disease that can even be asymptomatic. In the first-line setting, the major changes in the new guidelines are the upgrading of calcium channel blockers, the distinction between dihydropyridines and non-dihydropyridine calcium channel blockers, and the presence of important statements regarding the combination of calcium channel blockers with beta-blockers. In the second-line setting, the 2013 ESC guidelines recommend the addition of long-acting nitrates, ivabradine, nicorandil or ranolazine to first-line agents. Trimetazidine may also be considered. However, no clear distinction is made among different second-line drugs, despite different quality of evidence in favour of these agents. For example, the use of ranolazine is supported by strong and recent evidence, while data supporting the use of the traditional agents appear relatively scanty. PMID:27222385

  18. 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

  19. Case of angina pectoris at rest and during effort due to coronary spasm and myocardial bridging

    OpenAIRE

    Teragawa, Hiroki; Fujii, Yuichi; Ueda, Tomohiro; Murata, Daiki; Nomura, Shuichi

    2015-01-01

    We present a case of a 71-year-old male who had chest 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,...

  20. Incidentally detected diaphragmatic hernia mimicking angina pectoris with Tc-99m MIBI myocardial perfusion imaging

    International Nuclear Information System (INIS)

    In recent years 99mTechnetium methoxy-isobutyl-isonitrile (99mTc MIBI) is widely used in the evaluation of myocardial perfusion imaging (MPI). In this imaging protocol besides the cardiac evaluation, numerous other organs are included in the field of view. 99mTechnetium MIBI is taken up in all metabolically active tissue in the body except for the brain. Extracardiac uptake patterns as benign or serious conditions can be revealed during the MPI. In the imaging protocol, we should be aware of distribution of this radiotracer in order to recognize the abnormal uptake. Here in, we present a large diaphragmatic hernia, seemed as a mirror vision of myocardium that was determined incidentally during the MPI with 99mTc MIBI

  1. Incidentally detected diaphragmatic hernia mimicking angina pectoris with Tc-99m MIBI myocardial perfusion imaging

    Science.gov (United States)

    Cınar, Alev; Sadıc, Murat; Demırel, Koray; Korkmaz, Meliha

    2013-01-01

    In recent years 99mTechnetium methoxy-isobutyl-isonitrile (99mTc MIBI) is widely used in the evaluation of myocardial perfusion imaging (MPI). In this imaging protocol besides the cardiac evaluation, numerous other organs are included in the field of view. 99mTechnetium MIBI is taken up in all metabolically active tissue in the body except for the brain. Extracardiac uptake patterns as benign or serious conditions can be revealed during the MPI. In the imaging protocol, we should be aware of distribution of this radiotracer in order to recognize the abnormal uptake. Here in, we present a large diaphragmatic hernia, seemed as a mirror vision of myocardium that was determined incidentally during the MPI with 99mTc MIBI. PMID:24379540

  2. Incidentally detected diaphragmatic hernia mimicking angina pectoris with Tc-99m MIBI myocardial perfusion imaging

    OpenAIRE

    Cınar, Alev; Sadıc, Murat; Demırel, Koray; Korkmaz, Meliha

    2013-01-01

    In recent years 99mTechnetium methoxy-isobutyl-isonitrile (99mTc MIBI) is widely used in the evaluation of myocardial perfusion imaging (MPI). In this imaging protocol besides the cardiac evaluation, numerous other organs are included in the field of view. 99mTechnetium MIBI is taken up in all metabolically active tissue in the body except for the brain. Extracardiac uptake patterns as benign or serious conditions can be revealed during the MPI. In the imaging protocol, we should be aware of ...

  3. Microcirculatory effects of hemosorption in patients with stable angina pectoris: radioindication data

    International Nuclear Information System (INIS)

    The impact of hemosorption on microhemo- and lumphocirculation, reserve microcirculatory bed potenstials, and capillary permeability was examined by using radionuclide techniques in 46 patients with coronary heart disease refractory to drug antianginal therapy. Hemosorption was found to yield a beneficial clinical effect in 47.8 % of the patients, resulting in a substantial increase in microcirculation and its reserves and a decrease in microvascular resistance both at rest and in reactive postischemic hyperemia

  4. A Case of a Senile Systemic Amyloidosis Patient Presenting With Angina Pectoris and Dilated Cardiomyopathy

    OpenAIRE

    Kang, Gu Hyun; Ryu, Dong Ryeol; Song, Pil Sang; Song, Young Bin; Hahn, Joo-Yong; Choi, Seung-Hyuck; Gwon, Hyeon-Cheol

    2011-01-01

    A 77-year-old man visited our hospital complaining of aggravated exertional chest pain. He was diagnosed with syndrome X 7 years ago and underwent medical treatment in a regional hospital. Coronary angiography and echocardiography did not show any significant abnormalities. On the seventh in-hospital day, cardiogenic shock developed and echocardiography showed a dilated left ventricular (LV) cavity and severe LV systolic dysfunction. We thus inserted an intra-aortic balloon pump for hemodynam...

  5. 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

    assessment in Eastern Denmark are invited to join the study according to in- and exclusion criteria. Assessment includes demographic, clinical and psychosocial data, symptoms, electrocardiogram, blood- and urine samples and transthoracic echocardiography during rest and dipyridamol stress with measurement of......, advanced echocardiographic modalities at rest and during stress, and invasive measures of CFR and coronary vascular reactivity. The study will include 2000 women who will be followed for 5 years for cardiovascular outcomes. RESULTS: By May 2013, 1685 women have been screened, 759 eligible patients...... assessment. The study will provide information on methods to diagnose CMD and determine the prognostic value of routine non-invasive assessment of microvascular function. Future study will provide women identified with CMD participation in interventional substudies designed to test treatment strategies....

  6. Medications for Angina (Beyond the Basics)

    Science.gov (United States)

    ... of medications used to treat stable angina: ● Nitrates ● Beta blockers ● Calcium channel blockers ● Ranolazine Nitrates or beta blockers are usually preferred for initial treatment of angina, ...

  7. 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 ... please enable JavaScript. Coronary artery disease - living with Heart Disease and Angina Coronary heart disease (CHD) is a ...

  8. 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. PMID:5761833

  9. 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.

  10. [Exercise tolerance in angina patients 3 and 24 hours after administration of a new delayed-action preparation of metoprolol].

    Science.gov (United States)

    Giusti, C; Verdecchia, P; Pentimone, F; Regoli, F; Cordoni, M; Bongini, A M

    1981-01-01

    To assess the duration of improved exercise tolerance by metoprolol given in a new sustained-release formulation, 40 in-patients affected by stable exercise-induced angina pectoris received single-blind placebo in day 1 and thereafter, in double-blind cross-over once daily administration, metoprolol RETARD 100 mg and 200 mg in days 3 and 5. Symptom-limited cycloergometric exercise tests were performed at 3 and 24 hours after placebo and after each of the two doses of metoprolol RETARD. Duration of exercise, maximal workload and total work performed did significantly increase at 3 and 24 hours after metoprolol RETARD 100 mg (P less than 0.01) and 200 mg (P less than 0.01), without any significant difference between the two doses. Peak systolic arterial pressure and heart rate were lowered by metoprolol RETARD 200 mg at 3 (P less than 0.01) and 24 (P less than 0.01) hours, whereas only the peak heart rate at 3 hours was lowered (P less than 0.05) by the 100 mg dose. It is concluded that in patients with stable exercise-induced angina pectoris, metoprolol RETARD 200 mg appears to be able to increase exercise tolerance and to reduce exercise-induced myocardial oxygen consumption throughout 24 hours period. This may justify a once daily dosing schedule of the 200 mg dose, aimed at improving patient compliance. PMID:7343379

  11. STUDY OF VARIABLES IN UNSTABLE ANGINA

    OpenAIRE

    Vijay Kumar; Kashinath B; Sajjal; Shivraj B; Thirumala

    2014-01-01

    OBJECTIVES: Prevalence rates of coronary artery disease are reported to be very high in Asian Indians. Traditional risk factors alone fail to explain the high rates of coronary disease in Indians. Acute phase reactants C-reactive protein in Indian subjects with unstable angina were evaluated and compare them with suitable control to test the hypothesis that a relationship exists between acute phase reactants and unstable angina. METHODOLOGY: 50 cases unstable angina and 50...

  12. Angina

    Science.gov (United States)

    ... eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 71. Lange RA, Hillis LD. ... eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 72. Marrow DA, Boden WE. ...

  13. Factors Associated with the Types of Heparin used in the Treatment of Unstable Angina at a Brazilian Hospital

    Directory of Open Access Journals (Sweden)

    Maria Auxiliadora Parreiras Martins

    2010-06-01

    Full Text Available

    Unfractionated heparin (UFH and low-molecularweight heparins (LMWHs are widely used in curative and preventive treatments of thromboembolic disorders. The aim of the study was to investigate factors associated with the choice of these types of heparin to treat patients with unstable angina under real conditions of hospital use. A cross-sectional study was performed in a private general hospital in Belo Horizonte, Brazil, from January 1st to December 31th, 2001. Data were collected from the hospital electronic database. Inpatients with angina who received enoxaparin or UFH were included in the survey. Data for 555 patients were recorded, including 401 treated with enoxaparin and 154 with UFH. Univariate analysis showed that male and elderly people predominated in both groups, with no statistical difference in the proportions (p>0.05. Multivariate analysis showed 4 factors associated with the use of enoxaparin: cardiac revascularization surgery (OR=0.434, arrhythmias (OR=9.343, risk factors for coronary artery disease (OR=1.333 and private health insurance (OR=0.297. Thus, clinical and organizational factors were associated with the type of heparin used by patients with unstable angina at this hospital. Further drug utilization studies are necessary to expand and improve the data available on the use of heparins in the hospital setting. Keywords: Hospital pharmacy/assessment. Angina pectoris/treatment. Heparin/prescription. Enoxaparin/prescription. RESUMO Fatores associados com os tipos de heparina usados no tratamento da angina instável em um hospital brasileiro A heparina não-fracionada (HNF e heparinas de baixo peso molecular (HBPM são amplamente utilizadas em tratamentos curativos e preventivos de tromboembolismo. O objetivo do estudo foi investigar os fatores associados com a escolha desses tipos de heparinas para tratar pacientes com angina instável sob as condições reais de uso hospitalar. Trata-se de um estudo

  14. 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

  15. Angina - what to ask your doctor

    Science.gov (United States)

    ... Below are some questions you may want to ask your health care provider to help you take ... What to ask your doctor about angina and heart disease; Coronary artery disease - what to ask your doctor

  16. Therapy for Stable Angina in Women

    OpenAIRE

    Sarbaziha, Raheleh; Sedlak, Tara; Shufelt, Chrisandra; Mehta, Puja K.; Merz, C. Noel Bairey

    2012-01-01

    Mortality rates for cardiovascular disease are higher in women than in men, but studies of women have been conducted less frequently. Current pharmacological and nonpharmacological treatment options for women with stable angina are reviewed.

  17. STUDY OF VARIABLES IN UNSTABLE ANGINA

    Directory of Open Access Journals (Sweden)

    Vijay Kumar

    2014-08-01

    Full Text Available OBJECTIVES: Prevalence rates of coronary artery disease are reported to be very high in Asian Indians. Traditional risk factors alone fail to explain the high rates of coronary disease in Indians. Acute phase reactants C-reactive protein in Indian subjects with unstable angina were evaluated and compare them with suitable control to test the hypothesis that a relationship exists between acute phase reactants and unstable angina. METHODOLOGY: 50 cases unstable angina and 50 suitable cases enrolled for the study. Unstable angina had significantly increased level of CRP compare to control group (p=0.01098.RESULTS: Statistically significant difference was found between case and control group in TLC (p=0.0037 and ESR (p=0.0368, TLC and ESR being more in case group as compare to control group. C- reactive protein was significantly correlated with TLC and ESR in case group and TLC and ESR in control group. C reactive protein, TLC and ESR in case group while no correlation was observed with any variable in control group. CONCLUSION: The present study concludes that a relationship exists between acute phase reactant studied and unstable angina

  18. Sequelae of spinal cord stimulation for refractory angina pectoris. Reliability and safety profile of long-term clinical application

    NARCIS (Netherlands)

    Jessurun, GAJ; TenVaarwerk, IAM; DeJongste, MJL; Tio, RA; Staal, MJ

    1997-01-01

    Background Spinal cord stimulation (SCS) is effective in the treatment of severe coronary artery disease (CAD) unresponsive to anti-anginal medication or revascularization procedures. However, there is still concern about its safety, Objective To investigate the reliability, morbidity, and mortality

  19. Hospital utilization and costs for spinal cord stimulation compared with enhanced external counterpulsation for refractory angina pectoris

    DEFF Research Database (Denmark)

    Bondesson, Susanne M; Jakobsson, Ulf; Edvinsson, Lars;

    2013-01-01

    .001). Both SCS and EECP entailed fewer days of hospitalization for coronary artery disease in the 12-month follow-up compared with the 12 months preceding treatment. Patients treated with EECP showed an association between reduced hospital admissions and an improved Canadian Cardiovascular Society...... classification class compared with 1 year before treatment. A significant reduction in cost was seen in both the SCS group (P = 0.018 and P = 0.001, respectively) and the EECP group (P = 0.002 and P = 0.045, respectively) during 12 and 24 months of follow-up compared with before treatment. There were...

  20. Einfluss der perkutanen koronaren Intervention (PCI) auf das Ergebnis der elektiven chirurgischen Koronarrevaskularisation bei stabiler Angina pectoris

    OpenAIRE

    Müller, Erik

    2015-01-01

    Erkrankungen der Herzkranzgefäße sind die häufigste Todesursache in den Industrieländern. Chirurgische und interventionelle Verfahren spielen eine wichtige Rolle in ihrer Behandlung. Die Anzahl perkutaner koronarer Interventionen (PCI) nimmt seit ihrer Einführung stetig zu. Bislang ist unklar, welchen Einfluss diese Entwicklung auf das Ergebnis einer späteren chirurgischen Revaskularisierung hat. Für die vorliegende Arbeit wurden 815 Patienten untersucht, die sich im Jahr 2008 am Herzzentr...

  1. 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...

  2. 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.

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

    OpenAIRE

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

    2015-01-01

    Based on several studies, including ours, we estimate that 40–70 million individuals carry a chromosomally integrated copy of the human herpesvirus 6 (HHV-6) genome in every cell of their body. This condition is referred to as inherited chromosomally integrated HHV-6 (iciHHV-6). The regions targeted for integration are telomeres, which play important roles in the self-renewal capacity of cells. Whether iciHHV-6 is associated with disease remains unknown. After conducting a population screen (...

  4. CLINICAL EFFECT OF TESTOSTERONE IN MEN WITH STABLE ANGINA

    OpenAIRE

    A. Ya. Kravchenko; V. M. Provotorov

    2016-01-01

    Aim. To study efficacy of testosterone undecanoate (TU) therapy in men with stable angina and androgen deficiency.Material and methods. The serum testosterone level was detected in 247 men (aged 51,6±1,8 y.o.) with stable effort angina. 60 patients with androgen deficiency additionally to basic angina therapy received TU (120-160 mg daily). 54 patients with androgen deficiency (control group) received only basic angina therapy. Dynamics of clinical and ECG manifestations of myocardial ischemi...

  5. Utility of ranolazine in chronic stable angina patients

    OpenAIRE

    Patel, Pawan D; Arora, Rohit R

    2008-01-01

    Pawan D Patel, Rohit R AroraDepartment of Cardiology, Chicago Medical School, North Chicago, IL, USAAbstract: Chronic stable angina is a debilitating illness affecting at least 6.6 million US residents. Despite being optimally treated by pharmacotherapy and revascularization up to 26% of patients still experience angina. Diabetes mellitus is a common co-morbid condition in angina patients. Several new investigational medications are being tested for chronic angina. Advances in understanding o...

  6. Clinical Practice Guidelines for Unstable Angina Treatment.

    OpenAIRE

    Juan José Navarro López; Claudio Manuel González Rodríguez

    2009-01-01

    Clinical Practice Guidelines for Unstable Angina Treatment. It has been defined as the oppressive pain or uneasiness mainly thoracic, which is caused by a transitory myocardial ischemia. This document includes important aspects as classification, diagnosis, treatment (aimed at its principal strategies) and risk stratification. It includes assessment guidelines focused on the most important aspects to be accomplished.

  7. 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.

  8. Angina - Multiple Languages: MedlinePlus

    Science.gov (United States)

    ... Chinese - Simplified (简体中文) Chinese - Traditional (繁體中文) French (français) Hindi (हिन्दी) Japanese (日本語) Korean (한국어) Portuguese (português) ... poitrine - français (French) Bilingual PDF Health Information Translations Hindi (हिन्दी) Angina हिन्दी (Hindi) Bilingual PDF ...

  9. Utility of ranolazine in chronic stable angina patients

    Directory of Open Access Journals (Sweden)

    Pawan D Patel

    2008-08-01

    Full Text Available Pawan D Patel, Rohit R AroraDepartment of Cardiology, Chicago Medical School, North Chicago, IL, USAAbstract: Chronic stable angina is a debilitating illness affecting at least 6.6 million US residents. Despite being optimally treated by pharmacotherapy and revascularization up to 26% of patients still experience angina. Diabetes mellitus is a common co-morbid condition in angina patients. Several new investigational medications are being tested for chronic angina. Advances in understanding of myocardial ischemia have prompted evaluation of a number of new antianginal strategies. In this review we discuss the utility of ranolazine, a recently approved novel antianginal agent and its efficacy in the diabetic patient population. In addition to its antianginal action in diabetic patients with chronic angina, ranolazine may have favorable effects on glycated hemoglobin levels.Keywords: chronic stable angina, antianginal, ranolazine, diabetes mellitus, glycated hemoglobin

  10. The economic burden of angina on households in South Asia

    OpenAIRE

    Alam, Khurshid; Mahal, Ajay

    2014-01-01

    Background Globally, an estimated 54 million people have angina, 16 million of whom are from the WHO South-East Asia region. Despite the increasing burden of cardiovascular disease (CVD) in South Asia, there is no evidence of an economic burden of angina on households in this region. We investigated the economic burden of angina on households in South Asia. Methods We applied a novel propensity score matching approach to assess the economic burden of angina on household out-of-pocket (OOP) he...

  11. CHANGES OF CELLULAR ADHESION MOLECULES AND COMPLEMENT COMPONENT IN SERUM OF PATIENTS WITH UNSTABLE ANGINA%不稳定型心绞痛病人sCAMS与sC5b-9的变化

    Institute of Scientific and Technical Information of China (English)

    王立杰; 王红巧

    2011-01-01

    目的 探讨不稳定型心绞痛(UA)病人可溶性细胞黏附分子(sCAMS)与可溶性补体激活产物(sC5b-9)水平的变化及其意义.方法 采用ELISA方法 检测36例健康人和110例UA病人血清sCAMS、sC5b-9浓度的变化.结果 UA病人血清可溶性细胞间黏附分子-1(sICAM-1)、可溶性血管细胞间黏附分子-1(sVCAM-1)、sC5b-9浓度明显高于对照组,差异有极显著性(t=4.485~37.314,P<0.001);心绞痛发作时sICAM-1、sVCAM-1、sC5b-9的浓度增高较缓解后更明显(t=5.764~30.638,P<0.001);不同类型的心绞痛病人发作时和缓解后sICAM-1、sVCAM-1、sC5b-9浓度差异也有显著性(F=12.074~709.477,q=3.340~52.308,P<0.05~0.001);自发性心绞痛病人sCAMS、sC5b-9浓度增高较其他类型更明显.心绞痛发作时和缓解后,血清sC5b-9与sICAM-1、sVCAM-1浓度呈正相关(r=0.530~0.703,P<0.001).结论 UA的发生发展与CAMS和sC5b-9浓度变化有密切关系.%Objective To discuss the significance of changes of the levels of soluble cellular adhesion molecules (sCAMS) and complement activation component (sC5b-9) in patients with unstable angina (UA). Methods Using enzyme-linked immu-nosorbent assay (ELISA) , changes of serum levels of sCAMS and sC5b-9 were detected in 110 UA patients and 36 healthy people. Results Levels of soluble intercellular adhesion moleeule-1 (sICAM-1), soluble vascular cellular adhesion molecule-1 (sVCAM-1) and sC5b-9 in UA patients were significantly higher than that in healthy controls (t=4. 485 - 37. 314,P<0. 001) ; At angina pecto-ris attacks, the elevation of levels of sICAM-1, sVCAM-1 and sC5b-9 were more significant than after remission (2 = 5. 764 - 30. 638,P<0. 001). The differences of the above parameters in different type of patients at angina pectoris attacks and at remission were also significant (F=12. 074-709. 477;q=3. 340 - 52. 308;P<0. 05 - 0. 001), especially in those with spontaneous angina pectoris. The level of sC5b-9 was positively

  12. 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.

  13. 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.

  14. Angina de pecho con arterias angiográficamente normales: características epidemiológicas y clínicas

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    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

  15. Mediastinite descendente necrosante pós-angina de Ludwig Necrotizing descending mediastinitis afetr Ludwig angina

    Directory of Open Access Journals (Sweden)

    MARICÉLIA BROMMELSTROET

    2001-09-01

    Full Text Available A angina de Ludwig é uma infecção do espaço submandibular originada, em geral, da infecção do 2º ou 3º molar inferior. Como conseqüência, pode causar mediastinite descendente necrosante, que representa uma forma grave e rara de infecção mediastinal, a qual exige diagnóstico precoce e tratamento cirúrgico para reduzir a alta mortalidade associada a esta doença. Dois casos de mediastinite descendente necrosante pós-angina de Ludwig foram tratados com excelentes resultados em nosso hospital. A drenagem mediastinal transcervical está justificada em pacientes com doença limitada ao mediastino superior. Porém, sepse com comprometimento extenso do mediastino requer drenagem através de toracotomia sem demora.Ludwig's angina is an infection of the submandibular space generally caused by an infection of the 2nd or 3rd lower molar. As a consequence, descending necrotizing mediastinitis, a rare and severe form of mediastinal infection, may occur. The descending necrotizing mediastinitis represents a rare form of mediastinal infection. It presents a high mortality and to decrease that rate it is necessary prompt diagnosis and surgical treatment. Two cases of descending necrotizing mediastinitis due to Ludwig's angina were treated with excellent results in our hospital. The transcervical mediastinal drainage is justified in patients with disease limited to the upper mediastinum. Even so, when there is extensive involvement of the whole mediastinum it is suitable the accomplishment of a wide thoracotomy.

  16. 1例不稳定型心绞痛患者的药学监护%Pharmaceutical care on a patient with instable angina

    Institute of Scientific and Technical Information of China (English)

    赵维娟; 王金萍; 刘静; 许景峰

    2011-01-01

    One 78-year-old woman with instable angina, hypertension and type Ⅱ diabetes was hospitalized for acute coronary syndrome and received the therapy of distending the coronary artery, anti-platelet, lowering hypertension, etc. Three days later, the patient was treated with the therapy of PCI, and then the situation was stable. Considering the oral nitroglycerin having no effect on the patient, and the hypertension didn't control very well, the hypertension related gene (HRG) was detected. The results showed that the gene type of ALDH was WM (GA) (low activity). Therefore, the pharmacist advised that nitroglycerin should be withdrawn in acute angina pectoris situation because of low sensitivity. Suxiaojiuxinwan could be administrated against angina pectoris attacks.Basing on the low activity of β receptor blocker' s metabolic enzyme, ACE inhibitor (ACEI) and AT1 acceptor blockers (ARBs)could be chosen. The blood pressure and blood glucose were stable and the state was improved markedly according to the rational optimization based on the gene test.%1例78岁女性患者,因不稳定型心绞痛入院治疗,入院时合并有高血压病和2型糖尿病.给予扩张冠状动脉、抗血小板、降压等治疗,并于入院第3天行经皮冠状动脉介入治疗,术后患者情况稳定.针对患者心绞痛发病时舌下含服硝酸甘油症状不能缓解,高血压药物控制血压效果不佳,行乙醛脱氢酶(ALDH)和高血压药物相关基因检测,作为选用和调整药物依据.患者ALDH为WM(GA)型(低活性),其含服硝酸甘油效果差,不能作为急性心绞痛的治疗药,必要时含服速效救心丸;高血压药物相关基因检测显示,患者对β受体阻滞剂的代谢酶活性低,对ACE抑制剂(ACEI)和AT1受体阻断药(ARBs)敏感,可根据具体情况加以选择.经合理优化治疗方案,患者血压及血糖控制稳定,病情好转出院.

  17. Angina bullosa hemorrhagica: report of 11 cases

    Directory of Open Access Journals (Sweden)

    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.

  18. Hospital admissions of hypertension, angina, myocardial infarction and ischemic heart disease peaked at physiologically equivalent temperature 0°C in Germany in 2009-2011.

    Science.gov (United States)

    Shiue, Ivy; Perkins, David R; Bearman, Nick

    2016-01-01

    We aimed to understand and to provide evidence on relationships of the weather as biometeorological and hospital admissions due to hypertension, angina, myocardial infarction and ischemic heart disease in a national setting in recent years that might help indicate when to expect more admissions for health professionals and the general public. This is an ecological study. Ten percent of daily hospital admissions from the included hospitals (n = 1618) across Germany that were available between 1 January 2009 and 31 December 2011 (n = 5,235,600) were extracted from Statistisches Bundesamt, Germany. We identified I11 hypertensive heart disease, I13 hypertensive heart and renal disease, I15 secondary hypertension, I20 angina pectoris, I21 acute myocardial infarction and I25 chronic ischemic heart disease by International Classification of Diseases version 10 as the study outcomes. Daily weather data from 64 weather stations that covered 13 German States including air temperature, humidity, wind speed, cloud cover, radiation flux and vapour pressure were obtained and generated into physiologically equivalent temperature (PET). Two-way fractional-polynomial prediction was plotted with 95% confidence intervals. Hospital admissions of hypertension, angina, myocardial infarction, heart disease peaked in winter and early spring when PETs were around 0°C. Admissions had an apparent drop when PETs reached 10°C. More medical resources could have been needed on days when PETs were around 0°C than on other days. While adaptation to such weather change for health professionals and the general public would seem to be imperative, future research with a longitudinal monitoring would still be needed. PMID:26286805

  19. Emerging clinical role of ranolazine in the management of angina

    OpenAIRE

    Vadnais, David S; Wenger, Nanette K.

    2010-01-01

    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 loadi...

  20. CLINICAL EFFECT OF TESTOSTERONE IN MEN WITH STABLE ANGINA

    Directory of Open Access Journals (Sweden)

    A. Ya. Kravchenko

    2016-01-01

    Full Text Available Aim. To study efficacy of testosterone undecanoate (TU therapy in men with stable angina and androgen deficiency.Material and methods. The serum testosterone level was detected in 247 men (aged 51,6±1,8 y.o. with stable effort angina. 60 patients with androgen deficiency additionally to basic angina therapy received TU (120-160 mg daily. 54 patients with androgen deficiency (control group received only basic angina therapy. Dynamics of clinical and ECG manifestations of myocardial ischemia and quality of life (QOL parameters was studied.Results. Androgen deficiency is revealed in 114 (46,2% of patients. Therapy with TU during 3 months resulted in reduction of angina attacks and extent of myocardial ischemia (according to Holter ECG monitoring and stress test as well as QOL improvement.Conclusion. Androgen deficiency is observed in 46,2% of men with stable angina. TU increases of antianginal therapy efficacy, improves QOL and is well tolerated. 

  1. Ranolazine Reduces Patient-Reported Angina Severity and Frequency and Improves Quality of Life in Selected Patients with Chronic Angina

    OpenAIRE

    Muhlestein, Joseph B.; Grehan, Sharon

    2013-01-01

    Background Chronic stable angina negatively affects quality of life (QoL). American College of Cardiology/American Heart Association guidelines highlight maintaining/restoring a level of activity, functional capacity, and QoL that is satisfactory to the patient as an objective of treatment, and further define the treatment goal for most patients as maximizing survival and achieving prompt and complete (or near-complete) elimination of angina with a return to normal activities. Objective To as...

  2. Practical value of cardiac magnetic resonance imaging in unstable angina diagnosis%心脏核磁共振在不稳定型心绞痛诊治中的应用价值

    Institute of Scientific and Technical Information of China (English)

    唐新宇; 欧阳容

    2012-01-01

    Objective To investigate the value of magnetic resonance imaging of heart in diagnosis of unstable angina pectoris.Methods A total of 24 patients with unstable angina pectoris including 15 male and 9 female confirmed by coronary angiography (CAG) were enrolled.All 24 patients were scanned by cardiac magnetic resonance imaging ( CMR),and then the analyses of the first pass images and the delayed contrast enhancement images were carried out for comparison.The findings of cardiac structure,cardiac function,myocardial ischemia,myocardial necrosis,myocardial edema were taken for answering to the images made by echocardiography (UCG) and coronary angiography (CAG) linked with conventional examinations for the diagnosis of coronary disease.Results Compared with the UCG,CMR provided more detailed information about the right ventricle,and the information about left ventricular structure and function given by UCG was very good consistent with that offered by CMR,and CMR could detect myocardial ischemia,myocardial edema and the myocardial necrosis,which were of good consistency with findings often observed by conventional inspection methods.Conclusions Cardiac magnetic resonance imaging (CMR) is of high value in diagnosis and evaluation of unstable angina pectoris and is far superior over other conventional methods for examinations of unstable angina pectoris.%目的 研究心脏核磁共振在不稳定型心绞痛诊治中的价值.方法 选择确诊不稳定性心绞痛患者24例,其中男性15例,女性9例,均行冠脉造影.对24例患者进行心脏核磁共振(CMR)扫描,对图像进行首过灌注和延迟扫描分析(LEG),记录其在心脏结构、功能、心肌缺血、坏死、水肿等方面的信息,并使之与超声心动图(UCG)、冠脉造影(CAG)等传统检查结果对比.结果 CMR与UCG相比,可以提供更多右心室方面的信息.在左心室结构及功能方面,两者有很好的一致性;CMR能发现并检测心肌缺血、水肿及坏死,

  3. Functional Role of Dendritic Cells in Patients with Unstable Angina

    Institute of Scientific and Technical Information of China (English)

    LI Dazhu; Sharma Ranjit; ZENG Qiutang

    2005-01-01

    To investigate the function of dendritic cells (DC) in patients with unstable angina, 10 mL of blood was drawn from 30 subjects. 15 patients diagnosed as having unstable angina and 15 healthy subjects were included in an observation and a control groups respectively. The mononuclear cells were separated from the peripheral blood and cultured in RPMI1640 supplemented with recombinant human granulocyte/macrophage-colony stimulating factor (rh GM-CSF) and recombinant human interleukin-4 (rh IL-4) to induce dendritic cells. The shape and ultrastructure of DC was examined with electronic microscope. The phenotype of DC was analyzed with FACS and the alloantigen presenting capacity of DC was evaluated by mixed lymphocyte reaction (MLR). The expression rate of CD86 of DC in patients with unstable angina was (40.7±3.6) %, which was obviously higher than that of normal DC (29.6±2.5 %) (P<0.001). The capacity of the DCs in unstable angina patients to induce allogenic T cells (OD 2.73±1.10), was significantly higher than that of the normal DC (OD:0.9±0.21) (P<0.005). It is suggested that the function of DC in patients with unstable angina is increased, which may play an important role in the initiation of immune reaction in the plaque.

  4. 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 < 0.05) as compared with the patients with new-onset angina (11%). Complex coronary morphology was statistically more likely to be found in crescendo angina. The angiographic evidence of intracoronary thrombi was found in 33% (P < 0.05) patients with 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 < 0.05) lower in 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) PMID:7785791

  5. Circulating fibrocytes as predictors of adverse events in unstable angina.

    Science.gov (United States)

    Keeley, Ellen C; Schutt, Robert C; Marinescu, Mark A; Burdick, Marie D; Strieter, Robert M; Mehrad, Borna

    2016-06-01

    Half of the patients who present with unstable angina (UA) develop recurrent symptoms over the subsequent year. Identification of patients destined to develop such adverse events would be clinically valuable, but current tools do not allow for this discrimination. Fibrocytes are bone marrow-derived progenitor cells that co-express markers of leukocytes and fibroblasts and are released into the circulation in the context of tissue injury. We hypothesized that, in patients with UA, the number of circulating fibrocytes predicts subsequent adverse events. We enrolled 55 subjects with UA, 18 with chronic stable angina, and 22 controls and correlated their concentration of circulating fibrocytes to clinical events (recurrent angina, myocardial infarction, revascularization, or death) over the subsequent year. Subjects with UA had a >2-fold higher median concentration of both total and activated fibrocytes compared with subjects with chronic stable angina and controls. In UA subjects, the concentration of total fibrocytes identified those who developed recurrent angina requiring revascularization (time-dependent area under the curve 0.85) and was superior to risk stratification using thrombolysis in myocardial infarction risk score and N-terminal pro B-type natriuretic peptide levels (area under the curve, 0.53 and 0.56, respectively, P fibrocyte level was associated with recurrent angina (hazard ratio, 1.016 per 10,000 cells/mL increase; 95% confidence interval, 1.007-1.024; P fibrocytes are elevated in patients with UA and successfully risk stratify them for adverse clinical outcomes. Fibrocytes may represent a novel biomarker of outcome in this population. PMID:27012475

  6. Significance of Tc-99m pyrophosphate accumulation in unstable angina

    International Nuclear Information System (INIS)

    Tc-99m pyrophosphate (PYP) and Tl-201 simultaneous dual energy single photon emission computed tomography (SPECT) were performed in 33 patients with clinically unstable angina. According to the presence or absence of PYP accumulation in the myocardium, the patients were classified as PYP (+) group (n=22) and PYP (-) group (n=11). Clinical features, types of unstable angina, ECG changes, and serial creatine kinase (CK) data were compared in the two groups. The 'new angina at rest' type of unstable angina was more significantly common in the PYP (+) group (16/22) than the PYP (-) group (2/11). The remaining 6 patients in the PYP (+) group and 2 patients in the PYP (-) group had 'angina of effort with changing pattern'. There was a significant difference in the occurrence of ST elevation and ST depression between the group: 59% in the PYP (+) group vs. 18% in the PYP (-) group for ST elevation and 23% in the PYP (+) group vs. 64% in the PYP (-) group for ST depression. The PYP (+) group showed significant improvement in ejection fraction in the stable state (57±12%) as compared with the unstable state (62±11%), although there was no difference between the stable and unstable state in the PYP (-) group. Although wall motion abnormality index (WMI) was poorer in the PYP (+) group than the PYP (-) group, it improved to the same degree as the PYP (-) group one month later. These data suggest that the area showing PYP (+) may reflect stunned myocardium and that Tc-99m PYP accumulation may correlate with clinical features of unstable angina. (N.K.)

  7. 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)

  8. Assessment of myocardial fatty acid metabolism in patients with angina pectoris and diabetes mellitus using 123I-BMIPP myocardial scintigraphy

    International Nuclear Information System (INIS)

    We studied the effect of myocardial ischemia and diabetes mellitus (DM) on the myocardial fatty acid metabolism using 123I-BMIPP myocardial scintigraphy. We performed 123I-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 123I-BMIPP was obtained using the time activity curve. Myocardial washout rate of 123I-BMIPP was calculated using the polar images of early and delayed SPECT images. Myocardial uptake rate of 123I-BMIPP (%) were AP: 4.9±0.6, AP+DM: 5.5±0.5, DM 5.7±0.5 and N: 5.0±0.4. 123I-BMIPP myocardial uptake rate was increased in AP+DM and DM. 123I-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. 123I-BMIPP myocardial washout rate was increased in AP and AP+DM. 123I-BMIPP myocardial washout rate was increased particularly in patients with multi-vessels disease. 123I-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)

  9. Effect of statins on the serum soluble form of receptor for advanced glycation end-products and its association with coronary atherosclerosis in patients with angina pectoris

    OpenAIRE

    Tsuyoshi Nozue; Sho-ichi Yamagishi; Masayoshi Takeuchi; Tsutomu Hirano; Shingo Yamamoto; Shinichi Tohyama; Kazuki Fukui; Shigeo Umezawa; Yuko Onishi; Tomoyuki Kunishima; Kiyoshi Hibi; Mitsuyasu Terashima; Ichiro Michishita

    2014-01-01

    Background: Advanced glycation end-products (AGEs) and their receptor (RAGE) play an important role in the pathogenesis of diabetic vascular complications. Recently, soluble form of RAGE (sRAGE) has been identified in mice and humans. Statins have been reported to increase serum sRAGE levels. However, whether modulation of circulating sRAGE levels has a beneficial effect on the progression of atherosclerosis is unknown. Methods: We reviewed 91 patients who had undergone percutaneous corona...

  10. [The diagnostic value of delta-R and delta-Q as positive criteria of the ergometry test in a group of patients with angina pectoris of effort].

    Science.gov (United States)

    Doria, G; Cangemi, F; Gulizia, M; Cuocina, N; Tosto, A; Circo, A

    1989-11-01

    ECG-exercise tests were performed in 29 patients affected by effort chest pain. All patients underwent coronary angiography and/or revealed positive results in the cycloergometer effort test. The aim of the study was to evaluate ultrasonic variations in the R and Q waves due to maximal effort, so as to increase the information provided by the effort ECG. In the coronary angiographic test, 21 out of 29 patients revealed significant hemodynamic coronary stenosis; 10 patients were affected by previous myocardial necrosis; 8 patients showed no hemodynamic coronary lesions (OV). In the OV patients a statistically significant increase was observed in the Q wave at maximal effort in comparison with average basal values; on the other hand, there was a decrease, although not significant, in voltage at peak effort in patients with coronary stenosis. R wave amplitude was smaller in comparison to basal values in OV patients, while a significant increase was observed in the 21 patients with coronary lesions. PMID:2622535

  11. 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; Keller, N; Jespersen, J

    2000-01-01

    angiographically verified coronary atherosclerosis. They were served a low-fat (5% of energy from fat) breakfast and lunch and a high-fat (40% of energy from fat) breakfast and lunch on 2 different days. Venous blood samples were collected at 8:15 AM (fasting), 12:30 PM, 2:00 PM, 3:30 PM, and 4:45 PM and analyzed...

  12. 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; Hansen, Peter R; Prescott, Eva

    2014-01-01

    -specific interaction (P = 0.18). In a conditional logistic regression model, we found no dose-response relationship between CTFC and the risk of MACE, i.e., compared to the risk in the lowest CTFC quintile, the odds ratios for MACE were 1.3 (0.7-2.6), 0.7 (0.3-1.3), 0.7 (0.4-1.5) and 1.0 (0.5-2.1) in the second, third......, fourth and fifth CTFC quintiles, respectively. Adjustment for cardiac risk factors including diabetes, active smoking, body mass index, and use of lipid-lowering and antihypertensive medication did not significantly change the results. CONCLUSIONS: In patients with SAP symptoms without obstructive CAD at...

  13. Use of comparative effectiveness research for similar Chinese patent medicine for angina pectoris of coronary heart disease: a new approach based on patient-important outcomes

    OpenAIRE

    Cao, Hongbo; Zhai, Jingbo; Mu, Wei; Lei, Xiang; Cao, Hongxia; Liu, Chunxiang; Shang, Hongcai

    2014-01-01

    Background The practice of traditional Chinese medicine (TCM) has a profound history in many Asian countries. TCM syndrome is a set of characteristic physical signs and symptoms shared by a group of patients. Syndrome diagnosis and treatment assignment according to the identified TCM syndrome is a long-held practice of Chinese medicine. Owing to its distinctive way of interpreting illness and administering care, medical practitioners not well educated in TCM theories and practices are general...

  14. Capecitabine cardiac toxicity presenting as effort angina: a case report.

    Science.gov (United States)

    Lestuzzi, Chiara; Crivellari, Diana; Rigo, Fausto; Viel, Elda; Meneguzzo, Nereo

    2010-09-01

    We report a case of capecitabine-induced cardiotoxicity (effort angina) in a woman with metastatic breast carcinoma. Due to cancer progression, rechallenge of therapy with capecitabine was attempted, using several strategies in order to prevent cardiotoxicity. The most (even if not fully) effective strategy was reducing capecitabine dosage together with nitrates, calcium-channel blockers and trimetazidine therapy. PMID:20093950

  15. Transluminal angioplasty in the management of mesenteric angina

    International Nuclear Information System (INIS)

    The efficacy of transluminal angioplasty for the treatment of peripheral atherosclerotic disease has been well documented. The successful treatment of abdominal angina has been reported, although the follow-up is too short to accurately evaluate the long term results of this procedure. (orig.)

  16. 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

  17. 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

  18. Thoracic empyema resulting from direct extension of Ludwig's angina

    OpenAIRE

    Youssef, M

    2016-01-01

    A 17-year-old Egyptian male developed Ludwig's angina after a failed trial of treatment a left lower teeth abscess, which was complicated by LT sided empyema and pneumonia. Assessment/Results: The patient arrived at ER dep. .Intraoral examination showed moderate trismus, fetid odor. There was bilateral sublingual edema (left > right) and an ulceration in the left floor of the mouth that was spontaneously draining purulent fluid. No cardiac murmurs or rubs were evident.Initial diagnostic labor...

  19. Myocardial bridge: The cause of angina in a young man

    OpenAIRE

    Vijayvergiya, Rajesh; Mittal, Bhagwant Rai

    2013-01-01

    Myocardial bridging is basically the systolic narrowing of epicardial coronary arteries, secondary to their tunneled course in myocardium. Though it is a benign condition it can have the symptoms like acute coronary syndrome, arrhythmias and sudden cardiac death. We report a 32-year-old male, who presented with typical exertional angina, had positive exercise treadmill and thallium-201 test. Coronary angiography revealed myocardial bridge of distal left anterior descending coronary artery. He...

  20. 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 symptom...

  1. 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

  2. Myocardial bridge: The cause of angina in a young man

    International Nuclear Information System (INIS)

    Myocardial bridging is basically the systolic narrowing of epicardial coronary arteries, secondary to their tunneled course in myocardium. Though it is a benign condition it can have the symptoms like acute coronary syndrome, arrhythmias and sudden cardiac death. We report a 32-year-old male, who presented with typical exertional angina, had positive exercise treadmill and thallium-201 test. Coronary angiography revealed myocardial bridge of distal left anterior descending coronary artery. He was put on β-blockers and was doing well at 8 years of follow-up

  3. 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

  4. The impact of guideline compliant medical therapy on clinical outcome in patients with stable angina: findings from the Euro Heart Survey of stable angina

    DEFF Research Database (Denmark)

    Daly, Caroline; Clemens, Felicity; Lopez-Sendon, Jose L.;

    2006-01-01

    interest was death or myocardial infarction (MI). The increasing intensity of guideline compliant medical therapy was quantified by means of a simple treatment score based on the use of guideline advocated therapies: antiplatelets, statins, and beta-blockers. A total of 3779 patients were included in the...... initial survey. Increasing intensity of guideline compliant therapy at initial assessment was associated with a reduction in death and MI during follow-up in patients with angina and confirmed coronary disease (HR 0.68; 95% CI 0.49-0.95 per unit increase in treatment score). All cardiovascular events were...... stable angina. Methods and results The Euro Heart Survey of Stable Angina is a multicentre prospective observational study conducted between 2002 and 2003. Patients with a clinical diagnosis of stable angina by a cardiologist were enrolled and follow-up was conducted at 1 year. The primary outcome of...

  5. Assessing Quality of Life and Medical Care in Chronic Angina: An Internet Survey

    Science.gov (United States)

    2016-01-01

    Background Angina is a clinical syndrome whose recognition relies heavily on self-report, so its identification can be challenging. Most data come from cohorts identified by physicians and nurses at the point of care; however, current widespread access to the Internet makes identification of community cohorts feasible and offers a complementary picture of angina. Objective To describe a population self-identified as experiencing chronic angina by use of an Internet survey. Methods Using email and an Internet portal, we invited individuals with a diagnosis of angina and recent symptoms to complete an Internet survey on treatment and quality of life (QOL). In total, 1147 surveys were received. The main analysis was further limited to those reporting a definite coronary heart disease (CHD) history (N=646, 56% of overall). Results Overall, about 15% reported daily angina and 40% weekly angina. Those with more frequent angina were younger, more often depressed, and reported a shorter time since diagnosis. They also had substantially worse treatment satisfaction, physical function, and overall QOL. Fewer than 40% were on ≥ 2 anti-anginals, even with daily angina. The subjects without a history of definite CHD had unexpectedly low use of antianginal and evidence-based medicines, suggesting either a lack of specificity in the use of self-reported angina to identify patients with CHD or lack of access to care. Conclusions Use of inexpensive electronic tools can identify community-based angina cohorts for clinical research. Limitation to subjects with a definite history of CHD lends diagnostic face validity to the approach; however, other symptomatic individuals are also identified. PMID:27125492

  6. A case of relapsing polychondritis mimicking Ludwig’s angina

    Directory of Open Access Journals (Sweden)

    Adnan Agha

    2009-09-01

    Full Text Available Relapsing polychondritis (RP is a severe progressive inflammatory condition involving cartilaginous structures and caused by an autoimmune process, for which there is no confirmatory serological biomarker and which still is diagnosed on a mainly clinical basis. RP has been associated with many diseases like Sweet’s syndrome, Behcet’s disease, rheumatoid arthritis, and other autoimmune disorders. We attempt to describe here a unique case of a 38-year-old female with a high-grade fever, sore throat, difficulty in swallowing, hoarseness of the voice, and found to have signs of tongue swelling and inflammation of the oral cavity that mimicked Ludwig’s angina, necessitating antibiotic use. On careful re-evaluation the patient was diagnosed to have relapsing polychondritis based on auricular and respiratory tract chondritis and response to steroids. The purpose of this report is to emphasize the fact that careful clinical assessment is needed to diagnose RP, which may be misdiagnosed as Ludwig’s angina.

  7. Angina monocitica con sovrainfezione da Prevotella denticola: caso clinico

    Directory of Open Access Journals (Sweden)

    Maria Teresa Allù

    2005-06-01

    Full Text Available Monocytic angina with superinfection of Prevotella denticola: clinical case Monocytic angina is a clinical sindrome caused by Epstein-Barr virus characterized by fever, pharyngitis, exudative tonsillitis, swollen lymphoglands, splenomegaly and hepatomegaly.The inflamed pharynx and necrotic tonsils of infectious mononucleosis are subject to bacterial superinfection initially or during the course of the illness; the reduced PO2 tension and low oxidation-reduction potential that prevail in a vascular and necrotic tissues favour the growth of anaerobes. In this article we reported the clinical case of a ten years old children, who presented fever and tonsillopharyngitis; he was treated with cefotaxime and piperacillin, he did not improve in health. He was admitted to hospital (Department of Otorhinolaryngology. The patient was treated with aminoglycoside (tobramycin, piperacillin and cortisone; the clinical situation deteriorated. Pus sample was collected from the tonsils and cultured. Isolated strain from culture anaerobic was identified biochemically (Rapid-ID32ANA.The microorganism isolated was: Prevotella denticola (oral anaerobic gram-negative rods; β-lactamase production was tested by using the chromogenic cephalosporin disk test.The susceptibility to antibiotics was performed according to NCCLS recommendations. Prevotella denticola (β-lactamase production was resistant to penicillin, cefoxitin, cefotetan, piperacillin, clindamycin and metronidazole it was susceptible to piperacillin-tazobactam, amoxicillin-clavulanate, ticarcillin-clavulanate, imipenem and chloramphenicol. Children was treated with piperacillin-tazobactam, with rapid symptomatic relief.

  8. Understanding the Role of Autoimmune Disorders on the Initial Presentation of Cardiovascular Disease

    Science.gov (United States)

    2015-04-20

    Myocardial Infarction; Ischemic Stroke; Stroke; Subarachnoid Haemorrhage; Venous Thrombosis; Transient Ischemic Attack; Stable Angina Pectoris; Unstable Angina; Heart Failure; Peripheral Arterial Disease; Abdominal Aortic Aneurysm

  9. Current views on neurostimulation in the treatment of cardiac ischemic syndromes

    NARCIS (Netherlands)

    Jessurun, GAJ; DeJongste, MJL; Blanksma, PK

    1996-01-01

    Most clinicians are still unacquainted with the beneficial effects of neurostimulation as an additional therapeutic strategy for severe angina pectoris. Patients with therapeutically refractory angina pectoris suffer from chest discomfort during minimal exercise, despite maximal tolerated antiangina

  10. Efficacy of a device to narrow the coronary sinus in refractory angina

    DEFF Research Database (Denmark)

    Verheye, Stefan; Jolicœur, E Marc; Behan, Miles W; Pettersson, Thomas; Sainsbury, Paul; Hill, Jonathan; Vrolix, Mathias; Agostoni, Pierfrancesco; Engstrom, Thomas; Labinaz, Marino; de Silva, Ranil; Schwartz, Marc; Meyten, Nathalie; Uren, Neal G; Doucet, Serge; Tanguay, Jean-François; Lindsay, Steven; Henry, Timothy D; White, Christopher J; Edelman, Elazer R; Banai, Shmuel

    2015-01-01

    the coronary sinus, thus redistributing blood into ischemic myocardium. METHODS: We randomly assigned 104 patients with Canadian Cardiovascular Society (CCS) class III or IV angina (on a scale from I to IV, with higher classes indicating greater limitations on physical activity owing to angina) and...... treatment group (37 of 52 patients), as compared with 42% of those in the control group (22 of 52) (P=0.003). Quality of life as assessed with the use of the Seattle Angina Questionnaire was significantly improved in the treatment group, as compared with the control group (improvement on a 100-point scale...

  11. COMPARISON BETAXOLOL AND METOPROLOL TARTRATE THERAPIES IN PATIENTS WITH ARTERIAL HYPERTENSION ASSOCIATED WITH STABLE ANGINA

    OpenAIRE

    A.A. Anderzhanova; J. V. Gavrilov; V. A. Sulimov

    2016-01-01

    Aim. To compare antihypertensive, antianginal and antiischemic efficacy of β1-selective adrenoblockers (betaxolol and metoprolol tartrate) in patients with arterial hypertension (HT) of 1-2 degree associated with stable angina class II.Material and methods. 100 patients (aged 23-66 y.o.) with HT associated with stable angina or without angina were involved in the study. Patients were randomized into 2 groups (G1 and G2). G1 patients were treated with betaxolol, and G2 patients – with metoprol...

  12. An Unusual Case of Suspected Microvascular Angina in a Newborn

    Directory of Open Access Journals (Sweden)

    Stefania Cataldo

    2012-01-01

    Full Text Available Myocardial ischemia in pediatric population is uncommon and usually due to congenital heart disease or extracardiac conditions leading to poor coronary perfusion. A 6-day-old newborn presented with respiratory distress and signs of heart failure. ECG, echocardiography, and laboratory results were consistent with myocardial ischemia. Coronary angiography was performed to exclude anomalous origin of coronary arteries, showing normal coronary artery origin and course. Thrombophilia and extra-cardiac causes were ruled out. Clinical conditions improved with mechanical ventilation and diuretics, enzyme levels lowered, repolarisation and systolic function abnormalities regressed, but ischemic electrocardiographic and echocardiographic signs still presented during intense crying. Becaues of suspicion of microvascular angina, therapy with ASA and beta-blocker was started. At 5 month followup, the baby was in good clinical condition and no more episodes were recorded. We believe it is an interesting case, as no similar cases have been recorded till now.

  13. Clinical Observation of Sugar-free Particle of Rhodobryum giganteum in Treatment Angina of Diabetic Patients with Coronary Heart Disease%回心草无糖颗粒对糖尿病合并冠心病心绞痛的疗效观察

    Institute of Scientific and Technical Information of China (English)

    蔡鹰; 赵宁志; 张丽玲; 王爱萍

    2012-01-01

    Objective: To observe the clinical efficacy of sugar-free particle of Rhodobryum giganteum in treatment angina of diabetic patients with coronary heart disease. Method: A randomized double-blind method was used, 105 patients were divided into two groups, and respectively treated with Huixin grass sugar-free particles (66 cases in treatment group) and musk heart-protecting pill (36 patients in control group) , the change was observed on angina pain, electrocardiograph (ECG), stop or reduction rate nitroglycerin. Result; The efficiency of treatment group was 92. 4% in curing angina and 89. 7% in control group. There was no significant difference between treatment and control groups. Electrocardiogram efficiency in the treatment group was 57. 6% and the control group was 43. 6% ( P < 0. 05 ) . Reduction rate of nitroglycerin was 83. 3% in treatment group and the control group was 79.5%. Conclusion; The sugar-free particle of R. giganteum of angina pectoris has a good effect in treating angina of diabetic patients with coronary heart disease ( ECG improved more significantly).%目的:观察回心草无糖颗粒治疗糖尿病合并冠心病心绞痛的临床疗效.方法:采用随机双盲对照方法,将105例糖尿病合并冠心病心绞痛病人分为两组:回心草无糖颗粒组(治疗组,15 g/包,2次/d,每次1包,冲服,66例)和麝香保心丸组(对照组,3次/d,每次2丸,口服,36例).观察两组心绞痛发作频次、心电图、硝酸甘油停减率的变化.结果:心绞痛缓解总有效率:治疗组92.4%、对照组89.7%;心电图好转总有效率:治疗组57.6%、对照组43.6%(P<0.05);硝酸甘油停减率:治疗组83.3%、对照组79.5%.结论:回心草无糖颗粒对糖尿病合并冠心病心绞痛病人有效,疗效与麝香保心丸相当(心电图好转更明显).

  14. 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...... infarction in the first year was 2.3 per 100 patient years; the rate was 3.9 per 100 patient years in the subgroup (n = 994) with angiographic confirmation of coronary disease. The clinical and investigative factors most predictive of adverse outcome were comorbidity, diabetes, shorter duration of symptoms......, increasing severity of symptoms, abnormal ventricular function, resting electrocardiogaphic changes, or not having any stress test done. Results of non-invasive stress tests did not significantly predict outcome in the population who had tests done. A score was constructed using the parameters predictive of...

  15. Evaluating Symptoms to Improve Quality of Life in Patients with Chronic Stable Angina

    Directory of Open Access Journals (Sweden)

    Jeffrey W. Young

    2013-01-01

    Full Text Available Chronic stable angina (CSA is a significant problem in the United States that can negatively impact patient quality of life (QoL. An accurate assessment of the severity of a patient’s angina, the impact on their functional status, and their risk of cardiovascular complications is key to successful treatment of CSA. Active communication between the patient and their healthcare provider is necessary to ensure that patients receive optimal therapy. Healthcare providers should be aware of atypical symptoms of CSA in their patients, as patients may continue to suffer from angina despite the availability of multiple therapies. Patient questionnaires and symptom checklists can help patients communicate proactively with their healthcare providers. This paper discusses the prevalence of CSA, its impact on QoL, and the tools that healthcare providers can use to assess the severity of their patients’ angina and the impact on QoL.

  16. Treatment of refractory chest angina with spinal electrical stimulator: literature review

    International Nuclear Information System (INIS)

    There is a group of patients with chronic refractory chest angina, who are not ideal candidates for surgical or percutaneous revascularization and who although having a good medical handling continues to experience severe episodes of angina. The spinal electrical stimulator is a neuromodulators used as an alternative to treat these patients. The objective is to realize a review of scientific literature regarding the spinal electric stimulation in the treatment of chest angina, its mechanism of action, benefits and its cost effectiveness. Materials and methods: using the Cochrane methodology, a search of articles published from January 1980 to January 2007 in Medline using the terms spinal cord stimulation, was realized. The papers considered most pertinent were selected. Conclusions: the anti-ischemic effect of the electrical spinal stimulator reduces the episodes of chest angina, improves the quality of life and the tolerance to exercise, diminishes the hospital stay and delays the appearance of ischemic signs

  17. Gender differences in the management and clinical outcome of stable angina

    DEFF Research Database (Denmark)

    Daly, Caroline; Clemens, Felicity; Sendon, Jose L. Lopez;

    2006-01-01

    , 1.13 to 3.85), even after multivariable adjustment for age, abnormal ventricular function, severity of coronary disease, and diabetes. Conclusions- Significant gender bias has been identified in the use of investigations and evidence-based medical therapy in stable angina. Women were also less......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...... likely to be revascularized. The observed bias is of particular concern in light of the adverse prognosis observed among women with stable angina and confirmed coronary disease....

  18. Angina and exertional myocardial ischemia in diabetic and nondiabetic patients: assessment by exercise thallium scintigraphy

    International Nuclear Information System (INIS)

    Patients with diabetes mellitus and coronary artery disease are thought to have painless myocardial ischemia more often than patients without diabetes. We studied 50 consecutive patients with diabetes and 50 consecutive patients without diabetes, all with ischemia, on exercise thallium scintigraphy to show the reliability of angina as a marker for exertional ischemia. The two groups had similar clinical characteristics, treadmill test results, and extent of infarction and ischemia, but only 7 patients with diabetes compared with 17 patients without diabetes had angina during exertional ischemia. In diabetic patients the extent of retinopathy, nephropathy, or peripheral neuropathy was similar in patients with and without angina. Angina is an unreliable index of myocardial ischemia in diabetic patients with coronary artery disease. Given the increased cardiac morbidity and mortality in such patients, periodic objective assessments of the extent of ischemia are warranted

  19. Five year prognosis in patients with angina identified in primary care: incident cohort study

    OpenAIRE

    Buckley, B. S.; Simpson, C.R.; McLernon, D.J.; Murphy, A W; Hannaford, P.C.

    2009-01-01

    OBJECTIVE: To ascertain the risk of acute myocardial infarction, invasive cardiac procedures, and mortality among patients with newly diagnosed angina over five years. DESIGN: Incident cohort study of patients with primary care data linked to secondary care and mortality data. SETTING: 40 primary care practices in Scotland. PARTICIPANTS: 1785 patients with a diagnosis of angina as their first manifestation of ischaemic heart disease, 1 January 1998 to 31 December 2001. MAIN OUTCOME MEASURES: ...

  20. Nicorandil in patients with acute coronary syndrome and stable angina undergoing Percutaneous Coronary Intervention: literature review

    OpenAIRE

    Neda Partovi; Homa Falsoleiman

    2014-01-01

    Percutaneous coronary intervention is an option for the treatment of coronary artery disease such as acute coronary syndrome and stable angina.Acute coronary syndrome has two groups including acute myocardial infarction and unstable angina.Periprocedural myocardial infarction is a frequent and prognostically important complication of percutaneous coronary intervention and can be easily monitored by measuring myocardial enzymes. Coronary microvascular dysfunction in patients undergoing primary...

  1. Prognostic value of early post-infarction angina in elderly patients

    OpenAIRE

    Erceg Predrag; Davidović Mladen; Vasiljević Zorana; Mitrović Predrag M.; Vukčević Vladan D.; Milošević Dragoslav P.; Stević Radmila; Rajić Miodrag

    2005-01-01

    Although numerous studies have shown that early post-infarction angina was a predictor of poor prognosis in patients with acute myocardial infarction, not a single study has considered this issue in the elderly. The goal of this study, based on a five-year follow-up of elderly patients with acute myocardial infarction, was to determine whether early post-infarction angina in the elderly had any influence on mortality and the incidence of additional coronary events. The study population consis...

  2. Clinical and angiographic features associated with coronary collateralization in stable angina patients with chronic total occlusion

    OpenAIRE

    Sun, Zhen; Shen, Ying; Lu, Lin; Zhang, Rui-yan; Pu, Li-jin; Zhang, Qi; Yang, Zheng-kun; Hu, Jian; Chen, Qiu-jing; Shen, Wei-Feng

    2013-01-01

    Objective: Coronary collateral circulation is an alternative source of blood supply to myocardium in the presence of advanced coronary artery disease. We sought to determine which clinical and angiographic variables are associated with collateral development in patients with stable angina and chronic total coronary occlusion. Methods: Demographic variables, biochemical measurements, and angiographic findings were collected from 478 patients with stable angina and chronic total coronary occlus...

  3. Recent advances in the management of chronic stable angina II. Anti-ischemic therapy, options for refractory angina, risk factor reduction, and revascularization

    Directory of Open Access Journals (Sweden)

    Richard Kones

    2010-08-01

    Full Text Available Richard KonesThe Cardiometabolic Research Institute, Houston, Texas, USAAbstract: The objectives in treating angina are relief of pain and prevention of disease ­progression through risk reduction. Mechanisms, indications, clinical forms, doses, and side effects of the traditional antianginal agents – nitrates, ß-blockers, and calcium channel ­blockers – are reviewed. A number of patients have contraindications or remain unrelieved from anginal discomfort with these drugs. Among newer alternatives, ranolazine, recently approved in the United States, indirectly prevents the intracellular calcium overload involved in cardiac ischemia and is a welcome addition to available treatments. None, however, are disease-modifying agents. Two options for refractory angina, enhanced external counterpulsation and spinal cord stimulation (SCS, are presented in detail. They are both well-studied and are effective means of treating at least some patients with this perplexing form of angina. Traditional modifiable risk factors for coronary artery disease (CAD – smoking, hypertension, dyslipidemia, ­diabetes, and obesity – account for most of the population-attributable risk. Individual therapy of high-risk patients differs from population-wide efforts to prevent risk factors from appearing or reducing their severity, in order to lower the national burden of disease. Current American College of Cardiology/American Heart Association guidelines to lower risk in patients with chronic angina are reviewed. The Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE trial showed that in patients with stable angina, optimal medical therapy alone and percutaneous coronary intervention (PCI with medical therapy were equal in preventing myocardial infarction and death. The integration of COURAGE results into current practice is discussed. For patients who are unstable, with very high risk, with left main coronary artery lesions, in

  4. Evaluation of coronary microvascular function in patients with vasospastic angina

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    Ken Ishibashi

    2013-01-01

    Full Text Available AIM: To investigate endothelium-dependent and -independent coronary microvascular functions in patients with vasospastic angina (VSA. METHODS: Thirty-six patients with VSA (30 men and 6 women; mean age, 58 years were enrolled in this study. VSA was defined as ≥ 90% narrowing of the epicardial coronary arteries on angiography performed during a spasm provocation test, presence of chest pain, and/or ST-segment deviation on an electrocardiogram (ECG. Patients (n = 36 with negative spasm provocation test results and those matched for age and sex were enrolled as a control group (nonVSA group. Low-dose acetylcholine (ACh; 3 μg/min was infused into the left coronary ostium for 2 min during the spasm provocation test. Following the spasm provocation test, nitroglycerin (0.2 mg was administered intracoronally. Coronary blood flow (was calculated from quantitative angiography and Doppler flow velocity measurements, and the coronary flow reserve was calculated as the ratio of coronary flow velocity after injection of adenosine triphosphate (20 μg to the baseline value. Changes in the coronary artery diameter in response to ACh and nitroglycerin infusion were expressed as percentage changes from baseline measurements. RESULTS: Body mass index was significantly lower in the VSA group than in the nonVSA group. The frequency of conventional coronary risk factors and the rate of statin use were similar between the 2 groups. The left ventricular ejection fraction as evaluated by echocardiography was similar between the 2 groups. The duration of angina was 9 ± 2 mo. The results of blood chemistry analysis were similar between the 2 groups. Low-dose ACh did not cause coronary spasms. The change in coronary artery diameter in response to ACh was lower in the VSA group (-1.4% ± 9.3% than in the nonVSA group (3.1% ± 6.5%, P < 0.05, whereas nitroglycerin-induced coronary artery dilatation and coronary blood flow increase in response to ACh or coronary flow

  5. Importance of thrombosis and thrombolysis in silent ischaemia: comparison of patients with acute myocardial infarction and unstable angina.

    OpenAIRE

    Gurfinkel, E.; Altman, R.; Scazziota, A.; Rouvier, J.; Mautner, B

    1994-01-01

    OBJECTIVE--To investigate whether plaque rupture and thrombosis have a role in silent ischaemia as well as in unstable angina. DESIGN--Prospective analysis of the results of haemostatic diagnostic tests at the moment of developing silent ischaemia at rest. SETTING--Coronary care unit. PATIENTS--22 patients with acute myocardial infarction, 12 patients with symptomatic angina (unstable angina), and 10 normal volunteers (control group). INTERVENTIONS--Continuous cardiac monitoring detected 15 a...

  6. Relationship between the serologic status of helicobacter pylori with the presence of unstable angina

    International Nuclear Information System (INIS)

    To determine whether unstable angina is co-related to seropositivity to chronic Helicobacter pylori (HP) infection. It is a case control, descriptive study conducted at CCU in Razi Hospital in Ahwaz a city southwest Iran, from 2004 to 2005. We measured serum HP- lgG levels of participants in CCU in a hospital. Blood samples were drawn during study period from 96 patients (mean age 56 years) with Unstable Angina (UA) according to American Heart Association criteria and from 96 participants free of cardiovascular disease (mean age 58 years) and stored at 20 degree C. Serology results were studied in relation to UA. Using chi squared test, odds ratios (OR) and 95% confidence intervals (CI) were calculated, adjusting for age, gender, and established risk factors. Seventy nine (82.3%) of patients with unstable angina and 55(61.1%) in the control group presented a positive anti HP-lgG. Odds ratio was 3 with 95% CI: 1.9 to 4.3. There was significant relation between HP-lgG positivity and unstable angina (P0.05). Our study revealed relationship between seropositivity of HP-lgG and unstable angina. (author)

  7. A new scoring system to stratify risk in unstable angina

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    Salzberg Simón

    2003-08-01

    Full Text Available Abstract Background We performed this study to develop a new scoring system to stratify different levels of risk in patients admitted to hospital with a diagnosis of unstable angina (UA, which is a complex syndrome that encompasses different outcomes. Many prognostic variables have been described but few efforts have been made to group them in order to enhance their individual predictive power. Methods In a first phase, 473 patients were prospectively analyzed to determine which factors were significantly associated with the in-hospital occurrence of refractory ischemia, acute myocardial infarction (AMI or death. A risk score ranging from 0 to 10 points was developed using a multivariate analysis. In a second phase, such score was validated in a new sample of 242 patients and it was finally applied to the entire population (n = 715. Results ST-segment deviation on the electrocardiogram, age ≥ 70 years, previous bypass surgery and troponin T ≥ 0.1 ng/mL were found as independent prognostic variables. A clear distinction was shown among categories of low, intermediate and high risk, defined according to the risk score. The incidence of the triple end-point was 6 %, 19.2 % and 44.7 % respectively, and the figures for AMI or death were 2 %, 11.4 % and 27.6 % respectively (p Conclusions This new scoring system is simple and easy to achieve. It allows a very good stratification of risk in patients having a clinical diagnosis of UA. They may be divided in three categories, which could be of help in the decision-making process.

  8. The initial management of stable angina in Europe, from the Euro Heart Survey: a description of pharmacological management and revascularization strategies initiated within the first month of presentation to a cardiologist in 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: In order to assess adherence to guidelines and international variability in management, the Euro Heart Survey of Newly Presenting Angina prospectively studied medical therapy, percutaneous coronary intervention (PCI), and surgery in patients with new-onset stable angina in Europe. METHODS AND

  9. Detection of non-ST-elevation myocardial infarction and unstable angina in the acute setting: meta-analysis of diagnostic performance of multi-detector computed tomographic angiography

    Directory of Open Access Journals (Sweden)

    Sarno Giovanna

    2007-12-01

    Full Text Available Abstract Background Multi-detector computed tomography angiography (MDCTA has been increasingly used in the evaluation of the coronary arteries. The purpose of this study was to review the literature on the diagnostic performance of MDCTA in the acute setting, for the detection of non-ST-elevation myocardial infarction (NSTEMI and unstable angina pectoris (UAP. Methods A Pubmed and manual search of the literature published between January 2000 and June 2007 was performed. Studies were included that compared MDCTA with clinical outcome and/or CA in patients with acute chest pain, presenting at the emergency department. More specifically, studies that only included patients with initially negative cardiac enzymes suspected of having NSTEMI or UAP were included. Summary estimates of diagnostic odds ratio (DOR, sensitivity and specificity, negative (NLR and positive likelihood ratio (PLR were calculated on a patient basis. Random-effects models and summary receiver operating curve (SROC analysis were used to assess the diagnostic performance of MDCTA with 4 detectors or more. The proportion of non assessable scans (NAP on MDCTA was also evaluated. In addition, the influence of study characteristics of each study on diagnostic performance and NAP was investigated with multivariable logistic regression. Results Nine studies totalling 566 patients, were included in the meta-analysis: one randomised trial and eight prospective cohort studies. Five studies on 64-detector MDCTA and 4 studies on MDCTA with less than 64 detectors were included (32 detectors n = 1, 16 detectors n = 2, 16 and 4 detectors n = 1. Pooled DOR was 131.81 (95%CI, 50.90–341.31. The pooled sensitivity and specificity were 0.95 (95%CI, 0.90–0.98 and 0.90 (95%CI, 0.87–0.93. The pooled NLR and PLR were 0.12 (95%CI, 0.06–0.21 and 8,60 (95%CI, 5.03–14,69. The results of the logistic regressions showed that none of the investigated variables had influence on the diagnostic

  10. Chronic stable angina is associated with lower health-related quality of life: evidence from Chinese patients.

    Directory of Open Access Journals (Sweden)

    Jing Wu

    Full Text Available OBJECTIVES: To compare health-related quality of life (HRQoL between patients with stable angina and the general population in China and to examine factors associated with HRQoL among patients with stable angina. METHODS: A cross-sectional HRQoL survey of stable angina patients recruited from 4 hospitals (n = 411 and the general population recruited from 3 Physical Examination Centers (n = 549 was conducted from July to December, 2011 in two large cities, Tianjin and Chengdu. HRQoL was assessed using the EQ-5D, EQ-VAS, and SF-6D instruments. The health status specific to patients with stable angina was assessed using the Seattle Angina Questionnaire (SAQ. Information on socio-demographic, clinical, and lifestyle factors were also collected. Nested regressions were performed to explore how these factors were associated with HRQoL in patients with stable angina. RESULTS: Compared with the general population (44.2 ± 10 years, 49.9% females, stable angina patients (68.1 ± 12 years, 50.4% females had significantly lower HRQoL scores in EQ-5D utility index (0.75 ± 0.19 vs. 0.90 ± 0.20, p<0.05, SF-6D utility index (0.68 ± 0.12 vs. 0.85 ± 0.11, p<0.05, and EQ-VAS (71.2 ± 12.3 vs. 83.9 ± 10.9, p<0.05. The differences remained (-0.05 for EQ-5D, -9.27 for EQ-VAS and -0.13 for SF-6D after controlling for socio-economic characteristics. SAQ scores showed that stable angina patients experienced impaired disease-specific health status, especially in angina stability (40.5 ± 34.6. Nested regressions indicated stable angina-specific health status explained most of the variation in HRQoL, among which disease perception, physical limitation, and angina stability were the strongest predictors. More physical exercise and better sleep were positively related with HRQoL. CONCLUSIONS: Compared to the general population, stable angina patients were associated with lower HRQoL and lower health utility scores, which were largely impacted by clinical symptoms

  11. Manejo de la angina refractaria con estimulación eléctrica espinal: revisión de la literatura Treatment of refractory chest angina with spinal electrical stimulator: literature review

    OpenAIRE

    Omar F Gomezese; Paola Aranda; Luis E Echeverría; José F Saibi; Jaime Calderón; Juan G Barrera

    2008-01-01

    Justificación: existe un grupo de pacientes con angina de pecho crónica refractaria, que no son candidatos a revascularización quirúrgica o percutánea y que a pesar de recibir un manejo médico óptimo, aún experimentan severos episodios de angina. El estimulador eléctrico espinal es un neuromodulador que se emplea como alternativa de manejo en estos pacientes. Objetivos: se realizó una revisión sobre estimulación eléctrica espinal en el manejo de la angina, su mecanismo de acción, sus benefici...

  12. Evaluation of coronary hemodynamics and exercise sup 201 Tl-myocardial scintigraphy in patients with vasospastic angina

    Energy Technology Data Exchange (ETDEWEB)

    Matsumura, Kentaro; Nakase, Emiko; Haiyama, Tohru; Hasegawa, Akira; Saito, Takayuki (Kyoto Minami Hospital (Japan))

    1992-05-01

    To clarify the coronary hemodynamics and myocardial perfusion in patients with vasospastic angina, we performed exercise {sup 201}Tl-myocardial scintigraphy (planar and SPECT) in 72 patients and left coronary digital subtraction angiography (DSA) in 37 patients without significant organic coronary artery stenosis. Coronary artery spasm was documented by coronary angiography in all patients. Fifty-four patients (75%) developed exercise-induced {sup 201}Tl-myocardial perfusion defect on SPECT. {sup 201}Tl pulmonary uptake (L/H) was significantly increased in patients with vasospastic angina. Especially, L/H was higher in patients with multiple small perfusion defect on {sup 201}Tl-SPECT, so that exercise-induced left ventricular dysfunction existed in patients with vasospastic angina and especially in cases of multiple small perfusion defect on {sup 201}Tl-SPECT. The left coronary circulation time (CCT) was prolonged in patients with vasospastic angina. The mechanism of prolonged CCT is still unknown, but we suspected that prolonged CCT was induced by increased peripheral coronary vascular resistance in patients with vasospastic angina. It was concluded that the peripheral coronary circulation was disturbed in patients with vasospastic angina, but its abnormal coronary circulation had no relation to location of spasm-induced vessels. We concluded that impaired coronary microcirculation was taken a part of pathophysiology in vasospastic angina. (author).

  13. Transcoronary sinus administration of autologous bone marrow in patients with chronic refractory stable angina

    International Nuclear Information System (INIS)

    Purpose: Based on our preclinic studies with autologous unfractionated bone marrow (AUBM) via coronary sinus with transitory occlusion, a clinic study in patients with chronic stable angina was designed. The objectives were to evaluate safety, tolerance and feasibility. Methods and materials: A multicenter prospective study with inclusion and exclusion criteria defined by an Independent Clinical Committee was carried out. Fourteen patients underwent transcoronary sinus administration of freshly aspirated and filtered AUBM (60-120 ml). Safety and tolerance were evaluated. Feasibility was evaluated with Seattle Angina Questionnaire (SAQ), Canadian Cardiovascular Society (CCS) angina classification (baseline-Day 180), myocardial perfusion (baseline-Day 90) with independent core laboratory and coronary angiography (baseline and Day 30). Results: There were no changes in the safety and tolerance parameters. Preliminary clinical efficacy at Day 180 disclosed a significant improvement of 38%, evaluated by the SAQ. The CCS angina classification shows that the mean angina class was 3.0±0.55 at baseline and improved to 2.0±0.00 at Day 180 (P<.001). Semiquantitative radionuclide perfusion imaging (core lab) showed a significant improvement at Day 90 in 13/14 patients, with a mean improvement of 24% at rest (P<.01) and 33% at stress (P<.05). Coronary angiography showed more collateral vessels in 9/14 patients. Conclusions: We can conclude that AUBM via coronary sinus with transitory occlusion is tolerable and safe. Significant improvement in the myocardial perfusion at Day 90 and in the quality of life at Day 180 was observed

  14. VEGF 165 Gene Therapy for Patients with Refractory Angina: Mobilization of Endothelial Progenitor Cells

    Energy Technology Data Exchange (ETDEWEB)

    Rodrigues, Clarissa G. [Instituto de Cardiologia/Fundação Universitária de Cardiologia - Programa de Pós Graduação em Ciências da Saúde: Cardiologia, Porto Alegre, RS (Brazil); Duke University Medical Center, Durham, North Carolina (United States); Plentz, Rodrigo D.M. [Instituto de Cardiologia/Fundação Universitária de Cardiologia - Programa de Pós Graduação em Ciências da Saúde: Cardiologia, Porto Alegre, RS (Brazil); Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS (Brazil); Dipp, Thiago [Instituto de Cardiologia/Fundação Universitária de Cardiologia - Programa de Pós Graduação em Ciências da Saúde: Cardiologia, Porto Alegre, RS (Brazil); Salles, Felipe B. [Instituto de Cardiologia/Fundação Universitária de Cardiologia - Programa de Pós Graduação em Ciências da Saúde: Cardiologia, Porto Alegre, RS (Brazil); Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS (Brazil); Giusti, Imarilde I.; Sant' Anna, Roberto T.; Eibel, Bruna; Nesralla, Ivo A.; Markoski, Melissa [Instituto de Cardiologia/Fundação Universitária de Cardiologia - Programa de Pós Graduação em Ciências da Saúde: Cardiologia, Porto Alegre, RS (Brazil); Beyer, Nance N. [Instituto de Cardiologia/Fundação Universitária de Cardiologia - Programa de Pós Graduação em Ciências da Saúde: Cardiologia, Porto Alegre, RS (Brazil); Universidade Federal do Rio Grande do Sul, Porto Alegre, RS (Brazil); Kalil, Renato A. K., E-mail: kalil.pesquisa@gmail.com [Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, RS (Brazil)

    2013-08-15

    Vascular endothelial growth factor (VEGF) induces mobilization of endothelial progenitor cells (EPCs) with the capacity for proliferation and differentiation into mature endothelial cells, thus contributing to the angiogenic process. We sought to assess the behavior of EPCs in patients with ischemic heart disease and refractory angina who received an intramyocardial injections of 2000 µg of VEGF 165 as the sole therapy. The study was a subanalysis of a clinical trial. Patients with advanced ischemic heart disease and refractory angina were assessed for eligibility. Inclusion criteria were as follows: signs and symptoms of angina and/or heart failure despite maximum medical treatment and a myocardial ischemic area of at least 5% as assessed by single-photon emission computed tomography (SPECT). Exclusion criteria were as follows: age > 65 years, left ventricular ejection fraction < 25%, and a diagnosis of cancer. Patients whose EPC levels were assessed were included. The intervention was 2000 µg of VEGF 165 plasmid injected into the ischemic myocardium. The frequency of CD34+/KDR+ cells was analyzed by flow cytometry before and 3, 9, and 27 days after the intervention. A total of 9 patients were included, 8 males, mean age 59.4 years, mean left ventricular ejection fraction of 59.3% and predominant class III angina. The number of EPCs on day 3 was significantly higher than that at baseline (p = 0.03); however, that on days 9{sup th} and 27{sup th} was comparable to that at baseline. We identified a transient mobilization of EPCs, which peaked on the 3th day after VEGF 165 gene therapy in patients with refractory angina and returned to near baseline levels on 9{sup th} and 27{sup th}days.

  15. VEGF 165 Gene Therapy for Patients with Refractory Angina: Mobilization of Endothelial Progenitor Cells

    International Nuclear Information System (INIS)

    Vascular endothelial growth factor (VEGF) induces mobilization of endothelial progenitor cells (EPCs) with the capacity for proliferation and differentiation into mature endothelial cells, thus contributing to the angiogenic process. We sought to assess the behavior of EPCs in patients with ischemic heart disease and refractory angina who received an intramyocardial injections of 2000 µg of VEGF 165 as the sole therapy. The study was a subanalysis of a clinical trial. Patients with advanced ischemic heart disease and refractory angina were assessed for eligibility. Inclusion criteria were as follows: signs and symptoms of angina and/or heart failure despite maximum medical treatment and a myocardial ischemic area of at least 5% as assessed by single-photon emission computed tomography (SPECT). Exclusion criteria were as follows: age > 65 years, left ventricular ejection fraction < 25%, and a diagnosis of cancer. Patients whose EPC levels were assessed were included. The intervention was 2000 µg of VEGF 165 plasmid injected into the ischemic myocardium. The frequency of CD34+/KDR+ cells was analyzed by flow cytometry before and 3, 9, and 27 days after the intervention. A total of 9 patients were included, 8 males, mean age 59.4 years, mean left ventricular ejection fraction of 59.3% and predominant class III angina. The number of EPCs on day 3 was significantly higher than that at baseline (p = 0.03); however, that on days 9th and 27th was comparable to that at baseline. We identified a transient mobilization of EPCs, which peaked on the 3th day after VEGF 165 gene therapy in patients with refractory angina and returned to near baseline levels on 9th and 27thdays

  16. 调脂汤治疗冠心病稳定型心绞痛合并高脂血症临床研究%Clinical Observation of Tiaozhi Decoction for Treatment of Coronary Heart Disease Induced Stable Angina Complicated with Hyperlipemia

    Institute of Scientific and Technical Information of China (English)

    刘婷; 张士荣; 李培培

    2015-01-01

    Objective To investigate the therapeutic effect of Tiaozhi Decoction for the treatment of coronary heart disease induced stable angina complicated with hyperlipemia, and to observe its effect on serum inflammatory factors. Results One hundred qualified patients were evenly randomized into treatment group and control group. Both groups were given conventional western medical treatment with reference to Guide for Diagnosis and Treatment of Chronic Stable Angina, and additionally, the control group was given oral use of Simvastatin and the treatment group was given Tiaozhi Decoction orally. The treatment of the two groups covered 8 weeks. Before and after treatment, blood lipid levels of total cholesterol ( TC) , triglyceride ( TG) , low-density lipoprotein cholesterol ( LDL-C) , high- density lipoprotein cholesterol ( HDL-C) , apolipoprotein A (ApoA) and apolipoprotein B (ApoB) were observed. The frequency of angina pectoris attack and the dosage of Nitroglycerin Tablets per week in both groups were recorded during the treatment. Therapeutic effect on lowering blood lipid and on improving electrocardiogram was evaluated after treatment. Serum levels of hypersensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), homocysteic acid (Hcy), adiponectin (APN), and oxidized low-density lipoprotein (ox-LDL) were detected before and after treatment. Results(1) The results of Ridit analysis showed that the treatment group had better therapeutic effect on lowering blood lipid and on improving electrocardiogram than the control group ( P<0.05) . ( 2) After treatment, TG, HDL-C, ApoB and ApoA levels were much improved in the treatment group compared with those in the control group (P<0.01) . ( 3) The frequency of angina pectoris attack and the dosage of Nitroglycerin Tablets per week were reduced in the treatment group compared with those in the control group (P<0.01) . (4) After treatment, the treatment group had lower hs-CRP, IL-6, Hcy and ox-LDL levels, and higher APN

  17. Ranolazine for the treatment of chronic stable angina: a cost-effectiveness analysis from the UK perspective

    OpenAIRE

    Coleman, Craig I.; Freemantle, Nick; Kohn, Christine G

    2015-01-01

    Objectives To estimate the cost-effectiveness of ranolazine when added to standard-of-care (SoC) antianginals compared with SoC alone in patients with stable coronary disease experiencing ≥3 attacks/week. Setting An economic model utilising a UK health system perspective, a 1-month cycle-length and a 1-year time horizon. Participants Patients with stable coronary disease experiencing ≥3 attacks/week starting in 1 of 4 angina frequency health states based on Seattle Angina Questionnaire Angina...

  18. Effects of preinfarction angina on no-reflow phenomenon after percutaneous coronary intervention in patients with acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    王荣英

    2003-01-01

    Effects of preinfarction angina on no-reflow phenomenon after percutaneous coronary intervention in patients with acute myocardial infarction@王荣英$河北医科大学第二医院!石家庄050000 0311-70469016011

  19. Case management does not decrease mortality of patients with myocardial infarction or unstable angina: Evidence from a systematic review

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    Li-Juan Yi

    2016-06-01

    Conclusion: Case management is not beneficial to all-cause mortality after myocardial infarction or unstable angina compared to routine care. Additional, prospective RCTs of high quality and large scale are warranted to verify these results.

  20. PRESENTACIÓN DE UN CASO CON SÍNDROME X O ANGINA MICROVASCULAR / Report of a case with cardiac syndrome X or microvascular angina

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    Dayan A. García Cuesta

    2013-04-01

    Full Text Available Resumen: El término síndrome X o angina microvascular se emplea habitualmente para definir a un grupo de pacientes que presentan dolor torácico característico, depresión del segmento ST durante el esfuerzo y arterias coronarias angiográficamente normales. Muchos datos apuntan a un posible origen isquémico de los síntomas. Es más frecuente en mujeres y en casi el 50 % de ellas, el dolor anginoso se atribuye específicamente a cambios en la microvasculatura coronaria. Debido a que el pronóstico no es tan benigno como se creía hace años, en pacientes con angina y coronarias epicárdicas normales, se impone una evaluación clínica (incluyendo un cuidadoso análisis de los factores de riesgo e imagenológica, con el propósito de detectar isquemia funcionalmente significativa. La enfermedad coronaria microvascular es, por tanto, una enfermedad que requiere atención por parte del médico de asistencia. En este artículo se presenta una paciente con este diagnóstico, y se muestran las imágenes electrocardiográficas, ecocardiográfica, ergométricas y angiográficas. / Abstract: The term cardiac syndrome X or microvascular angina is commonly used to describe a group of patients who show a typical chest pain, ST segment depression during exercise and angiographically normal coronary arteries. Many data suggest the symptoms may have an ischemic origin. It is more common in women, and, in almost 50% of them, anginal pain is specifically attributed to changes in the coronary microvasculature. The prognosis is not as benign as it was believed for years; therefore, in patients with angina and a normal epicardial coronary, a clinical and imaging assessment is necessary (including a careful analysis of risk factors in order to detect a functionally significant ischemia. Therefore, coronary microvascular disease is a condition that requires attention by the attending physician. A patient with this diagnosis is reported in this article, and

  1. Trimetazidine: a new concept in the treatment of angina. Comparison with propranolol in patients with stable angina. Trimetazidine European Multicenter Study Group.

    OpenAIRE

    Detry, J M; Sellier, P; Pennaforte, S; D. Cokkinos; Dargie, H; Mathes, P

    1994-01-01

    1. Trimetazidine has a direct anti-ischaemic effect on the myocardium without altering the rate x pressure product or coronary blood flow. 2. The effects of trimetazidine (20 mg three times daily) were compared with those of propranolol (40 mg three times daily) in a double-blind parallel group multicentre study in 149 men with stable angina. 3. Reproducibility of exercise performance was verified during a 3 week run-in placebo washout period. All patients had > 1 mm ST-depression on exercise...

  2. Predictor value of some clinical-biological parameters for the onset of depressive disorder in elderly patients with unstable angina

    OpenAIRE

    Cristina Moşuţan; George Săraci; Caius R. Duncea

    2012-01-01

    Abstract. Objective: To evaluate the potential predictor value of some parameters for the onset of depression after an episode of unstableangina in elderly. Material and Methods: We included 103 elderly patients who suffered an acute unstable angina episode. Clinical, laband imagistic data was recorded in the first week after admittance. Six month after unstable angina episode, patients were evaluated for thepresence of depression. Results: Univariate analysis showed statistically significant...

  3. Association of Low Levels of Vitamin D with Chronic Stable Angina: A Prospective Case-Control Study

    OpenAIRE

    Ab Hameed Raina; Mohammad Sultan Allai; Zafar Amin Shah; Khalid Hamid Changal; Manzoor Ahmad Raina; Fayaz Ahmad Bhat

    2016-01-01

    Background: Coronary artery disease (CAD) is a major cause of death and disability in developed countries. Chronic stable angina is the initial manifestation of CAD in approximately 50% of the patients. Recent evidence suggests that vitamin D is crucial for cardiovascular health. The prevalence of vitamin D deficiency in our region is 83%. A low level of vitamin D is associated with chronic stable angina. Aim: This study was aimed at supporting or refuting this hypothesis in our population. M...

  4. Severe Life Threatening Maxillofacial Infection in Pregnancy Presented as Ludwig's Angina

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    M. Franklin Dolwick

    2006-08-01

    Full Text Available Background. Ludwig's angina is a rapidly spreading cellulitis that may produce upper airway obstruction often leading to death. There is very little published information regarding this condition in the pregnant patient. Case. A 24-year old black female was admitted at 26 weeks gestation with tooth pain, submandibular swelling, severe trismus, and dysphagea, consistent with Ludwig's angina. Her treatment included emergent tracheostomy, incision and drainage of associated spaces, teeth extraction, and antibiotic therapy. Conclusions. During a life threatening infectious situation such as the one described, risks of maternal and fetal morbidity include both septicemia and asphyxia. Furthermore, the healthcare provider must consider the risks that the condition and the possible treatments may cause the mother and her unborn child.

  5. ONE CASE REPORT OF ANGINA TONSILLARIS INDUCED MEDIASTINAL ABSCESS AND THORACIC EMPYEMA

    Institute of Scientific and Technical Information of China (English)

    LI Qing-yun; WANG Xi; WAN Huan-ying; DENG Wei-wu

    2009-01-01

    A 27-year-old female patient with mediastinal abscess and thoracic empyema developed from angina tonsillaris was studied clinically on the manifestations, computed tomography (CT) scan, and the treatment process. The patient was admitted to hospital with a history of fever, sore throat, and chest and neck pain. CT showed air and air-fluid levels within mediastinal dense fatty planes that extended from the thoracic inlet to the sub-carinal region and left pleural empyema. She was cured by mediastinal drainage and extensive debridement of the necrotic tissue under operation and broad spectrum antibiotics treatment. Angina tonsillaris induced acute mediastitis and mediastinal abscess is a relatively rare inflammatory pathology but actually a fatal situation for its high mortality rate. CT scanning is extremely useful for early diagnosis and surgical treatment planning. The main treatment is aggressive and adequate surgical drainage of the abscess and intravenous effective antibiotic treatment.

  6. Optimal treatment of chronic angina in patients with type 2 diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Kaur H

    2014-07-01

    Full Text Available Harjinder Kaur,1 Kully Sandhu,2 Awais Jabbar,3 Azfar G Zaman3,4 1City Hospitals Sunderland, Sunderland, UK; 2University Hospital of North Staffordshire, Stoke-on-Trent, UK; 3Freeman Hospital, Newcastle-upon-Tyne, UK; 4Institute of Cellular Medicine, Newcastle University, Newcastle, UK Abstract: Type 2 diabetes mellitus (T2DM trebles the risk of developing coronary artery disease (CAD; once CAD has developed, the risk of acute coronary syndromes (ACS and clinical risk associated with a coronary event, both double in diabetic patients. Patients with T2DM have more extensive CAD and present at a younger age; therefore, identification and management of chronic angina in these patients presents an opportunity to limit both cardiovascular symptoms and adverse outcomes. This article reviews the role of screening and treatment for chronic angina in patients with T2DM. There is a strong evidence base for modifying lifestyle as a way of reducing adverse cardiovascular outcomes in the diabetic population and this article reviews evidence of lifestyle modification as an important and necessary adjunct to pharmacologic intervention. Management of chronic stable angina is addressed by looking at treatments that reduce ischemic symptoms and those that reduce adverse cardiovascular outcomes. Trials specific to the diabetic population are limited, with information largely obtained from the diabetic subgroup analysis of large intervention trials. The growing diabetic population with increased propensity to cardiovascular disease mandates trials specifically in this patient population. Revascularization in patients with diabetes is associated with more complications than in the non-diabetic population. Recent trials specific to this population suggest surgical revascularization to be associated with better long-term outcomes and therefore, this article reviews the evidence for the optimal mode of revascularization in this population. Keywords: type 2 diabetes

  7. Can music improve the symptoms of stable angina? A randomized controlled trial

    OpenAIRE

    Premadasa Mudunkotuwa; Kumudu Wijewardena; Ruwan Ekanayaka; Samitha Siritunga

    2013-01-01

    Worldwide, the leading cause of death is ischemic heart disease. Other than medical and surgical management, alternative therapy such as relaxing music has been identified as having an impact on reducing morbidity in ischemic heart disease. Although several studies have been conducted to find out the impact of music on pain, anxiety, heart rate and stress in myocardial ischaemia, literature on the long term impact of music on severity of symptoms associated with stable angina is very sparse....

  8. Beneficial effects of intravenous glyceryl trinitrate in a case of Prinzmetal angina.

    OpenAIRE

    Antman, E; Gunther, S.; Barry, W

    1980-01-01

    A case is described of the successful use of intravenous glyceryl trinitrate in controlling ischaemia-induced high-grade ventricular ectopic activity occurring in a patient during a Prinzmetal angina attack. The intravenous form of glyceryl trinitrate is probably more effective than the sublingual form in controlling arrhythmias arising during acute ischaemic episodes because of prompt delivery of the drug to the coronary circulation where vasodilation occurs. In addition,the ability to contr...

  9. Treatment of Refractory Angina with Peripheral Blood-derived Stem Cell Using the Transendocardial Injection Route

    OpenAIRE

    Juan Jose González Ferrer; Pilar Jiménez-Quevedo; Maria del Trigo

    2011-01-01

    Despite the development of new anti-ischemic drugs and the improvements in revascularisation techniques, a substantial proportion of patients with ischemic heart disease remain symptomatic with severe debilitating angina. The major aim of therapy for these patients should be aggressive modification of risk factors and optimising medical and interventional treatment. Nevertheless, when disease progresses and standard treatments are not possible, new strategies should be established. In this se...

  10. Analgesia epidural torácica para el tratamiento de la angina inestable Thoracal epidural analgesia for the management of unstable angina

    Directory of Open Access Journals (Sweden)

    M. Castro

    2005-07-01

    Full Text Available La miocardiopatía isquémica en pacientes con angina inestable refractaria al tratamiento médico constituye un escenario clínico complicado. Una anatomía desfavorable o un riesgo quirúrgico excesivamente alto pueden desaconsejar la realización de una angioplastia o de una cirugía de derivación coronaria. En este artículo se pretende revisar la utilización de la analgesia/anestesia epidural torácica para el tratamiento y estabilización de este tipo de pacientes, a través de una breve descripción de la fisiopatología de la isquemia cardiaca, estudios experimentales en animales y humanos, uso en cirugía cardiaca y efectos secundarios.Ischemic cardiomyopathy in patients with unstable angina refractory to medical therapy is a difficult medical condition. Unfavorable anatomy or excessive surgical risk can advise against the performance of angioplasty or coronary bypass surgery. This study has reviewed the use of thoracal epidural analgesia/anesthesia for the management and stabilization of this type of patients, with a brief description of the physiopathology of cardiac ischemia, experimental studies in animals and human beings, use of cardiac surgery and side effects.

  11. ENDOTHELIAL DYSFUNCTION IN STABLE ANGINA AND MYOCARDIAL INFARCTION COMBINED WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

    Directory of Open Access Journals (Sweden)

    M. A. Popova

    2016-02-01

    Full Text Available The research objective is to determine the state of endothelium-dependent and endothelium-independent vasodilatation in patients with coronary heart disease (CHD associated with chronic obstructive pulmonary disease (COPD.Material and methods. In the cross-sectional study included 122 patients with CHD associated with COPD: 68 people of them are patients with stable angina without acute coronary events in history and 54 patients with acute ST segment elevation myocardial infarction (STEMI. Comparison group comprised 53 patients with stable angina and 51 patients after STEMI without concomitant COPD. Patients were included if they met the following inclusion criteria: male, age <60 years, verified forms of CHD (stable angina, STEMI, documented with COPD without exacerbation and forced expiratory volume in 1 second > 30% in the groups with CHD and COPD. Arterial endothelial function was tested with high-resolution ultrasonography: brachial artery diameter was measured at rest, after flow increase (which causes endothelium-dependent dilatation, and after administration of sublingual nitroglycerin (an endothelium-independent dilator.Results. We found that endothelial dysfunction in patients with acute and chronic forms of CHD in combination with COPD are more pronounced than in isolated CHD.Conclusion. Expressed depression functional vascular reserve in patients with CHD associated with COPD, should be taken into account when conducting individualized therapy of these patients.

  12. Efficacy evaluation of fluoxetine combined with conventional drug treatment on unstable angina patients complicated with depression

    Institute of Scientific and Technical Information of China (English)

    Chun-Hua Liao

    2015-01-01

    Objective:To study the efficacy of fluoxetine combined with conventional drug treatment on unstable angina patients complicated with depression. Methods:120 cases of unstable angina patients with depression were randomly divided into two groups. The anti-depression group received fluoxetine combined with conventional drug therapy; the conventional group received conventional drug therapy. Then contents of monoamine neurotransmitters and their metabolites, antioxidants and inflammatory mediators of both groups were compared. Results:Serum monoamine neurotransmitters NE, 5-HT and HA levels of the anti-depression group were higher than those of the conventional group and metabolites 5-HIAA and HVA contents were lower than those of the conventional group; serum SOD, CAT, GSH and HSP-70 contents of the anti-depression group were higher than those of the conventional group, and hs-CRP, MMP9, MCP1 and HMGB1 contents were lower than those of the conventional group. Conclusion:Fluoxetine combined with conventional drug therapy can increase the contents of monoamine neurotransmitters and antioxidants, and reduce oxidative stress response and inflammatory response; it is an ideal method for treating unstable angina complicated with depression.

  13. COMPARISON BETAXOLOL AND METOPROLOL TARTRATE THERAPIES IN PATIENTS WITH ARTERIAL HYPERTENSION ASSOCIATED WITH STABLE ANGINA

    Directory of Open Access Journals (Sweden)

    A. A. Anderzhanova

    2016-01-01

    Full Text Available Aim. To compare antihypertensive, antianginal and antiischemic efficacy of β1-selective adrenoblockers (betaxolol and metoprolol tartrate in patients with arterial hypertension (HT of 1-2 degree associated with stable angina class II.Material and methods. 100 patients (aged 23-66 y.o. with HT associated with stable angina or without angina were involved in the study. Patients were randomized into 2 groups (G1 and G2. G1 patients were treated with betaxolol, and G2 patients – with metoprolol tartrate. Ambulatory BP and electrocardiogram monitoring, exercise stress-test, echocardiography, evaluating of respiratory function, blood analysis was performed initially and in 30 and 90 days of treatment.Results. Target BP level was reached in 44 (88% patients treated with betaxolol (average daily dose 10±4 mg. 34 patients of G1 took 10 mg daily. Target BP level was reached in 41 (82% patients treated with metoprolol tartrate (average daily dose 150±27 mg. 30 patients of G2 took 150 mg daily. Exercise tolerance increased and a number of ischemic ST segment depressions reduced significantly in both groups. There were no significant differences in antihypertensive, antianginal, and antiischemic efficacy between groups.Conclusion. Betaxolol advantage is an ability to maintain target BP level more than 24 hours. A possibility to take betaxolol once a day raises patient’s compliance with therapy.

  14. The prevalence of angina symptoms and association with cardiovascular risk factors, among rural, urban and rural to urban migrant populations in Peru

    OpenAIRE

    Gilman Robert H; Loret de Mola Christian; Zaman M Justin S; Smeeth Liam; Miranda J Jaime

    2010-01-01

    Abstract Background Rural-to-urban migration in low- and middle-income countries causes an increase in individual cardiovascular risk. Cost-effective interventions at early stages of the natural history of coronary disease such as angina may stem an epidemic of premature coronary deaths in these countries. However, there are few data on the prevalence of angina in developing countries, whilst the understanding the aetiology of angina is complicated by the difficulty in measuring it across dif...

  15. Evaluation of the add-on effect of chinese patent medicine for patients with stable or unstable angina: a systematic review and meta-analysis.

    Science.gov (United States)

    Mao, Chen; Chung, Vincent C H; Yuan, Jin-Qiu; Yu, Yuan-Yuan; Yang, Zu-Yao; Wu, Xin-Yin; Tang, Jin-Ling

    2013-01-01

    Chinese herbal medicine (CHM) has been widely used as an adjunct to western medicine in treating angina in China. We carried out this systematic review to evaluate the effectiveness of CHM on top of western medicine for angina. This meta-analysis included 46 randomized control trials with 4212 patients. For trials that included stable angina patients, the CHM group had significant lower incidence of total heart events (relative risk (RR) = 0.50, 95% confidence interval (CI) 0.33-0.78), myocardial infarction (RR = 0.32, 95% CI 0.14-0.72), heart failure (RR = 0.37, 95% CI 0.15-0.91), and angina (RR = 0.46, 95% CI 0.30-0.71) than that of control group. For trials that included unstable angina patients, CHM led to significantly lower occurrence of total heart events (RR = 0.46, 95% CI 0.32-0.66), myocardial infarction (RR = 0.37, 95% CI 0.26-0.54), and angina (RR = 0.36, 95%CI 0.26-0.51). Likewise, for trials that included stable or unstable angina patients, the rates of myocardial infarction (RR = 0.34, 95% CI 0.17-0.68) and angina (RR = 0.46, 95% CI 0.30-0.70) in CHM group were significantly lower than that in control group. In conclusion, CHM is very likely to be able to improve the survival of angina patients who are already receiving western medicine. PMID:24416066

  16. Five year prognosis in patients with angina identified in primary care: incident cohort study.

    LENUS (Irish Health Repository)

    Buckley, Brian S

    2009-01-01

    OBJECTIVE: To ascertain the risk of acute myocardial infarction, invasive cardiac procedures, and mortality among patients with newly diagnosed angina over five years. DESIGN: Incident cohort study of patients with primary care data linked to secondary care and mortality data. SETTING: 40 primary care practices in Scotland. PARTICIPANTS: 1785 patients with a diagnosis of angina as their first manifestation of ischaemic heart disease, 1 January 1998 to 31 December 2001. MAIN OUTCOME MEASURES: Adjusted hazard ratios for acute myocardial infarction, coronary artery bypass grafting, percutaneous transluminal coronary angioplasty, death from ischaemic heart disease, and all cause mortality, adjusted for demographics, lifestyle risk factors, and comorbidity at cohort entry. RESULTS: Mean age was 62.3 (SD 11.3). Male sex was associated with an increased risk of acute myocardial infarction (hazard ratio 2.01, 95% confidence interval 1.35 to 2.97), death from ischaemic heart disease (2.80, 1.73 to 4.53), and all cause mortality (1.82, 1.33 to 2.49). Increasing age was associated with acute myocardial infarction (1.04, 1.02 to 1.06, per year of age increase), death from ischaemic heart disease (1.09, 1.06 to 1.11, per year of age increase), and all cause mortality (1.09, 1.07 to 1.11, per year of age increase). Smoking was associated with subsequent acute myocardial infarction (1.94, 1.31 to 2.89), death from ischaemic heart disease (2.12, 1.32 to 3.39), and all cause mortality (2.11, 1.52 to 2.95). Obesity was associated with death from ischaemic heart disease (2.01, 1.17 to 3.45) and all cause mortality (2.20, 1.52 to 3.19). Previous stroke was associated with all cause mortality (1.78, 1.13 to 2.80) and chronic kidney disease with death from ischaemic heart disease (5.72, 1.74 to 18.79). Men were more likely than women to have coronary artery bypass grafting or percutaneous transluminal coronary angioplasty after a diagnosis of angina; older people were less likely to

  17. Tratamento de angina mesentérica em pacientes com arterite de Takayasu Treatment of mesenteric angina in patients with Takayasu's arteritis

    Directory of Open Access Journals (Sweden)

    Luana Thayse Barros de Lima

    2011-04-01

    Full Text Available Aarterite de Takayasu (AT é uma doença inflamatória crônica do tecido conectivo, idiopática, que acomete preferencialmente a aorta e seus ramos. A terapêutica utilizada baseia-se sobretudo no uso de corticosteroides e imunossupressores. É relatado o caso de uma paciente, 33 anos, com mal-estar, febre, mialgia, cefaleia intensa, pulsátil, holocraniana, resistente a analgésicos, hipertensão arterial sistêmica de difícil controle, claudicação no membro inferior direito e dor abdominal de forte intensidade, a qual piorava após a alimentação. A angiotomografia revelou aneurisma da aorta ascendente, estenose da artéria ilíaca comum direita, estenose das artérias renais e estenose da artéria mesentérica superior, fato que embasou o diagnóstico de angina mesentérica e a conduta intervencionista através da angioplastia transluminal percutânea múltipla com a colocação de stents.Takayasu's arteritis (TA is an idiopathic chronic inflammatory disease of the connective tissue that affects mainly the aorta and its branches. Treatment is mainly based on corticosteroids and immunosuppressants. We report the case of a 33-year-old female complaining of malaise, fever, myalgia, severe pulsing holocranial headache resistant to analgesics, systemic arterial hypertension hard to control, right lower limb claudication, and severe abdominal pain that worsened after the meals. Angiotomography revealed aneurysm of the ascending aorta, and stenosis of the following vessels: right common iliac artery, renal arteries, and superior mesenteric artery. Those findings supported the diagnosis of mesenteric angina and the interventional approach by use of percutaneous transluminal angioplasty with stent placement.

  18. [The treatment of chronic stable angina with isradipine. A cooperative Latin American study].

    Science.gov (United States)

    Román, O; Alcocer, L; Espinoza, J; Arcos, R; Gómez, G; Mayorga, E; Buzzi, A; Tavella, N; Romero, C; Kuster, F

    1991-04-01

    In order to study the efficacy and tolerance of isradipine, a new Ca++ antagonist for the treatment of stable chronic angina, a multicentric cooperative study was carried out in eight Latin American countries (Argentine, Chile, Colombia, Ecuador, Mexico, Peru, Uruguay and Venezuela), which included 169 patients (60% men and 40% women), average age 62.6 +/- 9.7. Patients with more than 4 biweekly anginal crisis were accepted, with one or more of the following inclusion criteria: coronariographic evidence of obstruction greater than 60% in one or more vessels, IAM history, positive scintigraphy and positive effort test. The trial was single-blind, with placebo during the admission phase (2 weeks) and active treatment for 12 weeks. isradipine was administered in increasing doses of 2.5, 5, and 7 mg thrice a day, according to the presence or absence of anginal crisis. It was observed that the average frequency of weekly pains decreased from 8.2 +/- 7 under placebo to 6.3 +/- 7.5 under isradipine at low doses, and to 2.0 +/- 2.0 (p less than 0.001) under maximum doses. TNT intake decreased parallel also in a significant way. At the end of the trial, 37% of patients had become asymptomatic, and angina had reduced to less than two crisis a week in 33%. A clear relation doses-effect was observed. There was no alteration in laboratory exams neither in ECG. Seven patients had complications derived from the evolutional course of disease (2 IAM, 5 unstable angina and one sudden death). Adverse events were relatively frequent and the majority derived from vasodilator effect (tibial oedema 37%, flushing 17%, headache 23%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1829846

  19. Chest pain after percutaneous coronary intervention in patients with stable angina

    Directory of Open Access Journals (Sweden)

    Chang CC

    2016-08-01

    Full Text Available Chao-Chien Chang,1–3 Yueh-Chung Chen,4,5 Eng-Thiam Ong,1 Wei-Cheng Chen,1 Chia-Hsiu Chang,1 Kuan-Jen Chen,1 Cheng-Wen Chiang1 1Division of Cardiology, Department of Internal Medicine, Cathay General Hospital, Taipei, Taiwan, ROC; 2Graduate Institute of Medical Sciences, Taipei Medical University, Taipei, Taiwan, ROC; 3Department of Pharmacology, Taipei Medical University, Taipei, Taiwan, ROC; 4Division of Cardiology, Department of Internal Medicine, Taipei City Hospital Ren-Ai branch, Taipai, Taiwan, ROC; 5Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC Background: Percutaneous coronary intervention (PCI has been widely used to treat acute coronary syndrome but is only recommended as an additional treatment to medical therapy and risk modification in patients with refractory or progressing angina. The number of PCI in this patient population is still increasing. Post-PCI chest pain (PPCP is one of the common problems of PCI. Its presentation and causes in patients with stable angina are poorly understood.Patients and methods: This study retrospectively collected clinical information of 167 patients who had stable angina and underwent elective PCI, including 70 patients with PPCP 24 hours after procedure and 97 patients without PPCP. The incidence and predictors of PPCP were analyzed.Results: The incidence of PPCP was 41.9% (70/167. Compared with non-PPCP patients, PPCP patients had more abnormal post-PCI electrocardiogram (ECG changes (new Q-waves, ST-segment shifts, or T-waves inversion and serum cardiac troponin I (cTnI elevation, more PCI vessels, and stent placement (all P<0.05. More PPCP patients required repeat revascularization than non-PPCP patients after PCI (P=0.043. PPCP was correlated with abnormal post-PCI ECG changes (P<0.0001, cTnI elevation (P<0.0001, post-PCI serum level of cTnI (P<0.0001, number of stents placed (P=0.009, and pre-PCI cTnI level (P=0.049. The strongest predictors of

  20. Diagnostic Value of Spiral on Kidney Angina%螺旋CT对肾绞痛的诊断价值

    Institute of Scientific and Technical Information of China (English)

    杨泽年; 张婷

    2003-01-01

    Objective Study the three methods' diacrisis value:X ray sheet of kidney angina cause of urinary calculus,vein renal pelvis contrast and spiral CT. Method Look back on and study 50 clinical kidney angina patients who have taken X ray sheet,or vein renal pelvis contrast, or spiral CT treatment. Compare those three methods and find the calculus positive rate and the areas of calculus frequently happening. Result X ray sheet finds that the calculus positive rate is 58%. Vein renal pelvis contrast finds that the calculus positive rate is 74%. Spiral CT finds that the calculus positive rate is 96% .All the calculus leans to appearing at the hypo - segment of ureter. And the Same - side kidney gets dropsy of different degree.Conclusion Urinary calculus, especially ureter hypo - segment calculus is the main cause of kidney angina. And spiral CT scanning is the best way to find calculus.

  1. Verapamil and angiotensin-converting enzyme inhibitors in patients with coronary artery disease and reduced left ventricular ejection fraction

    DEFF Research Database (Denmark)

    Hansen, J F; Tingsted, L; Rasmussen, Verner;

    1996-01-01

    Verapamil is effective as antianginal medication but contraindicated in patients with congestive heart failure. Angiotensin-converting enzyme (ACE) inhibitors improve survival in patients with congestive heart failure but have limited effect on patients with angina pectoris. No studies have been...... published on the combined treatment with verapamil and ACE inhibitors in patients with stable angina pectoris and left ventricular dysfunction. We performed an open study in 14 patients with angina pectoris and ejection fraction

  2. Reduction of recurrent ischemia with abciximab during continuous ECG-ischemia monitoring in patients with unstable angina refractory to standard treatment (CAPTURE)

    NARCIS (Netherlands)

    S. Meij (Simon); R. Melkert (Rein); T. Lenderink (Timo); M.L. Simoons (Maarten); A.P.J. Klootwijk (Peter)

    1998-01-01

    textabstractBACKGROUND: In the CAPTURE (c7E3 Fab Anti Platelet Therapy in Unstable REfractory angina) trial, 1265 patients with refractory unstable angina were treated with abciximab or placebo, in addition to standard treatment from 16 to 24 hours preceding coronary intervention t

  3. Incidence of Diabetes and Cardiovascular Disease in Mexican Americans

    Science.gov (United States)

    2016-03-07

    Cardiovascular Diseases; Heart Diseases; Myocardial Infarction; Angina Pectoris; Death, Sudden, Cardiac; Cerebrovascular Disorders; Peripheral Vascular Diseases; Coronary Disease; Diabetes Mellitus, Non-insulin Dependent; Diabetes Mellitus

  4. RE-EVALUATION OF THE MECHANISM AND TREATMENT OF ANGINA DECUBITUS

    Institute of Scientific and Technical Information of China (English)

    陈纪林; 陈在嘉; 徐义枢; 高润霖; 寇文蓉; 姚康宝; 于全俊; 陶寿琪

    1996-01-01

    30 patients with angina decubittus(AD) were studied during hospitalization. These patients were found to have severe coronary artery obstructive lesions and an increase of myocardial oxygen consumption (MOC) before the onset to AD, indicating that AD belongs to the category of effort angina. 18 patients were investigated by continuous hemodynamic mordtoring. Three patients had significant increase in pulmonary artery diastolic pressure (PADP) before the onset. In the other 15 patients, PADP increased slightly in J2 and remained unchanged in 3 cases before the onset. Left ventriculography showed ejection fraction (EF))45% in 25 of the 27 patients. These results indicate that left ventricular (LV) systolic dysfunction is not a major factor in the pathogenesis of AD. The patients with LVEDP>12 mmHg constituted 60% of 25 patients with EF)45%, suggesting that these patients had obvious LV diastolic dysfunction, which may he the major factor in the pathogenesis of AD. According to the results of our treatment, Beta blockers may be used as the major form of treatment in the patients with AD.

  5. Ranolazine: Drug overview and possible role in primary microvascular angina management.

    Science.gov (United States)

    Cattaneo, Mattia; Porretta, Alessandra Pia; Gallino, Augusto

    2015-02-15

    Ranolazine is a novel well-tolerated anti-ischemic drug, which selectively inhibits late sodium current and exerts metabolic properties without any hemodynamic effect. Ranolazine has been approved as a second-line medical treatment for symptomatic stable coronary artery disease. Primary microvascular angina (MVA) is suspected when angina symptoms occur in patients with demonstrated myocardial ischemia, absence of myocardial disease and normal coronary artery angiography. Recent clinical data suggest that MVA represents a complex entity, which has been increasingly recognized as a significant cause of morbidity. High variability and low response to traditional anti-anginal treatment characterize primary MVA. Despite the fact that clinical and preclinical evidence provides information regarding ranolazine usefulness in primary MVA management, only three recent small randomized trials have investigated this issue. By selecting peer-reviewed literature in Pubmed and Cochrane Library, this review provides an overview on ranolazine pharmacology and efficacy, focusing on recent evidence suggesting its usefulness in management of primary MVA. PMID:25555283

  6. Unstable angina

    Science.gov (United States)

    ... a close relative such as a sibling or parent had heart disease before age 55 in a man or before age 65 in a woman) High blood pressure High LDL cholesterol Low HDL cholesterol Male gender Sedentary lifestyle (not getting enough exercise) Obesity Older ...

  7. Angina - discharge

    Science.gov (United States)

    ... Avoid salty and fatty foods. Stay away from fast-food restaurants. Your doctor can refer you to a ... Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine. J Am Coll Cardiol . 2007 Aug ...

  8. Unstable Angina

    Science.gov (United States)

    ... Privacy Policy What's Your Risk? Heart Attack Risk Assessment Determine your risk of having a heart attack or dying from coronary heart disease and get a report to discuss with your healthcare provider. Determine your risk of having a heart ...

  9. Microvascular Angina

    Science.gov (United States)

    ... Privacy Policy What's Your Risk? Heart Attack Risk Assessment Determine your risk of having a heart attack or dying from coronary heart disease and get a report to discuss with your healthcare provider. Determine your risk of having a heart ...

  10. Stable angina

    Science.gov (United States)

    ... and prasugrel). Your provider may recommend a cardiac rehabilitation program to help improve your heart's fitness. SURGICAL ... and the American Association for Thoracic Surgery, Preventive ... Society for Cardiovascular Angiography and Interventions, ...

  11. Ludwig's angina

    Science.gov (United States)

    ... the emergency room or call your local emergency number (such as 911) right away. Call your health care provider if you have symptoms of this condition, or if symptoms do not get better after treatment. Prevention Visit the dentist for regular checkups. Treat symptoms of mouth or ...

  12. Angina - discharge

    Science.gov (United States)

    ... Avoid salty and fatty foods. Stay away from fast-food restaurants. Your doctor can refer you to a ... Controlling your high blood pressure Dietary fats explained Fast food tips Heart attack - discharge Heart attack - what to ...

  13. 加味胸痹汤对冠心病心绞痛患者TNF-α、VEGF水平的影响%Influence of Xiongbitong Decoction on TNF-α and VEGF Levels of Coronary Heart Angina Patients

    Institute of Scientific and Technical Information of China (English)

    王文林

    2013-01-01

    Objective:To observe the effect of Xiongbi Decoction on TNF-α and VEGF levels of coronary heart disease patients with angina pectoris,and to explore the possible mechanisms in the pathogenesis of coronary heart disease.Methods:60 cases of coronary heart disease in patients with stable angina were randomly divided into treatment group and control group,30 in each group.based on the patients'conditions,ACE inhibitors,β-blockers,anti-platelet aggregation optimization were selected.Treatment group on the basis of the above treatment added with the Xiongbitong Decoction.The effects were observed after treatment.Results:After treatment,TCM syndrome was improved with statistical difference (P < 0.05),but there was no statistically significant ECG improvement.After treatment,TNF-c level was significantly lower than that of the comparison group (P < 0.05),treatment group serum levels of VEGF were significantly increased (P < 0.05),while the serum VEGF content in control group was not obviously increased (P > 0.05).Conclusion:Xiongbitong Decoction can improve the TCM syndromes,the party inflammatory cells to inhibit vascular endothelial secretion of TNF-α,and protect the role of vascular endothelial function.The promotion of vascular endothelial cells to secrete VEGF has a distinct role,speculating that the drug may have a role to promote myocardial angiogenesis,which may be one of the mechanisms of the protective effect of the drug for ischemic myocardium.%目的:观察加味胸痹汤对冠心病心绞痛患者TNF-α、VEGF水平的影响,探讨在冠心病发病中的部分可能机制.方法:将60例冠心痛稳定型心绞痛患者随机分成治疗组和对照组,每组各30例,两组均根据病人病情选用ACE抑制剂、β受体阻滞剂、抗血小板聚集等最优化的西药治疗;治疗组在以上治疗的基础上加用中药加味胸痹汤口服,疗程结束后观察疗效与结果.结果:两组治疗后中医证候疗效改善情

  14. STIMULATION CHARACTERISTICS, COMPLICATIONS, AND EFFICACY OF SPINAL-CORD STIMULATION SYSTEMS IN PATIENTS WITH REFRACTORY ANGINA - A PROSPECTIVE FEASIBILITY STUDY

    NARCIS (Netherlands)

    DEJONGSTE, MJL; NAGELKERKE, D; HOOYSCHUUR, CM; JOURNEE, HL; MEYLER, PWJ; STAAL, MJ; DEJONGE, P; LIE, KI

    1994-01-01

    Objectives: In a prospective study with a 1-year follow-up we evaluated: (1) the feasibility of a method for the adjustment of spinal cord stimulator (SCS) parameters, (2) complications of SCS, and (3) efficacy of SCS. Methods: In patients receiving an SCS for severe angina unresponsive to standard

  15. Spinal cord stimulation in the treatment of refractory angina : systematic review and meta-analysis of randomised controlled trials

    NARCIS (Netherlands)

    Taylor, Rod S.; De Vries, Jessica; Buchser, Eric; DeJongste, Mike J. L.

    2009-01-01

    Background: The aim of this paper was undertake a systematic review and meta-analysis of the use of spinal cord stimulation ( SCS) in the management of refractory angina. Methods: We searched a number of electronic databases including Medline, Embase and Cochrane Library up to February 2008 to ident

  16. Myocardial rest iodine-123-β-methyl-iodophenyl-pentadecanoic acid scintigraphy compared with dipyridamole stress thallium-201 scintigraphy in unstable angina

    International Nuclear Information System (INIS)

    Twelve patients with stable angina and 12 patients with unstable angina underwent rest iodine-123-β-methyl-iodophenyl-pentadecanoic acid (BMIPP), dipyridamole stress thallium scintigraphy and delayed thallium scintigraphy. In stable angina, sensitivity for detecting ischemic segments was higher in dipyridamole thallium (74%) than rest BMIPP (48%) images (p<0.05), but there was no significant difference between the 2 images in unstable angina. In unstable angina, the incidence of segments with higher defect scores on BMIPP images than on delayed thallium images and the opposite pattern was 27 and 5 (p<0.01). In stable angina, there was no difference. The mean defect score on BMIPP (6.3±5.6) was higher than that on delayed thallium scintigraphy (2.9±2.7) and it was almost the same as on the initial dipyridamole stress test (6.5±5.2). In conclusion, BMIPP scintigraphy is safer and may be as useful in detecting myocardial ischemia in patients with unstable angina as thallium scintigraphy. (author)

  17. Bloqueo de Ganglio Estrellado en el tratamiento de angina de pecho refractaria: un posible tratamiento coadyuvante

    Directory of Open Access Journals (Sweden)

    Isaías Salas Herrera

    2002-04-01

    Full Text Available El presente trabajo corresponde una revisión bibliográfica de los estudios clínicos realizados en síndromes anginosos refractarios al tratamiento convencional, utilizando como tratamiento el bloqueo de ganglio estrellado. Se realizó una búsqueda de literatura publicada entre los años 1.900 al 2.000 en las bases de datos MDConsult, Medline y ProQuest. A su vez se revisaron las publicaciones en la Biblioteca del Hospital Rafael Ángel Calderón Guardia y en la Biblioteca del BINASSS (Biblioteca Nacional de Salud del Seguro Social. De acuerdo a los estudios analizados el bloqueo de ganglio estrellado se describe como posibilidad terapéutica para el control de dolor de la angina de pecho refractaria . La descripción clásica de la inervación cardíaca consiste en tres nervios simpáticos mayores originados de los ganglios cervicales superior, medio e inferior. Esta inervación simpática en conjunto con diversos nervios parasimpáticos, se describen como el plexo cardíaco. En contraste Jane et. al. (1986 en un estudio anatómico de 23 cadáveres describe que la inervación cardiopulmonar en el hombre se origina en el ganglio estrellado y las mitades caudales de las cadenas simpáticas cervicales junto con nervios que se originan del nervio recurrente laríngeo o del vago. De estas estructuras derivan los dos plexos cardiopulmonares. De estos plexos derivan tres nervios cardíacos mayores que se proyectan hacia el corazón. Se estima que determinado porcentaje de los pacientes diagnosticados con angina inestable progresará a desarrollar una angina refractaria al tratamiento. El bloqueo de ganglio estrellado podría ser un nuevo método terapéutico para controlar el dolor de dicha condición. Sin embargo se necesitan estudios clínicos randomizados a doble ciego para obtener resultados concluyentes.

  18. Evaluation of the Add-On Effect of Chinese Patent Medicine for Patients with Stable or Unstable Angina: A Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Chen Mao

    2013-01-01

    Full Text Available Chinese herbal medicine (CHM has been widely used as an adjunct to western medicine in treating angina in China. We carried out this systematic review to evaluate the effectiveness of CHM on top of western medicine for angina. This meta-analysis included 46 randomized control trials with 4212 patients. For trials that included stable angina patients, the CHM group had significant lower incidence of total heart events (relative risk (RR=0.50, 95% confidence interval (CI 0.33–0.78, myocardial infarction (RR=0.32, 95% CI 0.14–0.72, heart failure (RR=0.37, 95% CI 0.15–0.91, and angina (RR=0.46, 95% CI 0.30–0.71 than that of control group. For trials that included unstable angina patients, CHM led to significantly lower occurrence of total heart events (RR=0.46, 95% CI 0.32–0.66, myocardial infarction (RR=0.37, 95% CI 0.26–0.54, and angina (RR=0.36, 95%CI 0.26–0.51. Likewise, for trials that included stable or unstable angina patients, the rates of myocardial infarction (RR=0.34, 95% CI 0.17–0.68 and angina (RR=0.46, 95% CI 0.30–0.70 in CHM group were significantly lower than that in control group. In conclusion, CHM is very likely to be able to improve the survival of angina patients who are already receiving western medicine.

  19. Evaluation of the Add-On Effect of Chinese Patent Medicine for Patients with Stable or Unstable Angina: A Systematic Review and Meta-Analysis

    OpenAIRE

    Chen Mao; Vincent C H Chung; Jin-Qiu Yuan; Yuan-Yuan Yu; Zu-Yao Yang; Xin-Yin Wu; Jin-Ling Tang

    2013-01-01

    Chinese herbal medicine (CHM) has been widely used as an adjunct to western medicine in treating angina in China. We carried out this systematic review to evaluate the effectiveness of CHM on top of western medicine for angina. This meta-analysis included 46 randomized control trials with 4212 patients. For trials that included stable angina patients, the CHM group had significant lower incidence of total heart events (relative risk (RR) = 0.50, 95% confidence interval (CI) 0.33–0.78), myocar...

  20. Psychophysical rehabilitation aspects of patient with coronary heart disease and Angina.

    Directory of Open Access Journals (Sweden)

    Mohammed Ali Khaleel.

    2012-03-01

    Full Text Available It is analyzed scientific and methodological literature, considered the views of scientists on the link of stress and cardiovascular diseases. It is determined causes of stress, with recommendations for combating stress and its prevention. A program of rehabilitation for patients with coronary artery disease after hospital discharge is shown. The experiment involved 88 patients of coronary heart disease and angina, II and III functional class at the age of 40-65 years. Participants were divided into two groups the main and control. The control group performed a program of physical rehabilitation, including breathing and physical exercises, in the program we have added to the main group autogenic exercises. At the end the experiment revealed that the health indicators of main group better than the control group in 23%.

  1. Endothelial Dysfunction and Blood Viscosity Inpatients with Unstable Angina in Different Periods of a Solar Activity

    Science.gov (United States)

    Parshina, S. S.; Tokaeva, L. K.; Dolgova, E. M.; Afanas'yeva, T. N.; Strelnikova, O. A.

    The origin of hemorheologic and endothelial defects in patients with unstable angina (comparing with healthy persons) is determined by a solar activity period: the blood viscosity increases in a period of high solar activity in the vessels of small, medium and macro diameters, a local decompensate dysfunction of small vessels endothelium had been fixed (microcirculation area). In the period of a low solar activity there is an increase of a blood viscosity in vessels of all diameters, generalized subcompensated endothelial dysfunction is developed (on the background of the III phase blood clotting activating). In the period of a high solar activity a higher blood viscosity had been fixed, comparing with the period of a low solar activity.

  2. Serum Adenosine deaminase activity and C-reactive protein levels in unstable angina

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    Rani Surekha

    2003-01-01

    Full Text Available In unstable angina (USA patients, immunological responses contributing to inflammation play a vital role in plaque rupture and thrombosis causing stroke. In the present study an attempt is made to estimate the levels of adenosine deaminase activity, an immunoenzyme marker and C-reactive protein, a marker of inflammation in USA patients. 45 patients presenting USA and 50 age and sex matched healthy controls were included in the study. Serum ADA activity was measured spectrophotometrically at 630nm and serum C-reactive protein was detected using Avitex CRP kit, which is a rapid latex agglutination test. The Mean ADA levels were 41.15 ± 11.04 in patients and 20.71±5.63 in controls and 66.6% of patients and none of the controls were positive to CRP. The present study observed the importance of ADA as a serum marker in addition to CRP for assessing the immune response in USA patients.

  3. INFLUENCE OF MILDRONATE ON EFFICIENCY OF ANTIANGINAL THERAPY IN PATIENTS WITH STABLE BURDEN ANGINA

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    N. P. Kutishenko

    2015-12-01

    Full Text Available Aim. To study influence of mildronate (M on treatment efficiency of patients with ischemic heart disease (IHD, receiving standard antianginal therapy (AATMaterials and methods. Double-blind, randomized, placebo-controlled study was carried out in parallel groups. All patients continued the earlier prescribed AAT without changes. After control period (10-14 days was over, randomization of patients either to the treatment group (M 500mg twice per day, or to the control group (placebo (Pl twice per day was made for 6 weeks therapy. Criterion of treatment efficiency: increase in duration of trial with burden on treadmill (TB, decrease in angina attack frequency (AA and reduction in nitroglycerin taking (NTT. TB was carried out at the beginning (TB-1, at the end of the control period (TB-2, and at the end of the treatment (TB-3.Results. TB-1 and TB-2 had good reproducibility, their duration didn’t differ. At the end of the treatment additionally with M, growth in duration of TB-3 (p=0,002 was registered, while there was no growth of TB duration with the Pl treatment (p=0,07. During the treatment decrease in AA number both with M (p=0,002, and with Pl (p=0,02 was noted. With M treatment decrease in NTT treatment (p=0.02 was observed, while NTT with Pl didn’t change (p=0,7. Number of side effects, registered with M and Pl, didn’t differ.Conclusion. Mildronate provides additional benefits for patients with IHD with stable burden angina, when they do not reach desired effect with the prescribed AAT.

  4. Estratificando o risco na angina instável com a ecocardiografia sob estresse com dobutamina Stratifying the risk in unstable angina with dobutamine stress echocardiography

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    Brivaldo Markman Filho

    2006-09-01

    Full Text Available OBJETIVO: Avaliar a importância da ecocardiografia sob estresse pela dobutamina (EED na estratificação de risco de pacientes com angina instável (AI de baixo a moderado risco, quanto à capacidade de predizer os eventos clínicos combinados (morte de causa cardiovascular, infarto agudo do miocárdio (IAM, AI recorrente, necessidade de revascularização miocárdica no seguimento de 6 meses. MÉTODOS: Estudo prospectivo, multicêntrico. Os pacientes incluídos estavam internados, assintomáticos havia 24 horas e a medicação em uso não era suspensa para a realização do exame. O EED era realizado preferencialmente até 72 horas da chegada ao hospital. RESULTADOS: Foram avaliados 95 pacientes consecutivos. O EED foi positivo para isquemia em 40 pacientes (42,1% e em 55 (57,9%, foi negativo. Eventos ocorreram em 28 pacientes, 26 dos quais tinham o EED positivo para isquemia miocárdica. Os outros 67 pacientes não tiveram eventos; desses, 53 tinham o EED negativo. A sensibilidade, especificidade, acurácia, valor preditivo positivo e negativo do teste frente aos desfechos foram: 92,9%, 79,1%, 83,2%, 65% e 96,4%, respectivamente. Sobrevida livre de eventos após 6 meses para os pacientes com EED negativo foi de 96%, comparada com 35% nos que tiveram o EED positivo (pOBJECTIVE: To evaluate the role of dobutamine stress echocardiography (DSE in the risk stratification of low to moderate risk unstable angina (UA patients, to predict the combined clinical outcome of cardiovascular death, myocardial infarction (MI, recurrent UA and the need of revascularization procedures in a 6 month period. METHODS: Multicenter prospective study. Patients should be admitted to the hospital and asymptomatic in the last 24 hours. The exam was performed up to 72 hours from the hospital admission and no medication was stopped prior to the test. RESULTS: Ninety-five consecutive patients were evaluated by DSE. Forty patients (42,1% had a positive ischemic test and

  5. Effect of Atorvastatin and Pioglitazone on Plasma Levels of Adhesion Molecules in Non-Diabetic Patients With Hypertension or Stable Angina or Both

    OpenAIRE

    Pattan, Vishwanath; Seth, Sandeep; Jehangir, Waqas; Bhargava, Balram; Maulik, Subir Kumar

    2015-01-01

    Background It was to study the effect of atorvastatin, pioglitazone and their combination on plasma levels of adhesion molecules in patients with hypertension or stable angina or both. Methods It was an open-label, randomized parallel-group study. Forty-five atorvastatin-naive patients with hypertension or stable angina or both, were randomized to receive either atorvastatin (19 patients; 10 mg OD for 12 weeks) or pioglitazone (26 patients; 30 mg OD for 12 weeks). Another group of 30 patients...

  6. Factors Associated with the Types of Heparin used in the Treatment of Unstable Angina at a Brazilian Hospital

    OpenAIRE

    Maria Auxiliadora Parreiras Martins; Sérgia Maria Starling de Magalhães; Cibele Comini César; Adriano Max Moreira Reis; Mauro Henrique Nogueira Guimarães de Abreu

    2010-01-01

    Unfractionated heparin (UFH) and low-molecularweight heparins (LMWHs) are widely used in curative and preventive treatments of thromboembolic disorders. The aim of the study was to investigate factors associated with the choice of these types of heparin to treat patients with unstable angina under real conditions of hospital use. A cross-sectional study was performed in a private general hospital in Belo Horizonte, Brazil, from January 1st to December 31th, 2001. Data...

  7. Can C reactive protein or troponins T and I predict outcome in patients with intractable unstable angina?

    OpenAIRE

    Curzen, N; Patel, D; Kemp, M; Hooper, J.; Knight, C.; Clarke, D.; Wright, C; Fox, K.

    1998-01-01

    Objective—To determine whether a single blood test for the measurement of C reactive protein, or troponin I or T concentrations could be used to stratify patients with intractable unstable angina awaiting transfer for coronary angiography by correlating these values with coronary anatomy and transient myocardial ischaemia.
Design—Prospective study.
Setting—Tertiary cardiac unit.
Patients—All patients admitted to their local hospital with ischaemic chest pain, uncontrolled by medical treatment...

  8. The Relationship Between Ankle-Brachial Index and Number of Involved Coronaries in Patients with Stable Angina

    OpenAIRE

    Sadeghi, Masoumeh; Tavasoli, Aliakbar; Roohafza, Hamidreza; Sarrafzadegan, Nizal

    2010-01-01

    BACKGROUND Atherosclerosis is the commonest cause of vascular disease which can involve peripheral and/or cardiac vessels. This study was conducted to evaluate the possible link between Ankle-Brachial Index (ABI) and coronary vessel involvement in patients with stable angina. METHODS This cross-sectional study was conducted in 2008 on 120 individuals who were hospitalized in Chamran Heart Center and underwent coronary angiography. A questionnaire was completed to obtain demographic informatio...

  9. Association of low levels of vitamin D with chronic stable angina: A prospective case-control study

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    Ab Hameed Raina

    2016-01-01

    Full Text Available Background: Coronary artery disease (CAD is a major cause of death and disability in developed countries. Chronic stable angina is the initial manifestation of CAD in approximately 50% of the patients. Recent evidence suggests that vitamin D is crucial for cardiovascular health. The prevalence of vitamin D deficiency in our region is 83%. A low level of vitamin D is associated with chronic stable angina. Aim: This study was aimed at supporting or refuting this hypothesis in our population. Materials and Methods: The study was a prospective case-control study. We studied 100 cases of chronic stable angina and compared them with 100 matched controls. Vitamin D deficiency was defined as <20 ng/mL, vitamin D insufficiency as 20-30 ng/mL and normal vitamin D level as 31-150 ng/mL. Results: The prevalence of vitamin D deficiency among cases and controls was 75% and 10%, respectively. 75% of the cases were vitamin D-deficient (<20 ng/mL; 12% were vitamin D-insufficient (20-30 ng/mL, and 13% had normal vitamin D levels (31-150 ng/mL. None had a toxic level of vitamin D. Among the controls, 10% were vitamin D-deficient, 33% were vitamin D-insufficient, and 57% had normal vitamin D levels. The mean vitamin level among cases and controls was 15.53 ng/mL and 40.95 ng/mL, respectively, with the difference being statistically significant (P ≤ 0.0001. There was no statistically significant relation between the disease severities, i.e., on coronary angiography (CAG with vitamin D level. Among the cases, we found that an increasing age was inversely related to vitamin D levels (P = 0.027. Conclusion: Our study indicates a correlation between vitamin D deficiency and chronic stable angina. Low levels may be an independent, potentially modifiable cardiovascular risk factor.

  10. Evidence of a cellular protective effect by antecedent angina independent of collateral flow recruitment during coronary angioplasty in humans

    International Nuclear Information System (INIS)

    The main aim of this study was to elucidate whether the beneficial effect of antecedent angina is a cellular protective effect or the result of an increase of collateral flow. Of 42 patients with angina who underwent percutaneous transluminal coronary angioplasty (PTCA) for proximal left anterior descending artery (LAD) stenosis, 22 had experienced antecedent anginal pain (AP) within 7 days prior to PTCA. 99mTc-sestamibi was injected during balloon inflation, and quantitative analysis of ischemic severity during coronary occlusion was calculated (SS). An electrocardiogram was recorded during ballooning to calculate the sum of ST elevation (ΣST). ΣST was significantly reduced in patients with AP compared with patients without AP (1.88±0.89 mV vs 1.18±0.74 mV, p=0.0088); however, no difference was observed in defect severity. A close correlation was observed between SS and ΣST in both groups. The multivariate regression model demonstrated that both a large SS (p<0.0001) and the absence of preceding AP (p=0.001) were significantly related to the elevation of ΣST. Recent angina can render the myocardium more resistant to subsequent ischemia during angioplasty and is true preconditioning rather than simply an increase of flow. (author)

  11. Use of Health Care System-Supplied Aspirin by Veterans With Postoperative Heart Attack or Unstable Angina.

    Science.gov (United States)

    Rivera, Cathleen M; Copeland, Laurel A; McNeal, Catherine J; Mortensen, Eric M; Pugh, Mary J; MacCarthy, Daniel J

    2015-10-01

    Evidence-based guidelines for the use of aspirin in secondary prevention of cardiovascular disease events are well established. Despite this, the prevalence of aspirin use for secondary prevention is suboptimal. The study aimed to determine the prevalence of aspirin use for secondary prevention of cardiovascular disease events when it is dispensed as a prescription, as is performed in the Veterans Affairs (VA) managed care system. VA patients who had undergone major surgery and experienced a postoperative myocardial infarction (MI) or unstable angina between the years 2005 and 2009 were identified from administrative databases. VA pharmacy records were used to determine whether a prescription for aspirin was filled after the postoperative MI or unstable angina. Multivariable logistic regression models estimated odd ratios of filling aspirin prescriptions for the predictors of interest. Of the 321,131 men and women veterans who underwent major surgery, 7,700 experienced a postoperative MI or unstable angina. Among those 7,700, 47% filled an aspirin prescription. Only 59% of veterans with no co-pay filled an aspirin prescription. Aspirin fills were more common in younger veterans, Blacks, Hispanics, males, hypertensive veterans, mentally ill patients, those with no co-pay and those prescribed antiplatelets/anticoagulants in addition to aspirin postoperatively. These findings suggest that the impact of dispensing aspirin as a prescription may not be significant in increasing the appropriate use of aspirin for secondary prevention. PMID:26351774

  12. Pacing-induced ST segment deviation in patients with unstable angina: clinical, angiographic, and hemodynamic correlation.

    Science.gov (United States)

    Hussain, K M; Gould, L; Pomerantsev, E V; Angirekula, M; Bharathan, T

    1995-07-01

    To assess the clinical, coronary arteriographic, and hemodynamic differences between the unstable angina patients manifesting ST segment depression and those showing ST segment elevation as well as those demonstrating chest pain only without ST segment deviation during pacing, low-dose digital subtraction ventriculography was performed in 33 patients before and after abrupt cessation of atrial pacing during selective coronary arteriography. Transient ST segment depression during pacing was observed in 17 patients (52%), whereas 6 patients (18%) showed ST segment elevation; however, 10 patients (30%) did not manifest any ST segment deviation in spite of typical chest pain. Hypertension and a history of myocardial infarction were observed in a significantly higher (P < 0.05) proportion of patients with ST segment depression than in those with ST elevation. Patients who manifested ST segment depression during pacing had a higher incidence of triple-vessel disease (65 vs 17%; P < .05) as compared with the patients with ST segment elevation. Indirect evidence of intracoronary thrombi (complicated lesion, abrupt occlusion, and intraluminal filling defect) was noticed in a higher frequency (P < 0.05) in the group of patients with ST elevation during pacing. In patients with ST segment depression, no significant changes of global left ventricular (LV) functional parameters were observed. However, the length of the LV severe hypokinetic region was increased significantly (6.2 +/- 3.1 vs 23.5 +/- 6.2%; P < 0.005) during pacing in this group of patients. The shortening of the affected segments of the left ventricle was decreased significantly (52.3 +/- 3.6 vs 38.3 +/- 4.9%; P < 0.05) in these patients during pacing. In the group of patients with ST segment elevation during pacing, decrease in ejection fraction was associated with significant (P < 0.01) increase in midwall equatorial diastolic stress as compared with the patients with pacing-induced ST segment depression as

  13. The prevalence of angina symptoms and association with cardiovascular risk factors, among rural, urban and rural to urban migrant populations in Peru

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    Gilman Robert H

    2010-10-01

    Full Text Available Abstract Background Rural-to-urban migration in low- and middle-income countries causes an increase in individual cardiovascular risk. Cost-effective interventions at early stages of the natural history of coronary disease such as angina may stem an epidemic of premature coronary deaths in these countries. However, there are few data on the prevalence of angina in developing countries, whilst the understanding the aetiology of angina is complicated by the difficulty in measuring it across differing populations. Methods The PERU MIGRANT study was designed to investigate differences between rural-to-urban migrant and non-migrant groups in specific cardiovascular disease risk factors. Mass-migration seen in Peru from 1980s onwards was largely driven by politically motivated violence resulting in less 'healthy migrant' selection bias. The Rose angina questionnaire was used to record chest pain, which was classified definite, possible and non-exertional. Mental health was measured using the General Health Questionnaire (GHQ-12. Mantel-Haenszel odds ratios (adjusted for age, sex, cardiovascular disease risk factors and mental health were used to assess the risk of chest pain in the migrant and urban groups compared to the rural group, and further to assess the relationship (age and sex-adjusted between risk factors, mental health and chest pain. Results Compared to the urban group, rural dwellers had a greatly increased likelihood of possible/definite angina (multi-adjusted OR 2.82 (1.68- 4.73. Urban and migrant groups had higher levels of risk factors (e.g. smoking - 20.1% urban, 5.5% rural. No diabetes was seen in the rural dwellers who complained of possible/definite angina. Rural dwellers had a higher prevalence of mood disorder and the presence of a mood disorder was associated with possible/definite angina in all three groups, but not consistently with non-exertional chest pain. Conclusion Rural groups had a higher prevalence of angina as

  14. Optimizing prescription of chinese herbal medicine for unstable angina based on partially observable markov decision process.

    Science.gov (United States)

    Feng, Yan; Qiu, Yu; Zhou, Xuezhong; Wang, Yixin; Xu, Hao; Liu, Baoyan

    2013-01-01

    Objective. Initial optimized prescription of Chinese herb medicine for unstable angina (UA). Methods. Based on partially observable Markov decision process model (POMDP), we choose hospitalized patients of 3 syndrome elements, such as qi deficiency, blood stasis, and turbid phlegm for the data mining, analysis, and objective evaluation of the diagnosis and treatment of UA at a deep level in order to optimize the prescription of Chinese herb medicine for UA. Results. The recommended treatment options of UA for qi deficiency, blood stasis, and phlegm syndrome patients were as follows: Milkvetch Root + Tangshen + Indian Bread + Largehead Atractylodes Rhizome (ADR = 0.96630); Danshen Root + Chinese Angelica + Safflower + Red Peony Root + Szechwan Lovage Rhizome Orange Fruit (ADR = 0.76); Snakegourd Fruit + Longstamen Onion Bulb + Pinellia Tuber + Dried Tangerine peel + Largehead Atractylodes Rhizome + Platycodon Root (ADR = 0.658568). Conclusion. This study initially optimized prescriptions for UA based on POMDP, which can be used as a reference for further development of UA prescription in Chinese herb medicine. PMID:24078826

  15. Nitric Oxide Synthetic Pathway in Patients with Microvascular Angina and Its Relations with Oxidative Stress

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    Benedetta Porro

    2014-01-01

    Full Text Available A decreased nitric oxide (NO bioavailability and an increased oxidative stress play a pivotal role in different cardiovascular pathologies. As red blood cells (RBCs participate in NO formation in the bloodstream, the aim of this study was to outline the metabolic profile of L-arginine (Arg/NO pathway and of oxidative stress status in RBCs and in plasma of patients with microvascular angina (MVA, investigating similarities and differences with respect to coronary artery disease (CAD patients or healthy controls (Ctrl. Analytes involved in Arg/NO pathway and the ratio of oxidized and reduced forms of glutathione were measured by LC-MS/MS. The arginase and the NO synthase (NOS expression were evaluated by immunofluorescence staining. RBCs from MVA patients show increased levels of NO synthesis inhibitors, parallel to that found in plasma, and a reduction of NO synthase expression. When summary scores were computed, both patient groups were associated with a positive oxidative score and a negative NO score, with the CAD group located in a more extreme position with respect to Ctrl. This finding points out to an impairment of the capacity of RBCs to produce NO in a pathological condition characterized mostly by alterations at the microvascular bed with no significant coronary stenosis.

  16. Evaluation of Role of C-Reactive Protein Level on Cardiovascular Events During 14 Days after Admission of Patients with Unstable Angina in the Ekbatan Hospital, Hamadan, 2002

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    B. Naghsh Tabrizi

    2007-01-01

    Full Text Available Introduction & Objective: Unstable angina is in the center of spectrum from chronic stable angina to acute myocardial infarction. Due to high prevalence of unstable angina, it is important to find a factor that predicts prognosis and management modality. We decided to measure CRP level for the items that mentioned above.Materials & Methods: This study was a cross-sectional study that 138 patients who were admitted with unstable angina in the CCU and cardiac ward of Ekbatan Hospital in Hamedan were considered for measuring CRP level. Age, sex, period of disease, and left ventricular ejection fraction percentile were worked out. After quantitative CRP measuring and 14 days follow up, the questionnaire was completed.Results: CRP levels were 116.3 and 124.3 ng/ml in the patients with and without cardiovascular events (whole events respectively during 14 days follow up. Recurrent unstable angina, myocardial infarction and mortality rate were higher in the patients with elevated level of CRP but need to perform coronary angiography was lower.Conclusion: CRP level had no correlation with occurrence of cardiovascular events (whole events during 14 days follow up.

  17. Estudio de eficacia y coste en la electroestimulación medular como tratamiento de la angina refractaria Cost-effectiveness study of medullary electrostimulation for the management of refractory angina

    OpenAIRE

    Mayo, M.; Pallarés, J; C. Villalaín; A. Moreno-Gázquez; M. A. Canos; Almenar, L.

    2004-01-01

    Objetivo: Valorar la evolución de los pacientes, de nuestro hospital, diagnosticados de angina refractaria y tratada con estimulación eléctrica medular (EEM) cervical desde 1994-2002, además de valorar los costes asociados a dicho tratamiento y su relación coste/beneficio. Material y métodos: Estudio retrospectivo de 12 pacientes observando su evolución a lo largo de 8 años con controles clínicos periódicos, objetivándose tanto en la historia previa como posterior al implante, las siguientes ...

  18. CASE OF DIAGNOSIS OF APICAL FORM OF HYPERTROPHIC CARDIOMYOPATHY WITH A PATIENT WITH PROGRESSIVE ANGINA CLINIC

    Directory of Open Access Journals (Sweden)

    N. S. Krylova

    2014-01-01

    Full Text Available Objective of work: to describe the apical form of hypertrophic cardiomyopathy (AFHC developing under the "mask" of the ischemic heart disease not diagnosed for a long period.Materials and methods. Patient B., 73 y.o., female, was brought to the cardiology department with complains of severe pressing pain behind the breastbone caused with no apparent reason and lasting for over 4 hours. The following examination of the patient was performed: electrocardiography (ECG, echocardiography (EchoCG, Holter ECG monitoring, coronary angiography (CAG, ventriculography.Results. The final diagnosis for the patient was set on the basis of the following readings: ECG data (basic rhythm – atrial fibrillation, left ventricle (LV hypertrophy, negative T-waves in leads V1–6, ST segment depression up to 1–2 mm in leads V4–6, EchoCG (hypertrophy of apical segments of the LV with decreasing of its cavity, moderate dilatation of the left atrium, intraventricular obstruction in the apical third of the LV with the maximum pressure gradient of up to 48 mm Hg., CAG (stenotic lesions of coronary arteries were found, ventriculography (LV volume is not increased, no violations of local contractility, narrowing of the LV cavity in the lower third is observed with thinning in the apex, which indicatesexpressed apical hypertrophy of the LV myocard. AFHC, apical form with moderate obstruction in the lower third of the left ventricle. Stress angina syndrome. CAG and ventriculography were main diagnostic methods that allowed setting the final diagnosis.Conclusion. The clinical case sets forth the peculiarities of diagnostics, therapy, and post-therapy management of patients with this form of AFHC.

  19. CASE OF DIAGNOSIS OF APICAL FORM OF HYPERTROPHIC CARDIOMYOPATHY WITH A PATIENT WITH PROGRESSIVE ANGINA CLINIC

    Directory of Open Access Journals (Sweden)

    N. S. Krylova

    2015-01-01

    Full Text Available Objective of work: to describe the apical form of hypertrophic cardiomyopathy (AFHC developing under the "mask" of the ischemic heart disease not diagnosed for a long period.Materials and methods. Patient B., 73 y.o., female, was brought to the cardiology department with complains of severe pressing pain behind the breastbone caused with no apparent reason and lasting for over 4 hours. The following examination of the patient was performed: electrocardiography (ECG, echocardiography (EchoCG, Holter ECG monitoring, coronary angiography (CAG, ventriculography.Results. The final diagnosis for the patient was set on the basis of the following readings: ECG data (basic rhythm – atrial fibrillation, left ventricle (LV hypertrophy, negative T-waves in leads V1–6, ST segment depression up to 1–2 mm in leads V4–6, EchoCG (hypertrophy of apical segments of the LV with decreasing of its cavity, moderate dilatation of the left atrium, intraventricular obstruction in the apical third of the LV with the maximum pressure gradient of up to 48 mm Hg., CAG (stenotic lesions of coronary arteries were found, ventriculography (LV volume is not increased, no violations of local contractility, narrowing of the LV cavity in the lower third is observed with thinning in the apex, which indicatesexpressed apical hypertrophy of the LV myocard. AFHC, apical form with moderate obstruction in the lower third of the left ventricle. Stress angina syndrome. CAG and ventriculography were main diagnostic methods that allowed setting the final diagnosis.Conclusion. The clinical case sets forth the peculiarities of diagnostics, therapy, and post-therapy management of patients with this form of AFHC.

  20. Unstable angina and non-ST-segment myocardial infarction: an evidence-based approach to management.

    Science.gov (United States)

    Kou, Victoria; Nassisi, Denise

    2006-01-01

    Unstable angina (UA) and non-ST-segment elevation myocardial infarction (NSTEMI) represent two common, closely related acute coronary syndromes with potentially high morbidity and mortality. Integration of information from the history, physical exam, electrocardiogram, and cardiac biomarkers is used to formulate both the diagnosis of UA/NSTEMI and the overall assessment of patient prognosis and risk. Early diagnosis and risk stratification of patients with UA/NSTEMI enable the physician to initiate timely, appropriate treatment. (There is strong clinical evidence supporting the tailoring of specific therapies to the risk profile of the patient.) In recent years, powerful new medical and invasive therapies have been developed. Pharmaceutical agents for UA/NSTEMI may be broadly grouped into one of three categories: anti-ischemic, anti-platelet, and anti-thrombotic agents. Standard therapy for UA/NSTEMI has commonly included oxygen, aspirin, nitrates, morphine, beta-blockers and heparin. Potent new anti-platelet agents, including inhibitors of platelet adenosine diphosphate and glycoprotein IIb/IIIa receptors, play important, expanding roles in the management of these syndromes. Low-molecular-weight heparins have been shown to be an effective alternative to unfractionated heparin in their treatment. Major advances in invasive techniques and devices over the last decade include revascularization with percutaneous coronary intervention and drug-eluting intracoronary stents. Strong interest exists in studying the potential benefits and risks associated with an early invasive therapeutic strategy rather than an aggressive medical regimen for patients with UA/NSTEMI. As new treatments are rapidly added to our growing arsenal of management options, clinicians are constantly challenged with incorporating complex new information and guidelines into their practices in a timely fashion. To assist clinicians with this challenge, this article will review the evidence to support

  1. Predictive factors of recurrent angina after acute coronary syndrome: the global registry acute coronary events from China (Sino-GRACE)

    Institute of Scientific and Technical Information of China (English)

    ZHAO Fu-hai; CHEN Yun-dai; SONG Xian-tao; PAN Wei-qi; JIN Ze-ning; YUAN Fei; LI Yong-bin; Ren Fang; L(U) Shu-zheng

    2008-01-01

    Background Many patients with acute coronary syndrome (ACS) develop recurrent angina (RA) during hospitalization. The aim of this non-randomized, prospective study was to investigate the predictive factors of RA in unselected patients with ACS enrolled in the global registry acute coronary events (GRACE) during hospitalization in China. Methods Between March 2001 and October 2004, enrolled were 1433 patients with ACS, including ST segment elevation myocardial infarction (662, 46.2%), non-ST segment elevation myocardial infarction (239, 16.7%) and unstable angina (532, 37.1%). The demographic distribution, medical history and clinical data were collected to investigate the predictive factors of RA by Logistic regression.Results During hospitalization 275 (19.2%) patients were documented with RA including unstable angina (53.2%), non-ST segment elevation myocardial infarction (27.5%), ST segment elevation myocardial infarction (19.3%). A comorbidity of dyslipidemia, prior angina, percutaneous coronary Intervention (PCI) within 6 months was more common in patients with RA, P<0.05. In the patients with RA, a significantly higher proportion of patients with acute pulmonary edema was observed, 23 (8.4%) versus 43 (3.7%), P=0.001. Acute renal failure was present in 8 (2.9%) of patients with RA versus 19 (1.6%) of patients without RA,P=0.165. Hemorrhagic events were present in 6 (2.2%) of patients with RA versus 8 (0.7%) of patients without RA, ventricular tachycardia/ ventricular fibrillation events in 12 patients (4.3%) versus 22 patients (1.9%), congestive heart failure in 69 patients (25.0%) versus 94 patients (8.1%), myocardial re-infarction in 28 patients (10.1%) versus 15 patients (1.3%), P<0.05, respectively. A lower proportion of patients with RA underwent in-hospital PCI, 687 (59.3%) versus 114 (41.5%), P=0.000. A higher proportion of patients with RA received heparin, 260 (94.5%) versus 1035 (89.4%), P=0.006; and beta-blockers 176(64.0%) versus 864 (74

  2. Exercise testing in patients with variant angina: results, correlation with clinical and angiographic features and prognostic significance

    International Nuclear Information System (INIS)

    Eighty-two patients with variant angina underwent a treadmill exercise test using 14 ECG leads, and 67 also underwent exercise thallium-201 scans. The test induced ST elevation in 25 patients (30%), ST depression in 21 (26%) and no ST-segment abnormality in 36 (44%). ST elevation during exercise occurred in the same ECG leads as during spontaneous attacks at rest, and was always associated with a large perfusion defect on the exercise thallium scan. In contrast, exercise-induced ST depression often did not occur in the leads that exhibited ST elevation during episodes at rest. The ST-segment response to exercise did not accurately predict coronary anatomy: Coronary stenoses greater than or equal to 70% were present in 14 of 25 patients (56%) with ST elevation, in 13 of 21 (62%) with ST depression and in 14 of 36 (39%) with no ST-segment abnormality (NS). However, the degree of disease activity did correlate with the result of the exercise test: ST elevation occurred during exercise in 11 of 14 patients who had an average of more than two spontaneous attacks per day, in 12 of 24 who had between two attacks per day and two per week, and in only two of 31 who had fewer than two attacks per week (p<0.005). ST elevation during exercise was reproducible in five of five patients retested during an active phase of their disease, but not in three of three patients who had been angina-free for a least 1 month before the repeat test. We conclude that in variant angina patients, the results of an exercise test correlate well with the degree of disease activity but not with coronary anatomy, and do not define a high-risk subgroup

  3. Influence of nifedipine on left ventricular perfusion and function in patients with unstable angina: Evaluation with radionuclide techniques

    Energy Technology Data Exchange (ETDEWEB)

    Wall, E.E. van der; Kerkkamp, H.J.; Simoons, M.L.; Rijk, P.P. van; Reiber, J.H.C.; Bom, N.; Lubsen, J.C.; Lie, K.I.

    1986-04-01

    In 1981, a large, double-blind, randomized trial was started in The Netherlands to evaluate the therapeutic effects of nifedipine and/or metoprolol in patients with unstable angina. This study has been called the Holland Interuniversity Nifedipine/metoprolol Trial (HINT) and required several hundred patients to establish potential therapeutic effects. From December 1982 to January 1984 the effects of nifedipine on left ventricular (LV) performance in a subgroup of 52 HINT patients were studied using radionuclide techniques. All patients (23 on nifedipine, 29 controls) underwent thallium-201 scintigraphy or radionuclide angiography just before and 48 h after the start of experimental medication. The radionuclide angiographic studies were also performed at 1 and 4 h after treatment. Nifedipine did not influence the incidence of disapperance of perfusion defects on the 48-h thallium images. No significant differences in overall LV ejections fraction (EF) were seen at any time between nifedipine-treated patients and controls. However, paired observations in 37 patients showed improvement of LVEF after 48 h in 8 patients on nifedipine and in only 1 control patient. Scintigraphic measurements on admission were not related to clinical outcome after 48 h. Concomitant administration of metoprolol did not influence LVEF in either group. It is concluded that nifedipine improves LVEF after 48 h in a subset of patients with unstable angina without affecting myocardial perfusion. This finding indicates that nifedipine has a predominant effect on afterload reduction in patients with unstable angina. Also, early scintigraphic measurements had no significant predictive value for subsequent cardiac events.

  4. Influence of nifedipine on left ventricular perfusion and function in patients with unstable angina: Evaluation with radionuclide techniques

    International Nuclear Information System (INIS)

    In 1981, a large, double-blind, randomized trial was started in The Netherlands to evaluate the therapeutic effects of nifedipine and/or metoprolol in patients with unstable angina. This study has been called the Holland Interuniversity Nifedipine/metoprolol Trial (HINT) and required several hundred patients to establish potential therapeutic effects. From December 1982 to January 1984 the effects of nifedipine on left ventricular (LV) performance in a subgroup of 52 HINT patients were studied using radionuclide techniques. All patients (23 on nifedipine, 29 controls) underwent thallium-201 scintigraphy or radionuclide angiography just before and 48 h after the start of experimental medication. The radionuclide angiographic studies were also performed at 1 and 4 h after treatment. Nifedipine did not influence the incidence of disapperance of perfusion defects on the 48-h thallium images. No significant differences in overall LV ejections fraction (EF) were seen at any time between nifedipine-treated patients and controls. However, paired observations in 37 patients showed improvement of LVEF after 48 h in 8 patients on nifedipine and in only 1 control patient. Scintigraphic measurements on admission were not related to clinical outcome after 48 h. Concomitant administration of metoprolol did not influence LVEF in either group. It is concluded that nifedipine improves LVEF after 48 h in a subset of patients with unstable angina without affecting myocardial perfusion. This finding indicates that nifedipine has a predominant effect on afterload reduction in patients with unstable angina. Also, early scintigraphic measurements had no significant predictive value for subsequent cardiac events. (orig.)

  5. Novel variant of dual left anterior descending artery arising from single right coronary artery anomaly presenting with angina inversa

    Science.gov (United States)

    Arslan, Gokhan; Iyisoy, Atilla; Bingol, Hakan

    2015-01-01

    A 55-year-old female without a history of coronary artery disease, hypertensive for the past 17 years, was admitted with resting chest pain. Electrocardiography revealed a negative T-wave in anterior chest leads. Coronary angiography visualised anomalous coronary anatomy, with a common origin of the right coronary artery and the left main coronary artery in the right sinus of Valsalva serving as a common coronary trunk. It should be emphasised that T-wave abnormalities and chest angina may be related to this congenital coronary anomaly. PMID:26702282

  6. Correlation between C-Reactive Protein in Peripheral Vein and Coronary Sinus in Stable and Unstable Angina

    OpenAIRE

    Weverton Ferreira Leite; José Antonio Franchini Ramires; Luiz Felipe Pinho Moreira; Célia Maria Cassaro Strunz; José Armando Mangione

    2015-01-01

    Background: High sensitivity C-reactive protein (hs-CRP) is commonly used in clinical practice to assess cardiovascular risk. However, a correlation has not yet been established between the absolute levels of peripheral and central hs-CRP. Objective: To assess the correlation between serum hs-CRP levels (mg/L) in a peripheral vein in the left forearm (LFPV) with those in the coronary sinus (CS) of patients with coronary artery disease (CAD) and a diagnosis of stable angina (SA) or unstable an...

  7. Prinzmetal's variant angina evolved in inferior myocardial infarction with involvement of the right ventricle: Sequential radionuclide evaluation

    International Nuclear Information System (INIS)

    A patient with Prinzmetal's variant angina (PVA) who developed an inferolateral myocardial infarction with right-ventricle involvement was studied using sequential radionuclide imaging until 5 months after the acute event. The patient also underwent-contrast ventriculography and coronary-artery angiography. Equilibrium-gated radionuclide angiography (EGRA) revealed the localization of ventricular dysfunction, the results obtained being in agreement with haemodynamic data. We emphasize the usefulness of the parameters obtained using EGRA (regional wall motion, systolic and diastolic parameters) in planing therapy and follow-up. (orig.)

  8. FEATURES OF CYTOKINE PRODUCTION IN PATIENTS WITH UNSTABLE ANGINA: DEPENDENCE ON ETHNICITY IN THE REPUBLIC OF SAKHA (YAKUTIA)

    OpenAIRE

    A. S. Golderova; I. N. Nikolaeva; V. E. Tarasova; V. A. Kozlov

    2014-01-01

    Abstract. We investigated levels of spontaneous and mitogen-induced cytokine production (IL-1β, IL-4, IL-6, IL-10 and IFNγ) by peripheral blood cells of 24 men with unstable angina (UA), including indigenous population (n = 12, Yakuts), and a group of Russian migrants to the Republic of Sakha (n = 12). Activation of inflammatory response was revealed in the total group of patients with UA, manifesting by increase of spontaneous and induced production of the pro-inflammatory IL-1β, IL-6 cytoki...

  9. GAMMAGRAFÍA DE PERFUSIÓN MIOCÁRDICA EN MUJERES POSMENOPÁUSICAS CON ANGINA Y CORONARIAS EPICÁRDICAS ANGIOGRÁFICAMENTE NORMALES / Myocardial perfusion scintigraphy in postmenopausal women with angina and angiographically normal epicardial coronary

    Directory of Open Access Journals (Sweden)

    Sherien Sixto Fernández

    2011-03-01

    Full Text Available Introduction and Objectives: Microvascular angina is common in postmenopausal women. Myocardial ischemia was induced by stress testing, and reports have been published about the relationship between endothelial dysfunction and myocardial perfusion. The objective of this research was to determine whether myocardial ischemia can be evidenced by abnormalities in perfusion and function, as detected by myocardial scintigraphy in women with typical angina, normal coronary angiography and endothelial dysfunction. Methods: 59 women underwent lipid and endothelial function measurements by brachial artery ultrasound, in addition, a 24-hour ECG study (Holter. During the scintigraphy a stress-rest protocol was applied. Patients were divided into two groups according to presence (group I or absence (group II of myocardial perfusion defects. Results: 21 patients showed perfusion defects. 57 % of group I exhibited greater endothelial dysfunction. Only twelve patients showed reversible perfusion defects, and 75 % of the cases was associated with a reduction of post-stress left ventricular ejection fraction, greater than 5 %, and regional abnormalities of wall motion. Three patients in group I showed evidence of ischemia compared with four in Group II. Conclusions: The stress-induced ischemia was associated with a reduced post-stress ejection fraction and endothelial dysfunction in the studied women, and no ischemic changes in the Holter were found.

  10. Estudio de eficacia y coste en la electroestimulación medular como tratamiento de la angina refractaria Cost-effectiveness study of medullary electrostimulation for the management of refractory angina

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    M. Mayo

    2004-07-01

    Full Text Available Objetivo: Valorar la evolución de los pacientes, de nuestro hospital, diagnosticados de angina refractaria y tratada con estimulación eléctrica medular (EEM cervical desde 1994-2002, además de valorar los costes asociados a dicho tratamiento y su relación coste/beneficio. Material y métodos: Estudio retrospectivo de 12 pacientes observando su evolución a lo largo de 8 años con controles clínicos periódicos, objetivándose tanto en la historia previa como posterior al implante, las siguientes variables: fracción de eyección del ventrículo izquierdo (FEVI, estadio funcional NYHA, frecuencia de ingresos hospitalarios, frecuencia de episodios anginosos e ingesta de cafinitrinas, sensación subjetiva de mejora del dolor anginoso, exitus, costes hospitalarios previos y posteriores a la colocación del EEM. Resultados: El electrodo de EEM fue implantado a nivel cervical siendo más frecuente la localización C2-C3 (58,3%. No se presentó ninguna complicación intraoperatoria. En el postoperatorio inmediato tuvimos como única complicación un desplazamiento del electrodo. No hubo ninguna complicación a largo plazo. Comprobamos que existió una disminución del número de anginas por semana (14 vs 4 p = 0,005 asociada a una disminución del número de tomas de nitroglicerina de acción rápida (15,7 vs 3,8 p = 0,002 y a una disminución en el número de ingresos hospitalarios/año (2,62 vs 0,84 p = 0,003. La mejoría subjetiva por parte del paciente tras la colocación del neuroestimulador fue del 70%. En cuanto al coste hospitalario quinquenal (conformado sólo por el coste del ingreso sin pruebas complementarias fue de 37.921,85 e en los pacientes con angina refractaria que no portaban EEM, frente a los 15.150,25 € de los pacientes portadores EEM.Objective: To assess the evolution of patients in our hospital with diagnosis of refractory angina treated with cervical medul-lary electrostimulation (MES over the period 1994-2002, and to

  11. Behavior of right and left ventricles during episodes of variant angina in relation to the site of coronary vasospasm

    International Nuclear Information System (INIS)

    The effects of single-vessel coronary occlusion on simultaneously evaluated right (RV) and left ventricular (LV) performance were assessed and compared with LV perfusion patterns in 25 patients with variant angina. Coronary spasm involved the right coronary artery in 15 patients (group 1) and the left anterior descending coronary artery in 10 patients (group 2). Biventricular function was assessed by radionuclide angiography under basal conditions, during spontaneous or ergonovine-induced ischemia, and after resolution of the ischemic attack. Myocardial perfusion was assessed by thallium 201 scintigraphy in 21 patients of this series during superimposable ischemic episodes. In group 1, ischemia caused RV (14 of 15 patients) and LV (13 of 15 patients) regional dysfunction with significant reduction in RV and LV ejection fractions. The interventricular spetum was involved in six of 15 patients, causing a more pronounced LV impairment. In group 2, all patients showed septal dyssynergies associated with a reduction of LV ejection fraction; absent or trivial RV involvement was observed. In both groups, LV perfusion defects were present in all patients with LV wall motion abnormalities during ischemia, matching the site of regional dyssynergies. Thus, in a group of patients with variant angina and single-vessel disease, transient occlusion of the right coronary artery directly caused RV and LV impairment; in these patients, the extent of LV but not RV dysfunction appeared related to the presence of septal ischemia. Vasospasm of the left anterior descending coronary artery consistently caused LV dysfunction not associated with secondary effects on RV systolic function

  12. Evaluation of plaque texture by means of multislice computed tomography in patients with acute coronary syndrome and stable angina

    International Nuclear Information System (INIS)

    In the present study, multislice spiral computed tomography (MSCT), which allows non-invasive assessment of coronary artery plaque, was used to compare the CT density of plaque between patients with acute coronary syndrome (ACS) and those with stable angina (SA). MSCT was performed in 20 patients with ACS (17 with acute myocardial infarction, 3 with unstable angina) and 22 patients with SA. The presence of the plaque was defined on the basis of multi-planar reformation and axial images. At least 4 regions of interest were then placed within the plaque and the minimum CT density was measured and expressed as Hounsfield units (HU). The number of plaques did not differ between the 2 groups, but the minimum CT density was significantly lower in patients with ACS (25±15 HU) than in those with SA (71±16 HU, range 46-101 HU, p<0.001). Similarly, the minimum plaque density was significantly lower in the culprit coronary segment (26±16 HU) than in the non-culprit segment (48±17 HU) in 15 ACS patients with multiple plaques. MSCT can potentially differentiate vulnerable from stable plaque in patients with coronary artery disease, although long-term, prospective analysis is needed to establish the conclusion. (author)

  13. Correlation between C-Reactive Protein in Peripheral Vein and Coronary Sinus in Stable and Unstable Angina

    Energy Technology Data Exchange (ETDEWEB)

    Leite, Weverton Ferreira, E-mail: wfleite@cardiol.br [Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, SP (Brazil); Hospital Beneficência Portuguesa de São Paulo, São Paulo, SP (Brazil); Ramires, José Antonio Franchini; Moreira, Luiz Felipe Pinho; Strunz, Célia Maria Cassaro [Instituto do Coração (InCor) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), São Paulo, SP (Brazil); Mangione, José Armando [Hospital Beneficência Portuguesa de São Paulo, São Paulo, SP (Brazil)

    2015-03-15

    High sensitivity C-reactive protein (hs-CRP) is commonly used in clinical practice to assess cardiovascular risk. However, a correlation has not yet been established between the absolute levels of peripheral and central hs-CRP. To assess the correlation between serum hs-CRP levels (mg/L) in a peripheral vein in the left forearm (LFPV) with those in the coronary sinus (CS) of patients with coronary artery disease (CAD) and a diagnosis of stable angina (SA) or unstable angina (UA). This observational, descriptive, and cross-sectional study was conducted at the Instituto do Coração, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, and at the Hospital Beneficência Portuguesa de Sao Paulo, where CAD patients referred to the hospital for coronary angiography were evaluated. Forty patients with CAD (20 with SA and 20 with UA) were included in the study. Blood samples from LFPV and CS were collected before coronary angiography. Furthermore, analysis of the correlation between serum levels of hs-CRP in LFPV versus CS showed a strong linear correlation for both SA (r = 0.993, p < 0.001) and UA (r = 0.976, p < 0.001) and for the entire sample (r = 0.985, p < 0.001). Our data suggest a strong linear correlation between hs-CRP levels in LFPV versus CS in patients with SA and UA.

  14. Correlation between C-Reactive Protein in Peripheral Vein and Coronary Sinus in Stable and Unstable Angina

    Directory of Open Access Journals (Sweden)

    Weverton Ferreira Leite

    2015-03-01

    Full Text Available Background: High sensitivity C-reactive protein (hs-CRP is commonly used in clinical practice to assess cardiovascular risk. However, a correlation has not yet been established between the absolute levels of peripheral and central hs-CRP. Objective: To assess the correlation between serum hs-CRP levels (mg/L in a peripheral vein in the left forearm (LFPV with those in the coronary sinus (CS of patients with coronary artery disease (CAD and a diagnosis of stable angina (SA or unstable angina (UA. Methods: This observational, descriptive, and cross-sectional study was conducted at the Instituto do Coração, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, and at the Hospital Beneficência Portuguesa de Sao Paulo, where CAD patients referred to the hospital for coronary angiography were evaluated. Results: Forty patients with CAD (20 with SA and 20 with UA were included in the study. Blood samples from LFPV and CS were collected before coronary angiography. Furthermore, analysis of the correlation between serum levels of hs-CRP in LFPV versus CS showed a strong linear correlation for both SA (r = 0.993, p < 0.001 and UA (r = 0.976, p < 0.001 and for the entire sample (r = 0.985, p < 0.001. Conclusion: Our data suggest a strong linear correlation between hs-CRP levels in LFPV versus CS in patients with SA and UA.

  15. Correlation between C-Reactive Protein in Peripheral Vein and Coronary Sinus in Stable and Unstable Angina

    International Nuclear Information System (INIS)

    High sensitivity C-reactive protein (hs-CRP) is commonly used in clinical practice to assess cardiovascular risk. However, a correlation has not yet been established between the absolute levels of peripheral and central hs-CRP. To assess the correlation between serum hs-CRP levels (mg/L) in a peripheral vein in the left forearm (LFPV) with those in the coronary sinus (CS) of patients with coronary artery disease (CAD) and a diagnosis of stable angina (SA) or unstable angina (UA). This observational, descriptive, and cross-sectional study was conducted at the Instituto do Coração, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, and at the Hospital Beneficência Portuguesa de Sao Paulo, where CAD patients referred to the hospital for coronary angiography were evaluated. Forty patients with CAD (20 with SA and 20 with UA) were included in the study. Blood samples from LFPV and CS were collected before coronary angiography. Furthermore, analysis of the correlation between serum levels of hs-CRP in LFPV versus CS showed a strong linear correlation for both SA (r = 0.993, p < 0.001) and UA (r = 0.976, p < 0.001) and for the entire sample (r = 0.985, p < 0.001). Our data suggest a strong linear correlation between hs-CRP levels in LFPV versus CS in patients with SA and UA

  16. Angina pré-infarto na evolução intra-hospitalar de pacientes idosos com infarto agudo do miocárdio Preinfarction angina and in-hospital outcome of elderly patients with acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Chiu Wen Shian

    2007-12-01

    Full Text Available FUNDAMENTO: A angina pré-infarto (API pode ser um marcador de pré-condicionamento isquêmico. Foi demonstrada redução da área infartada, do remodelamento ventricular, da incidência de insuficiência cardíaca, choque cardiogênico ou morte, quando a API estava presente. Esses resultados foram mais evidentes em adultos, porém, não em idosos. OBJETIVO: Avaliar a relação entre API e a evolução clínica de pacientes idosos com infarto agudo do miocárdio (IAM. MÉTODOS: Estudo tipo série de casos com grupo de comparação. Foram incluídos 36 pacientes com diagnóstico de IAM com elevação do segmento ST. Os pacientes foram distribuídos em grupo A (21 pacientes com API e grupo B (15 pacientes sem API. RESULTADOS: A idade média da população estudada foi 70,5 anos. A maioria (73% dos pacientes era do sexo masculino. O índice de massa corpórea médio foi 25,3 kg/m2. A amostra era constituída por 77,8% de hipertensos, 27,8% de diabéticos e 32,4% de dislipidêmicos. Dor torácica tipo A foi relatada por 71,4% dos estudados. A maioria (72,2% dos idosos foi classificada em Killip I. Os desfechos clínicos nos grupos A e B foram: angina pós-infarto 9,5% versus 20%, p=0,630; insuficiência cardíaca 23,8% versus 13,3%, p=0,674; revascularização de urgência 4,8% versus 6,7%, p=1; arritmia cardíaca 0% versus 6,7%, p=0,417. Não foi constatado nenhum caso de reinfarto, choque cardiogênico e morte até 30 dias em ambos os grupos. CONCLUSÃO: A presença da angina pré-infarto não se associou com uma melhor evolução clínica em idosos acometidos por IAM nesta série de casos.BACKGROUND: Preinfarction angina (PIA may be a marker of ischemic preconditioning. A decrease in infarct size, ventricular remodeling, congestive heart failure, cardiogenic shock or death was demonstrated in the presence of preinfarction angina. These findings were more evident in adults, but not in the elderly. OBJECTIVE: To assess the relationship between PIA

  17. The Diagnosis and Treatment of Patients With Prinzmetal's Variant Angina%变异性心绞痛的临床特征、诊断评估、处置现状及预后分析

    Institute of Scientific and Technical Information of China (English)

    尹春琳; 魏嘉平; 郝恒剑; 许冀; 徐东; 范振兴; 夏经纲

    2011-01-01

    目的:了解变异性心绞痛(PVA)的临床诊治现状,加深对冠状动脉(冠脉)痉挛导致心肌缺血的认识,为临床及时诊断、避免误诊和漏诊,采取合理治疗提供依据.方法:收集我院2001-01至2011-01临床诊断的PVA患者30例,分析每例患者的临床特征、诊断和临床处置方法及随访结果.结果:本组中年男性多发,吸烟是最主要的危险因素.20例(66.7%)患者PVA发作呈昼夜节律性,13例(43.3%)患者伴有活动时心绞痛发作.PVA可发生心肌梗死、晕厥等严重并发症,通常发生在症状初发后的3~6个月内,远期预后良好.8例患者PVA发作时心电图呈现特征性的巨"R"波或"墓碑"波.PVA累及前降支为41.7%,右冠为45.8%,回旋支为12.5%.本组PVA发生于非显著性狭窄的冠脉和正常冠脉13例(占54.2%).本组21例患者从PVA初发到确诊的时间在3个月之内,占70%.钙拮抗剂是PVA有效治疗的基石,但不能完全控制血管痉挛,60%以上的病例需要联合治疗.针对狭窄病变的介入治疗不是PVA治疗的有效治疗方法.结论:PVA在临床上的诊断仍然易被忽视,及时诊断是防止致命事件的关键,药物治疗是PVA的首选,对药物治疗失效的患者,介入治疗应在有选择的病例中进行.%Objective: To study the current clinical features, diagnosis and treatment of Prinzmetal' s variant angina( PVA) in order to better understand myocardial ischemia caused by coronary artery spasm and to improve the managanent of patients with PVA.Methods: We retrospectively analyzed 30 PVA patients who were treated in our hospital from January 2001 to January 2011 with their clinical features, diagnosis, treatment and follow-up prognosis.Results: PVA patients had more male gender and smoking history. There were 20 (66.7% ) cases had a circadian rhythm upon the onset,13(43. 3% ) had angina pectoris induced by physical efforts. PVA could be complicated with myocardiial infarction, syncope and sudden card iac

  18. Role of multi-slice CT coronary angiography in evaluating the different patterns of coronary artery disease in patients with unstable angina

    Directory of Open Access Journals (Sweden)

    Gamal Eldine M. Niazi

    2015-09-01

    Conclusion: Non-invasive multi-slice CT coronary angiography is a reliable technique of high ability to detect coronary artery disease and estimate the degree of obstruction, number of affected arteries and the pattern of their affection and can be used in workup in patients with unstable angina.

  19. Angina pré-infarto na evolução intra-hospitalar de pacientes idosos com infarto agudo do miocárdio Preinfarction angina and in-hospital outcome of elderly patients with acute myocardial infarction

    OpenAIRE

    Chiu Wen Shian; Sandro Gonçalves de Lima; Brivaldo Markman Filho

    2007-01-01

    FUNDAMENTO: A angina pré-infarto (API) pode ser um marcador de pré-condicionamento isquêmico. Foi demonstrada redução da área infartada, do remodelamento ventricular, da incidência de insuficiência cardíaca, choque cardiogênico ou morte, quando a API estava presente. Esses resultados foram mais evidentes em adultos, porém, não em idosos. OBJETIVO: Avaliar a relação entre API e a evolução clínica de pacientes idosos com infarto agudo do miocárdio (IAM). MÉTODOS: Estudo tipo série de casos com ...

  20. Cardiac rehabilitation: a good measure to improve quality of life in peri- and postmenopausal women with microvascular angina

    Directory of Open Access Journals (Sweden)

    Wojciech Szot

    2015-05-01

    Full Text Available Cardiac Syndrome X (CSX was considered a stable coronary syndrome, yet due to its nature, CSX symptoms often have a great impact on patients’ Quality of Life (QoL. According to ESC 2013 stable coronary artery disease criteria, CSX was replaced by Microvascular Angina (MA.Unfortunately, most CSX or MA patients, after classical angina (involving main coronary vessels has been ruled out, often do not receive proper treatment. Indications for pharmacological treatment of MA patients were introduced only recently. Another problematic issue is that scientists describing the pathophysiology of both CSX and MA stress a lack of a deeper insight into the multifactorial etiology of the source of pain associated with this disease. In the presented article we have attempted to study the influence of cardiac rehabilitation (3 months programme on the QoL of patients recognized as suffering from MA, as well as to check if changes in myocardial perfusion in these patients at baseline and after completion of cardiac rehabilitation match changes in their QoL. Therefore, after screening 436 women for MA, we studied 55 of them who were confirmed as having MA and who agreed to participate in the study. Exercise tests, Myocardial Perfusion Imaging, and QoL questionnaires were studied at baseline and after completing 3 months period of cardiac rehabilitation. Results were subsequently compared, which showed a link between improved perfusion score in SPECT study and improved overall physical capacity, on one hand, and improved QoL score on the other. These results confirm that cardiac rehabilitation is a very useful treatment option for MA patients. It seems that training during cardiac rehabilitation is a very important factor (improved physical efficiency –> increase in self-belief, and that taking into consideration the multifactor pathophysiology of pain, it is connected with a better quality of life for MA patients.

  1. Salvia miltiorrhiza and ischemic diseases

    Institute of Scientific and Technical Information of China (English)

    Xin-Yan JI; Benny K-H TAN; Yi-Zhun ZHU

    2000-01-01

    The demonstration of beneficial effects of salvia miltiorrhiza (DanShen) on ischemic diseases has revolutionized the management of angina pectoris, myocardial infarction (MI) or stroke in Chinese society. Experimental studies have shown that DanShen dilated coronary arteries, increased coronary blood flow, and scavenged free radicals in ischemic diseases, so that it reduced the cellular damage from ischemia and improved heart functions. Clinical trials also indicated that DanShen was an effective medicine for angina pectoris, MI, and stroke. This review will focus on DanShen's effects in angina pectoris, MI and stroke.

  2. Changes of serum hepatocyte growth factor before and after percutaneous coronary intervention in patients with unstable angina pectoris and significance there%不稳定性心绞痛患者冠脉介入手术前后血清肝细胞生长因子水平的改变及意义

    Institute of Scientific and Technical Information of China (English)

    王宁夫; 杨建敏; 潘浩; 童国新; 李佩璋; 张邢玮; 徐坚; 吴桂萍; 金建芬; 周亮; 叶显华

    2007-01-01

    目的 探讨不稳定性心绞痛患者经皮冠脉介入治疗(PCI)术前术中及术后血清肝细胞生长因子(HGF)水平的改变及意义.方法 70例不稳定性心绞痛患者根据是否介入治疗分成PCI组(49例)和非PCI组(21例),两组在PCI或冠脉造影术中均应用普通肝素,PCI组术后用低分子肝素7 d.分别在术前、术中、术后即刻、术后24 h及7 d以免联免疫法测定血清HGF的水平.PCI组于术前和术后24 h检测肌钙蛋白I(cTnI).结果 PCI组术前HGF水平显著高于非PCI组(13 566ng/L±3769 ng/L vs 1736 ng/L±604 ng/L,P<0.01),PCI组和非PCI组术后即刻HGF水平均比术前显著升高,(11 457 ng/L±2298 ng/L vs 967 ng/L±349 ng/L,P<0.01),但两组间比较HGF的改变无统计学意义.PCI术后第7天时cTnI阳性组血清HGF水平仍显著高于非PCI组(P<0.01),而cTnI阴性组已降至手术前水平.结论 严重冠脉病变的不稳定性心绞痛患者伴有外周血HGF水平升高;PCI术后cTnI阳性组血清HGF水平的延迟降低与心肌微梗死有一定的关系.

  3. 药物配合音乐疗法治疗心绞痛型冠心病伴焦虑抑郁疗效分析%Clinical Analysis on Angina Pectoris Accomponied with Anxiety and Depression Treated by Medicine Combined with Music Therapy

    Institute of Scientific and Technical Information of China (English)

    郭瑞萍; 李素平; 张云红

    2010-01-01

    目的:观察复方丹参滴丸配合音乐疗法治疗心绞痛型冠心病伴焦虑抑郁的疗效.方法:对照组50例给予复方丹参滴丸及一般心理治疗,治疗组50例另配合音乐疗法治疗.结果:治疗组心绞痛发作及心电图检查均较对照组改善明显(P<0.01),SDS和SAS评分较对照组降低显著(P<0.01).结论:复方丹参滴丸配合音乐疗法能显著提高心绞痛型冠心病伴焦虑抑郁的临床疗效.

  4. 参芎葡萄糖注射液治疗老年冠心病心绞痛的临床疗效观察%Therapeutic effects of Salivae Miltiorrhizae Liguspyragine Hydrochloride and Glucose injection in angina pectoris in elderly patients with coronary atherosclerotic heart disease

    Institute of Scientific and Technical Information of China (English)

    李豫川

    2013-01-01

    目的:探讨参芎葡萄糖注射液治疗老年冠心病心绞痛的临床疗效观察.方法:对68例老年冠心病心绞痛的患者随机分成观察组34例,对照组34例,均给予常规治疗,观察组加参芎葡萄糖注射液,疗程均为2周.观察临床症状及心电图的改善情况,测定血流变学指标的变化.结果:观察组临床症状及心电图改善明显优于对照组,观察组治疗前后血液流变学指标有显著下降(P<0.05).对照组治疗前后血液流变学指标无明显差异(P>0.05).结论:参芎葡萄糖注射液治疗老年冠心病心绞痛安全有效.

  5. Recent advances in the management of chronic stable angina I: Approach to the patient, diagnosis, pathophysiology, risk stratification, and gender disparities

    Directory of Open Access Journals (Sweden)

    Richard Kones

    2010-07-01

    Full Text Available Richard KonesThe Cardiometabolic Research Institute, Houston, Texas 77054 USAAbstract: The potential importance of both prevention and personal responsibility in ­controlling heart disease, the leading cause of death in the USA and elsewhere, has attracted renewed ­attention. Coronary artery disease is preventable, using relatively simple and inexpensive lifestyle changes. The inexorable rise in the prevalence of obesity, diabetes, dyslipidemia, and ­hypertension, often in the risk cluster known as the metabolic syndrome, drives the ­ever-increasing incidence of heart disease. Population-wide improvements in personal health habits appear to be a fundamental, evidence based public health measure, yet numerous barriers prevent implementation. A common symptom in patients with coronary artery disease, classical angina refers to the typical chest pressure or discomfort that results when myocardial oxygen demand rises and coronary blood flow is reduced by fixed, atherosclerotic, obstructive lesions. Different forms of angina and diagnosis, with a short description of the significance of pain and silent ischemia, are discussed in this review. The well accepted concept of myocardial oxygen imbalance in the genesis of angina is presented with new data about clinical pathology of stable angina and acute coronary syndromes. The roles of stress electrocardiography and stress myocardial perfusion scintigraphic imaging are reviewed, along with the information these tests provide about risk and prognosis. Finally, the current status of gender disparities in heart disease is summarized. Enhanced risk stratification and identification of patients in whom procedures will meaningfully change management is an ongoing quest. Current guidelines emphasize efficient triage of patients with suspected coronary artery disease. Many experts believe the predictive value of current decision protocols for coronary artery disease still needs improvement in order to

  6. Terapia celular associada à revascularização transmiocárdica laser como proposta no tratamento da angina refratária Cell therapy plus transmyocardial laser revascularization: a proposed alternative procedure for refractory angina

    Directory of Open Access Journals (Sweden)

    Luís Alberto Oliveira Dallan

    2008-03-01

    Full Text Available OBJETIVO: É descrita uma proposição cirúrgica para o tratamento de pacientes com doença arterial coronária (DAC terminal, não mais passíveis de revascularização miocárdica convencional. Constitui-se na revascularização transmiocárdica com raios laser (RTML, associada ao emprego de células progenitoras hematopoiéticas autólogas (CPH. MÉTODOS: Nove pacientes (oito homens, 65±5 anos, com as características supracitadas foram submetidos ao procedimento combinado. Além da avaliação clínica, o protocolo incluiu o estudo da perfusão miocárdica através da ressonância cardíaca (RMC sob estresse farmacológico, antes e seis meses após a intervenção cirúrgica. Procedeuse à RMTL através de minitoracotomia esquerda e utilização de laser de CO2, com média de 11±3 tiros por paciente. As CPH foram obtidas por punção medular, seguindo-se sua injeção direta (1,9±0,3x10(8 células/paciente em múltiplas áreas do miocárdio isquêmico. RESULTADOS: Não ocorreram óbitos ou complicações imediatas decorrentes dos procedimentos. Um paciente faleceu no segundo ano de pós-operatório, de causa não cardíaca (choque séptico. O seguimento clínico pós-operatório desses pacientes revelou redução significativa da classe funcional de angina de 3,7±0,2 para 1,3±0,2 (pOBJECTIVE: We tested the hypothesis that TMLR combined with intramyocardial injection of BMC is safe, and may help increase the functional capacity of patient with refractory angina. METHODS: Nine patients (eight men, 65±5 years old, with refractory angina for multivessel disease and previous myocardial revascularization procedures (CABG/PCI, not candidates for another procedure due to the extension of the disease were enrolled. TMLR (11±3 laser drills was performed via a limited thoracotomy using a CO2 Heart Laser System. BMC were obtained immediately prior to surgery, and the lymphomonocytic fraction separated by density gradient centrifugation. During

  7. Short‐term and long‐term outcomes in 133 429 emergency patients admitted with angina or myocardial infarction in Scotland, 1990–2000: population‐based cohort study

    OpenAIRE

    Capewell, S; Murphy, N F; MacIntyre, K.; Frame, S; Stewart, S.; Chalmers, J.W.T.; Boyd, J.; Finlayson, A; Redpath, A.; McMurray, J J V

    2006-01-01

    Objective: To analyse short- and long-term outcomes and prognostic factors in a large population-based cohort of unselected patients with a first emergency admission for suspected acute coronary syndrome between 1990 and 2000 in Scotland. Methods: All first emergency admissions for acute myocardial infarction (AMI) and all first emergency admissions for angina (the proxy for unstable angina) between 1990 and 2000 in Scotland (population 5.1 million) were identified. Survival to five years...

  8. Syndrome of diminished vasodilator reserve of the coronary microcirculation (microvascular angina or syndrome X): Diagnosis by combined atrial pacing and thallium 201 imaging--a case report

    Energy Technology Data Exchange (ETDEWEB)

    Magarian, G.J.; Palac, R.; Reinhart, S. (Veterans Administration Medical Center, Portland, OR (USA))

    1990-08-01

    Patients with angina-like chest pain without evidence of epicardial coronary artery disease or coronary arterial vasospasm are becoming increasingly recognized. These are often related to noncardiac causes including esophageal, musculoskeletal, and hyperventilatory or panic states. However, recently a subgroup of such patients are being recognized as having true myocardial ischemia and chest pain on the basis of diminished coronary microvascular vasodilatory reserve (microvascular ischemia or Syndrome X). The authors describe such a patient who was found to have replication of anginal pain associated with a reversible ischemic defect on thallium 201 imaging during atrial pacing, suggesting ischemia in this myocardial segment. Resolution of angina and ST segment electrocardiographic changes of ischemia occurred with cessation of pacing. We believe this is the first report of a patient with this form of myocardial ischemia diagnosed by this method and should be considered in patients with anginal chest pain after significant coronary artery disease and coronary vasospasm have been excluded.

  9. Syndrome of diminished vasodilator reserve of the coronary microcirculation (microvascular angina or syndrome X): Diagnosis by combined atrial pacing and thallium 201 imaging--a case report

    International Nuclear Information System (INIS)

    Patients with angina-like chest pain without evidence of epicardial coronary artery disease or coronary arterial vasospasm are becoming increasingly recognized. These are often related to noncardiac causes including esophageal, musculoskeletal, and hyperventilatory or panic states. However, recently a subgroup of such patients are being recognized as having true myocardial ischemia and chest pain on the basis of diminished coronary microvascular vasodilatory reserve (microvascular ischemia or Syndrome X). The authors describe such a patient who was found to have replication of anginal pain associated with a reversible ischemic defect on thallium 201 imaging during atrial pacing, suggesting ischemia in this myocardial segment. Resolution of angina and ST segment electrocardiographic changes of ischemia occurred with cessation of pacing. We believe this is the first report of a patient with this form of myocardial ischemia diagnosed by this method and should be considered in patients with anginal chest pain after significant coronary artery disease and coronary vasospasm have been excluded

  10. Virtual histology study of atherosclerotic plaque composition in patients with stable angina and acute phase of acute coronary syndromes without ST segment elevation

    Directory of Open Access Journals (Sweden)

    Ivanović Miloš

    2013-01-01

    Full Text Available Introduction. Rupture of vulnerable atherosclerotic plaques is the cause of most acute coronary syndromes (ACS. Postmortem studies which compared stable coronary lesions and atherosclerotic plaques in patients who have died because of ACS indicated high lipid-core content as one of the major determinants of plaque vulnerability. Objective. Our primary goal was to assess the potential relations of plaque composition determined by IVUS-VH (Intravascular Ultrasound - Virtual Histology in patients with stable angina and subjects in acute phase of ACS without ST segment elevation. Methods. The study comprised of 40 patients who underwent preintervention IVUS examination. Tissue maps were reconstructed from radio frequency data using IVUS-VH software. Results. We analyzed 53 lesions in 40 patients. Stable angina was diagnosed in 24 patients (29 lesions, while acute phase of ACS without ST elevation was diagnosed in 16 patients (24 lesions. In the patients in acute phase of ACS without ST segment elevation IVUS-VH examination showed a significantly larger area of the necrotic core at the site of minimal lumen area and a larger mean of the necrotic core volume in the entire lesion comparing to stable angina subjects (1.84±0.90 mm2 vs. 0.96±0.69 mm2; p<0.001 and 20.94±15.79 mm3 vs. 11.54±14.15 mm3; p<0.05 respectively. Conclusion. IVUS-VH detected that the necrotic core was significantly larger in atherosclerotic lesions in patients in acute phase of ACS without ST elevation comparing to the stable angina subjects and that it could be considered as a marker of plaque vulnerability.

  11. An effective tool to detect lesions causing unstable angina with multivessel disease. Iodine-123-betamethyl-p-iodophenyl-pentadecanoic acid single photon emission computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Fukuzawa, Shigeru; Inagaki, Masayuki; Morooka, Shigeru; Inoue, Toshihisa; Sugioka, Juji; Ozawa, Shun [Funabashi Municipal Medical Center, Chiba (Japan)

    1996-10-01

    Radiolabeled fatty acids such as iodine-123-betamethyl-p-iodophenyl-pentadecanoic acid (BMIPP) have unique metabolic properties suggesting potential use as myocardial perfusion tracers. The uptakes of BMIPP and thallium 201 were compared using single photon emission computed tomography (SPECT) in 24 patients displaying unstable angina with multivessel disease at a mean of 3.4 days after admission. Coronary angiography was performed within a week. Uptake was considered normal if the activity was greater than 80% of the normal area, mildly reduced if 50% to 79%, and severely reduced if less than 50%. The regional activities in four quadrants in short-axis slices were measured from basal, mid and apical sets. We attempted to identify the causative lesion on dual SPECT imaging. We planned the following management of each patient based on the results of the dual SPECT study. BMIPP activity imaging found 4 segments (1.4%) with severe decrease, 70 (24.3%) with mild decrease, and 214 (74.3%) with normal uptake. In contrast, Tl activity imaging showed normal uptake in 68 of 74 abnormal BMIPP activity segments. Furthermore, all segments with abnormal BMIPP uptake were matched with locations of coronary artery stenosis by coronary angiography. Accordingly, coronary revascularization (percutaneous transluminal coronary angioplasty, coronary artery bypass grafting) was performed based on BMIPP SPECT. Reductions in BMIPP activity were common in patients with unstable angina with multivessel disease. BMIPP SPECT is an excellent tool for detecting the causative lesion in unstable angina. The subsequent intervention could be performed with less risk based on the strategy of dilating the only causative lesion which was detected by the BMIPP SPECT in patients with multivessel disease displaying unstable angina. (author)

  12. Efficacy of nifedipine and metoprolol in the early treatment of unstable angina in the coronary care unit: Findings from the Holland Interuniversity Nifedipine/metoprolol Trial (HINT)

    OpenAIRE

    Lubsen, J; Tijssen, J.G.P.; HINT Research Group

    1987-01-01

    A multicenter, double-blind, placebo-controlled, randomized trial of nifedipine, metoprolol and their combination was conducted in 338 patients with unstable angina (hospital admission diagnosis) who had not previously received treatment with a β blocker. In addition, nifedipine was compared with placebo in 177 patients who were receiving β blockers upon hospital admission. The main outcome event was the recurrence of ischemia or progression to myocardial infarction within 48 hours. Trial med...

  13. Non-invasive diagnostic workup of patients with suspected stable angina by combined computed tomography coronary angiography and magnetic resonance perfusion imaging

    International Nuclear Information System (INIS)

    The background of this study was to evaluate additional adenosine magnetic resonance perfusion (MRP) imaging in the diagnostic workup of patients with suspected stable angina with computed tomography coronary angiography (CTCA) as first-line diagnostic modality. Two hundred and thirty symptomatic patients (male, 52%; age, 56 year) with suspected stable angina underwent CTCA. In patients with a stenosis of >50% as visually assessed, MRP was performed and the quantitative myocardial perfusion reserve index (MPRI) was calculated. Coronary flow reserve (CFR) using invasive coronary flow measurements served as the standard of reference. CTCA showed non-significant coronary artery disease (CAD) in 151/230 (66%) patients and significant CAD in 79/230 patients (34%), of whom 50 subsequently underwent MRP and CFR. MRP showed reduced perfusion in 32 patients (64%), which was confirmed by CFR in 27 (84%). All 18 cases of normal MRP (36%) were confirmed by CFR. The positive likelihood ratio of MRP for the presence of functional significant disease in patients with a lesion on CTCA was 4.49 (95% confidence interval [CI] 2.12-9.99). The negative likelihood ratio was 0.05 (95% CI 0.01-0.34). CTCA as first-line diagnostic modality excluded coronary artery disease in a high percentage of patients referred for diagnostic workup of suspected stable angina. MRP made a significant contribution to the detection of functional significant lesions in patients with a positive CTCA. (author)

  14. Comparative study between patients with infarction and angina about the fear of pain, anxiety pain symptoms, heart focused anxiety, psychopathology and hostility

    Directory of Open Access Journals (Sweden)

    Bakella P.

    2010-10-01

    Full Text Available Background: To examine the fear of pain, anxiety pain symptoms, heart focused anxiety, psychopathology and hostility between patients with infarction and angina. Method: Subjects were 104 patients with infarction or angina, who completed the Hostility and Direction of Hostility Questionnaire, the Symptom Checklist-90-R, Cardiac Anxiety Questionnaire, the Pain Anxiety Symptoms Scale-20 and the Fear of Pain Questionnaire – III. Results: For all patients higher levels of fear and anxiety of pain, heart-focused anxiety psychopathology, and a tendency to develop a hostile attitude were observed. For angina group higher levels of fearfull thinking and total PASS-20, avoidance CAQ, somatization and anxiety (SCL-90. In addition, all patients were found to be significantly correlated (P< .005 with sex, fearfull PASS-20, physiological responses PASS-20, total PASS-20, avoidance CAQ, somatization SCL-90, anxiety SCL-90 Conclusion: There is a variety of general factors that may promote the development of cardiophobia. These processes are likely nonspecific in the sense that they increase the chance of negative emotional responding and poor affect regulatory strategies. For persons exposed to cardiac-related illnesses or persons who model the potential dangers of cardiac-related sensations, there may be an enhanced specificity to that general vulnerability.

  15. Pharmaceutical care for patients with unstable angina%不稳定性心绞痛患者的药学监护

    Institute of Scientific and Technical Information of China (English)

    牟燕; 王清; 张勇; 李宏建

    2011-01-01

    Unstable angina (UA) is a common coronary heart disease with the clinical symptom situated between stable angina and acute myocardial infarction. For the complexity of its drug treatment, the clinical pharmaceutical care for patients with UA is very important. In this article, to further optimize the therapeutic project and ensure the safety of drug use, the contents of pharmaceutical care were discussed from the following four aspects respectively: undergoing anti-ischemia therapy, antiplatelet and anticoagulant therapy, lipid adjusting and plaque stabilizing therapy, and simultaneous therapy for some other disease.%不稳定性心绞痛(unstable angina,UA)是介于稳定性心绞痛与急性心肌梗死之间的一组临床综合征,其治疗药物十分复杂,临床药学监护尤为重要.本文结合实例,对抗心肌缺血治疗、抗血小板与抗凝治疗、调脂稳定斑块治疗、合并其他疾病用药时等情况下的药学监护内容进行逐一讨论,以期为该疾病的临床药学工作提供思路,优化临床治疗方案设计,保障患者的用药安全.

  16. Evaluation of coronary artery remodeling in patients with acute coronary syndrome and stable angina by multislice computed tomography

    International Nuclear Information System (INIS)

    Multislice computed tomography (MSCT) was used to evaluate coronary artery remodeling in patients with acute coronary syndrome (ACS) and stable angina (SA). MSCT was performed in 31 patients with ACS and 26 patients with SA and intravascular ultrasound (IVUS) was performed in 28 of these 57 patients. In both the MSCT and IVUS analyses, coronary artery remodeling was assessed by the remodeling index (RI): RI>1.10 was defined as positive coronary artery remodeling (PCAR) and RI<0.95 was defined as negative coronary artery remodeling (NCAR). The RI assessed by MSCT closely correlated with that of IVUS (r=0.86, n=28). The vessel area at the region of maximum luminal narrowing was also comparable between the MSCT and IVUS measurements (r=0.92). PCAR was present in 19 patients (61.3%) with ACS, but in none of the patients with SA (p<0.0001). However, NCAR was present in only 1 patient with ACS (3.2%), but was present in 18 patients (62.9%) with SA. The RI was significantly larger in patients with ACS (1.19±0.18) than in those with SA (0.89±0.10, p<0.0001). MSCT accurately assesses coronary artery remodeling. (author)

  17. Assessment of myocardial fatty acid metabolism in patients with vasospastic angina using {sup 123}I-BMIPP myocardial SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Kazuki; Sugihara, Hiroki; Terada, Kouji [Kyoto Prefectural Univ. of Medicine (Japan)] [and others

    1995-10-01

    Myocardial perfusion and fatty acid metabolism may be unpaired in the patients of vasospastic angina (VSA), because abnormal regional wall motion of left ventricle has been shown in some cases of VSA without apparent history of myocardial infarction. To study the clinical utility of {sup 123}I-BMIPP scintigraphy in diagnosis of myocardial ischemia in VSA, both {sup 123}I-BMIPP (rest) and {sup 201}Tl (exercise) SPECT were performed in the 20 patients of VSA diagnosed by coronary angiography. Defect scores were calculated visually from the 17 segments of myocardial images and were compared with patient`s anginal history, period from last attack, numbers of attack, left ventricular (LV) ejection fraction and severity of regional LV wall motion abnormality. {sup 123}I-BMIPP SPECT images showed decreased tracer uptake in 14 cases of 20 (70%) VSA patients. Exercise {sup 201}Tl SPECT images showed decreased tracer uptake in 3 cases of 20 (15%) of patients. Severity of regional LV wall motion abnormality was correlated with defect score of BMIPP. Though total defect score of BMIPP did not correlate with patient`s anginal history, number of symptoms and LV ejection fraction, correlated inversely with period from last attack. It was suggested that {sup 123}I-BMIPP myocardial SPECT images in VSA patients showed `memories` of myocardial ischemic damages induced by vasospasm. In summary, {sup 123}I-BMIPP myocardial SPECT images could be a useful test for diagnosis and evaluation of VSA. (author).

  18. FEATURES OF CYTOKINE PRODUCTION IN PATIENTS WITH UNSTABLE ANGINA: DEPENDENCE ON ETHNICITY IN THE REPUBLIC OF SAKHA (YAKUTIA

    Directory of Open Access Journals (Sweden)

    A. S. Golderova

    2014-07-01

    Full Text Available Abstract. We investigated levels of spontaneous and mitogen-induced cytokine production (IL-1β, IL-4, IL-6, IL-10 and IFNγ by peripheral blood cells of 24 men with unstable angina (UA, including indigenous population (n = 12, Yakuts, and a group of Russian migrants to the Republic of Sakha (n = 12. Activation of inflammatory response was revealed in the total group of patients with UA, manifesting by increase of spontaneous and induced production of the pro-inflammatory IL-1β, IL-6 cytokines, and mitogen-induced production of IFNγ. As compared with healthy individuals, spontaneous and induced production of anti-inflammatory IL-4 was decreased in UA patients, whereas the mitogen-induced production of IL-10 proved to be enhanced. Therefore, it is highly possible that a pro-atherogenic Th1-immune response is developing during UA, along with suppression of Th2-driving response. The differences revealed for different ethnic groups suggest that severity and prevalence of atherosclerotic disease, which is more common in the non-native patients, is associated with increased production of pro-inflammatory IL-1β and IL-6 cytokines.

  19. Identifying Metabolite and Protein Biomarkers in Unstable Angina In-patients by Feature Selection Based Data Mining Method

    Institute of Scientific and Technical Information of China (English)

    SHI Cheng-he; YANG Yi; WANG Wei; ZHAO Hui-hui; HOU Na; CHEN Jian-xin; SHI Qi; XU Xue-gong; WANG Juan; ZHENG Cheng-long; ZHAO Ling-yan

    2011-01-01

    Unstable angina(UA) is the most dangerous type of Coronary Heart Disease(CHD) to cause more and more mortal and morbid world wide. Identification of biomarkers for UA at the level of proteomics and metaboiomics is a better avenue to understand the inner mechanism of it. Feature selection based data mining method is better suited to identify biomarkers of UA. In this study, we carried out clinical epidemiology to collect plasmas of UA in-patients and controls. Proteomics and metabolomics data were obtained via two-dimensional difference gel electrophoresis and gas chromatography techniques. We presented a novel computational strategy to select biomarkers as few as possible for UA in the two groups of data. Firstly, decision tree was used to select biomarkers for UA and 3-fold cross validation was used to evaluate computational performances for the three methods. Alternatively, we combined independent t test and classification based data mining method as well as backward elimination technique to select, as few as possible, protein and metabolite biomarkers with best classification performances. By the method, we selected 6 proteins and 5 metabolites for UA. The novel method presented here provides a better insight into the pathology of a disease.

  20. Variabilidad de la frecuencia cardíaca en pacientes con angina inestable: correlación con otros marcadores pronósticos

    Directory of Open Access Journals (Sweden)

    Oswaldo Gutiérrez Sotelo

    2004-01-01

    Full Text Available Introducción: La importancia del análisis de la variabilidad de la frecuencia cardíaca (VFC está bien establecida como marcador pronóstico en pacientes que han tenido infarto agudo de miocardio y en otras cardiopatías. El objetivo de este estudio es establecer la correlación entre las variables de VFC y los índices pronósticos tradicionales en angina inestable Materiales y Métodos: Se reclutaron prospectivamente pacientes con diagnóstico de angina inestable. Se consignaron indicadores de riesgo cardiovascular clínicos (angor de reposo refractario, hipotensión arterial, insuficiencia cardíaca, presencia de cambios dinámicos en el ST-T, fracción de eyección =40% y los hallazgos angiográficos (2 ó más vasos, conformándose entonces dos grupos, de alto riesgo y de bajo riesgo. A todos los pacientes se les realizó un registro electrocardiográfico de 5 minutos y se analizaron diversas variables de VFC en dominio de tiempo y de frecuencia mediante un programa de computadora. Estas variables se compararon entre ambos grupos. Resultados: Se reclutaron 63 pacientes (44 hombres, 70% con edad promedio de 63 + 10.4 años (35-90; 46 se consideraron de alto riesgo por cambios electrocardiográficos dinámicos y la fracción de eyección disminuida y 17 de bajo riesgo. En el primer grupo, el poder espectral total fue significativamente menor que en el grupo de bajo riesgo (p=0.04. La banda de baja frecuencia mostró diferencia pero sin alcanzar significancia estadística (p=0.07 y otras variables como el SDNN, el NN50 y la banda de baja frecuencia, mostraron sólo tendencia de ser menores en el grupo de alto riesgo. Conclusión: En pacientes con angina inestable de alto riesgo, la presencia de indicadores pronósticos tiene correlación con una menor VFC en dominio de frecuencia.Introduction: The usefullness of heart rate variability (HRV analysis is well known in myocardial infarction as in other cardiac diseases as a prognostic tool. The

  1. ОЦЕНКА ВЛИЯНИЯ ПОЧЕЧНЫХ ФАКТОРОВ РИСКА НА ВЕРОЯТНОСТЬ РАЗВИТИЯ РЕЦИДИВА СТЕНОКАРДИИ У БОЛЬНЫХ, ПОДВЕРГШИХСЯ РЕВАСКУЛЯРИЗАЦИИ МИОКАРДА, ОПТИМИЗАЦИЯ МЕДИКАМЕНТОЗНОЙ ТЕРАПИИ

    Directory of Open Access Journals (Sweden)

    Е. С. Левицкая

    2012-01-01

    Full Text Available The aim of the study was to estimate the impact of renal risk factors (RRF, as well as drug therapy in patients with coronary heart disease and indication for revascularization in the risk of recurrence of angina pectoris. 90 patients with coronary heart disease and indications for the restoration of coronary blood flow were surveyed. The high prevalence of renal risk factors among the patients examined was established. It was revealed that within increase in the maximum risk of recurrence of stenosis of CA the risk of the development of angina pectoris after coronary revascularization is increasing, and with the presence of renal risk factors (microalbuminuria, β2-microglobulinuria, and chronic kidney disease, there is an additional increase in the risk of recurrence of angina pectoris. The analysis of the data demonstrated a significant reduction in risk of recurrence of angina pectoris with the ACE inhibitors and metoprolol tartrate prescription before myocardial revascularization.

  2. Effects of trimetazidine therapy on left ventricular function after percutaneous coronary intervention

    Institute of Scientific and Technical Information of China (English)

    许晓晗

    2013-01-01

    Objective To explore the effects of trimetazidine therapy on left ventricular(LV)function after percutaneous coronary intervention(PCI).Methods A total of 106 patients with unstable angina pectoris undergoing successful

  3. Nitrates and Nitrites in the Treatment of Ischemic Cardiac Disease

    OpenAIRE

    Nossaman, Vaughn E.; Nossaman, Bobby D.; Kadowitz, Philip J.

    2010-01-01

    The organic nitrite, amyl of nitrite, was initially used as a therapeutic agent in the treatment of angina pectoris in 1867, but was replaced over a decade later by the organic nitrate, nitroglycerin (NTG), due to the ease of administration and longer duration of action. The administration of organic nitrate esters, such as NTG, continues to be used in the treatment of angina pectoris and heart failure during the birth of modern pharmacology. The clinical effectiveness is due to vasodilator a...

  4. Short term effects of rosuvastation on plasma concentration of high sensitivity c-reactive protein in patients with chronic stable angina

    International Nuclear Information System (INIS)

    Objective: To determine the short term effects of rosuvastatin on elevated base line high-sensitivity C-reactive protein (hs-CRP) in patients with chronic stable angina. Methodology: This Quasi-experimental comparative study was conducted in Cardiology department, Lady Reading Hospital Peshawar, between March 2010 and February, 2011. We selected 44 consecutive patients age 40 years or above, of any gender having hs-CRP levels = 1.2 mg/l with chronic stable angina. Base line levels of hs-CRP, total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides, and creatine phosphokinase (CPK) were measured in fasting status. These patients were treated with rosuvastatin 20 mg once daily at night and followed up for one month. Using SPSS version 16 data was analyzed. Results: Mean age was 53 +- 7.2 and 50% were females. Following treatment with rosuvastatin 20 mg for one month the mean hs-CRP levels reduced from 4.08+-2.56 to 2.72 +- 2.40 (95 % CI, 0.41 to 2.29, p=0.006). Similarly mean total cholesterol levels decreased from 185.88 +- 37.62 to 147.45 +- 38.35, (p=0.0001). LDL cholesterol decreased from 118.34 +- 31.31 to 86.63 +-35.72 (p= 0.0001). But mean HDL cholesterol had no significant increase from baseline levels i.e. from 32.18+- 9.93 to 33.95 +-7.65 (p=0.174). TGs levels reduced from 240.11 +- 123.66 to 197.43 +- 88.24 (p=0.008). Mean CPK levels did not differ significantly from base line at follow up, from 101.43 +-58.63 to 96.22 +- 55.10 (p=0.646). Conclusion: Short term treatment with rosuvastatin significantly decreases elevated hs-CRP levels in patients with chronic stable angina. (author)

  5. Comparison of antianginal efficacy of nifedipine and isosorbide dinitrate in chronic stable angina: a long-term, randomized, double-blind, crossover study

    International Nuclear Information System (INIS)

    Using a double-blind, crossover design, the comparative efficacy and safety of nifedipine and isosorbide dinitrate in the treatment of stable angina were studied in 34 patients. The study included a 2-week placebo washout period and two 6-week periods during which patients were randomized to either nifedipine or isosorbide dinitrate. The doses were titrated for each patient, and mean doses of the 2 drugs were comparable. A time-limited thallium treadmill test was performed at the end of each phase. Ischemic zone count rates were normalized to those of the nonischemic zone, and the change in this ratio with redistribution was calculated as reversible thallium defect. Two patients were discontinued from the study within 1 week after initiation of isosorbide dinitrate because of severe, intolerable headache. Two patients were withdrawn while receiving nifedipine: one had new congestive heart failure and the other had increasing angina. Of the remaining 30 patients who tolerated both drugs for at least 1 week, 4 patients from the isosorbide dinitrate group were either prematurely crossed over or discontinued from the study because of headache. One patient suffered headache from both drugs and was discontinued from the study. In the 30 patients, only nifedipine significantly reduced resting arterial pressure compared with baseline. Further, only nifedipine therapy resulted in significant decreases in the rate-pressure product and systolic pressure at a given workload. However, significant decreases in angina frequency, nitroglycerin consumption and exercise-induced maximum ST-segment depression and reversible thallium perfusion defect were produced by both nifedipine and isosorbide dinitrate

  6. Diferencias en las características clínicas y en la evolución intrahospitalaria entre la angina inestable primaria y secundaria en ancianos

    OpenAIRE

    Giorgi, Mariano A; Andrés Ahuad Guerrero; Pablo Schygiel; Fernando Sokn; Guillermo Suárez; Jorge E. Trongé

    2007-01-01

    IntroducciónLa angina inestable (AI) se clasifica en primaria (AP) y secundaria (AS) sobre la base de la presencia o no de causas secundarias de isquemia. Estas condiciones son frecuentes en los ancianos y podrían influir en su pronóstico.ObjetivoEl presente trabajo se llevó a cabo con el objetivo de evaluar las características clínicas y la evolución intrahospitalaria de ancianos con AI primaria y secundaria.Material y métodosSe registraron 298 ancianos (edad ≥ 75 años) con diagnóstico final...

  7. Study on Effect of Zhixinkang Capsule (脂欣康胶囊)in Treating Unstable Effort Angina and Hyperlipidemia and Its Function in Vascular Endothelium Protection

    Institute of Scientific and Technical Information of China (English)

    张文高; 颜亭祥; 高福军; 孟宪忠; 刘建平; 尹格平; 刘丽莉; 罗南萍; 史炳娥; 马学盛

    2003-01-01

    Objective:To observe the clinical effect and protection of vascular endothelium of Zhixinkang Capsule (ZXKC) in middle-aged and old people with unstable effort angina and hyperlipidemia.Methods: Sixty-five patients with unstable effort angina were randomly divided into ZXKC group (34 cases)and control group (31 cases). Conventional western medical therapy was given to both groups, with ZXKC group receiving additional ZXKC treatment. Data of 20 healthy persons were taken as normal group. Forty-eight patients with hyperlipidemia were divided into ZXKC group treated with ZXKC (31 cases) and control group treated with Yixintong (17 cases). The changes of clinical symptoms and laboratory indexes in all the patients were observed before and after treatment. Results: In patients with unstable effort angina, the efficacy of treatment of ZXKC, the withdrawal rate of nitroglycerin, the relieving of symptoms, the improvement of the electrocardiogram, the counts of circulating endothelial cells, the content of platelet P-selectin, the content of plasma endothelin (ET), the activity of superoxide dismutase (SOD) and the activity of malonyldialdehyde (MDA) were all better than those in the control group. In patients with hyperlipidemia, there was no significant difference in lipids reduction between ZXKC group and the control group. In both groups, the total cholesterol (TC), triglyceride (TG), low density lipoprotein-cholesterol (LDL-C), lipoprotein(a) [Lp(a)], ET, oxidized low density lipoprotein, MDA, arteriosclerotic index (AI) all lowered obviously, while the SOD, HDL-C and calcitonin gene-related peptide (CGRP) were all elevated markedly. In the ZXKC group, the nitric oxide(NO) increased significantly whereas the ET/CGRP and ET/NO decreased markedly. The total effective rate in symptom relieving, the markedly effective rate, the reduction of TC, ET and ET/CGRP, and the elevation of SOD in ZXKC group were all superior to those in the control group. Conclusion: ZXKC could

  8. Comparison of 64-slice computed tomography angiography and coronary angiography for the detection and assessment of coronary artery disease in patients with angina: A systematic review

    International Nuclear Information System (INIS)

    Background: Coronary artery disease (CAD) is the leading cause of death in Western countries. It presents itself in various ways, the commonest being angina. According to the Royal College of Radiologist referral guidelines, Coronary Angiography (CA) is currently the gold standard for diagnosis and evaluation of CAD. However, due to the invasive nature and expense of CA there is a perceived need for a primary non-invasive imaging modality to supersede it. Computed tomography angiography (CTA), utilising 64-slice technology, may be a less invasive alternative to CA. Aim: To consider the research evidence for the current gold standard diagnostic test for CAD. Specifically, which is more sensitive and specific for detecting CAD in patients with angina; 64-slice CTA or CA? Inclusion Criteria: Prospective, non-randomised control trials and diagnostic accuracy studies comparing 64-slice CTA and CA were included. Participants were adults with angina with suspected or known CAD. Method: An electronic search of the databases; AMED, CINAHL, Cochrane Library, EMBASE, MEDLINE and Science Direct, was conducted between January 2004 and April 2012. Secondary hand-searching of grey literature was undertaken. Two reviewers independently determined studies for inclusion, assessed quality, using SIGN50, and extracted data. Diagnostic value of 64-slice CTA and CA was compared and analysed at patient and segment level. Results: Ten studies were included in the critical review enrolling 1188 patients. At patient level sensitivity for 64-slice CTA ranged from 88% to 100%, specificity 64–92%, PPV 86–97% and NPV 76.9–100%. At segment level sensitivity for 64-slice CTA ranged from 73% to 100%, specificity 83–98%, PPV 47–90% and NPV 89–100% Conclusion: At both patient and segment level, 64-slice CTA is a highly sensitive and specific non-invasive alternative to CA for diagnosis of significant stenosis in patients with angina. For standalone diagnosis of CAD current research would

  9. Universal health care no guarantee of equity: Comparison of socioeconomic inequalities in the receipt of coronary procedures in patients with acute myocardial infarction and angina

    Directory of Open Access Journals (Sweden)

    Kelman Chris W

    2009-12-01

    Full Text Available Abstract Background In Australia there is a socioeconomic gradient in morbidity and mortality favouring socioeconomically advantaged people, much of which is accounted for by ischaemic heart disease. This study examines if Australia's universal health care system, with its mixed public/private funding and delivery model, may actually perpetuate this inequity. We do this by quantifying and comparing socioeconomic inequalities in the receipt of coronary procedures in patients with acute myocardial infarction (AMI and patients with angina. Methods Using linked hospital and mortality data, we followed patients admitted to Western Australian hospitals with a first admission for AMI (n = 5539 or angina (n = 7401 in 2001-2003. An outcome event was the receipt, within a year, of a coronary procedure—angiography, angioplasty and/or coronary artery bypass surgery (CABG. Socioeconomic status was assigned to each individual using an area-based measure, the SEIFA Index of Disadvantage. Multivariable proportional hazards regression was used to model the association between socioeconomic status and procedure rates, allowing for censoring and adjustment of multiple covariates. Mediating models examined the effect of private health insurance. Results In the AMI patient cohort, socioeconomic gradients were not evident except that disadvantaged women were more likely than advantaged women to undergo CABG. In contrast, in the angina patient group there were clear socioeconomic gradients for all procedures, favouring more advantaged patients. Compared with patients in the most disadvantaged quintile of socioeconomic status, patients in the least disadvantaged quintile were 11% (1-21% more likely to receive angiography, 52% (29-80% more likely to undergo angioplasty and 30% (3-55% more likely to undergo CABG. Private health insurance explained some of the socioeconomic variation in rates. Conclusions Australia's universal health care system does not guarantee

  10. To evaluate the effect of Ranolazine on Fasting Plasma Glucose in patients of Type –II Diabetes Mellitus with Stable Angina as add on therapy

    OpenAIRE

    2013-01-01

    Objective: The study was aimed to evaluate the effect of Ranolazine on Fasting Plasma Glucose (FPG) in patients of Type –II Diabetes Mellitus with StableAngina as add on therapy.Material & Methods: An open-labeled, randomized, controlled parallel group study was conducted in 76diagnosed patients of Type –II Diabetes Mellitus with StableAnginaat S.N. medical College and Hospital, Agra.The selected patientsrandomly assigned into 2 groups, Control group (Group 1): was on their regular therap...

  11. Trends in time to invasive examination and treatment from 2001 to 2009 in patients admitted first time with non-ST elevation myocardial infarction or unstable angina in Denmark

    DEFF Research Database (Denmark)

    Mårtensson, Solvej; Gyrd-Hansen, Dorte; Prescott, Eva;

    2014-01-01

    examination and treatment probability (CAG, PCI and CABG at 3, 7, 10, 30 and 60 days) for the years 2001-2009, taking the competing risk of death into account using Aalen-Johansen estimators and a Fine-Gray model. SETTING: Nationwide Danish cohort. RESULTS: The proportion of patients receiving a CAG and PCI...... hospitalisations with NSTEMI and unstable angina were identified in the National Patient Registry (n=65 909). Time from admission to initiation of coronary angiography (CAG), percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) was calculated. We described the development in invasive...... increased substantially over time while the proportion receiving a CABG decreased for both NSTEMI and unstable angina. For both NSTEMI and unstable angina, a significant increase in invasive examination and treatment probability at 3 days for CAG and PCI were seen especially from 2007 through to 2009. For...

  12. Research Progress of Unstable Angina Syndromes Objectification——Metabonomics Article%不稳定型心绞痛中医证候客观化研究进展——代谢组学篇

    Institute of Scientific and Technical Information of China (English)

    周亚滨; 于晓红

    2011-01-01

    代谢组学的不断发展为不稳定型心绞痛的研究带来了新的思路和技术手段,对近年来从代谢组学角度研究不稳定心绞痛中医证候的文献进行了总结.%Metabolomics development for unstable angina study brings new ideas and technology, this paper in recent years from the Angle of metabonomics studies unstable angina syndromes of literature was summarized.

  13. Usefulness of thallium-201 myocardial scintigraphy during hyperventilation and accelerated exercise test in patients with vasospastic angina and nearly normal coronary artery

    International Nuclear Information System (INIS)

    The usefulness of thallium-201 (201Tl) myocardial scintigraphy was studied in 109 patients with vasospastic angina who had nearly normal coronary arteries (degree of stenosis 201Tl myocardial scintigraphy was compared between four groups, 34 patients performing graded bicycle ergometer exercise starting at a work load of 50 W with increments of 25 W every 3 min (Ergo(3) group), 14 patients performing hyperventilation for 5 min (HV(5) group), 31 patients performing bicycle ergometer exercise with increments of 25 W every 1 min after 5 min hyperventilation (HV(5)+Ergo(1) group), and 30 patients at rest (Rest group). The value of the visual redistribution rate on 201Tl myocardial scintigrams in the HV(5)+Ergo(l) group (65%) was higher than that in the patients of other groups (Ergo(3) 41%, HV(5) 43%, Rest 33%). However, there were no significant differences between the four groups. Stress 201Tl imaging after hyperventilation and accelerated exercise is useful to disclose ischemic evidence in about two thirds of patients with vasospastic angina and nearly normal coronary arteries, whereas about 40% of patients had visual redistribution on 201Tl myocardial scintigrams by performing standard procedures. (author)

  14. The dynamics of platelet α-granule membrane protein and serum thromboxane B2 in patients with acute myocardial infarction and unstable angina

    International Nuclear Information System (INIS)

    To evaluate the dynamics of platelet activation in patients with acute myocardial infarction (AMI) and unstable angina (UA), the levels of platelet α-granule membrane protein (GMP-140)and serum thromboxane B2 (TXB2) were studied by RIA in 20 AMI and 30 UA patients and 20 controls. The results are: 1) The levels of GMP-140 and TXB2 were significantly higher in AMI patients within 12 h after the onset than those in controls (P0.05). TXB2 still remained at higher level in AMI patients on the 7th day after onset (P2 were markedly higher in UA patients when angina episode than those in controls (P0.05), but the peak level of GMP-140 and TXB2 and its persistent duration of elevation in UA were much lower than those in AMI. The platelet is highly activated in the patients with AMI and UA. In AMI there are more thrombplastic factors in coronary artery than in UA

  15. Living with Angina

    Science.gov (United States)

    ... usual, call 9–1–1 for emergency care. Emotional Stress Anger, arguing, and worrying are examples of ... normal activities. This includes work, hobbies, and sexual relations. However, if you do very strenuous activities or ...

  16. Une entite electrocardiographique peu connue, mais pourtant importante aux urgences ... le syndrome de Wellens.

    OpenAIRE

    Javillier, B.; Jacquet, C.; Legrand, Victor

    2012-01-01

    We report the case of a 54-year-old patient admitted to an emergency department, because of a thoracic pain suspicious for angina pectoris. Although the patient had become asymptomatic on admission, his electrocardiogram presented abnormalities (biphasic T waves in V1 to V4 ) which prompted a diagnosis of unstable angina.This electrocardiophic pattern is known as Wellens' syndrome.

  17. Comparação de biomarcadores inflamatórios entre pacientes diabéticos e não-diabéticos com angina instável Comparación de biomarcadores inflamatorios entre pacientes diabéticos y no-diabéticos con angina inestable Comparison of inflammatory biomarkers between diabetic and non-diabetic patients with unstable angina

    Directory of Open Access Journals (Sweden)

    Marçal de Oliveira Huoya

    2009-04-01

    Full Text Available FUNDAMENTO: Poucos estudos compararam a atividade inflamatória entre pacientes diabéticos e não-diabéticos com síndrome coronariana aguda, e ainda não foi publicado nenhum somente com portadores de angina instável (AI. OBJETIVO: Este estudo teve dois objetivos. Em primeiro lugar, comparar os níveis séricos de proteína C reativa (PCR e interleucina - 6 (IL-6 em pacientes diabéticos e não-diabéticos com angina instável (AI para determinar se a diferença na atividade inflamatória justifica o pior prognóstico nos pacientes diabéticos. Em segundo, avaliar a correlação entre os marcadores inflamatórios e o perfil metabólico em pacientes diabéticos e entre a resposta inflamatória e os desfechos hospitalares, como morte, infarto agudo do miocárdio, insuficiência cardíaca congestiva e tempo de hospitalização. MÉTODOS: Estudo de coorte prospectivo de 90 pacientes consecutivos admitidos na Unidade de Dor Torácica com angina instável. Os pacientes foram divididos em dois grupos: diabéticos e não-diabéticos. Os níveis séricos de PCR e IL-6, o perfil metabólico e a contagem de leucócitos foram obtidos na chegada ao hospital. RESULTADOS: Dos pacientes analisados, 42 (47% eram diabéticos (idade 62 ± 9 e 48 (53% não eram diabéticos (idade 63 ± 12. Não foram encontradas diferenças entre a mediana da PCR (1,78 vs. 2,23 mg/l, p = 0,74 e da IL-6 (0 vs. 0 pg/ml, p = 0,31 entre os dois grupos. Houve uma correlação positiva entre PCR e colesterol total (rs = 0, 21, p = 0, 05, PCR e colesterol LDL (r s = 0,22, p = 0,04 e PCR e contagem de leucócitos (r s = 0,32, p = 0,02 nos dois grupos. Nenhuma associação foi encontrada entre os marcadores inflamatórios e os desfechos hospitalares. CONCLUSÃO: Não encontramos diferença na atividade inflamatória entre os pacientes diabéticos e não-diabéticos com AI, o que indica que esse quadro clínico pode equilibrar a atividade inflamatória entre os dois grupos e aumentar a

  18. Neural Mechanisms That Underlie Angina-Induced Referred Pain in the Trigeminal Nerve Territory: A c-Fos Study in Rats

    Science.gov (United States)

    Hayashi, Bunsho; Maeda, Masako; Inoue, Tomio

    2013-01-01

    The present study was designed to determine whether the trigeminal sensory nuclear complex (TSNC) is involved in angina-induced referred pain in the trigeminal nerve territory and to identify the peripheral nerve conducting nociceptive signals that are input into the TSNC. Following application of the pain producing substance (PPS) infusion, the number of Fos-labeled cells increased significantly in the subnucleus caudalis (Sp5C) compared with other nuclei in the TSNC. The Fos-labeled cells in the Sp5C disappeared when the left and right cervical vagus nerves were sectioned. Lesion of the C1-C2 spinal segments did not reduce the number of Fos-labeled cells. These results suggest that the nociceptive signals that conduct vagal afferent fibers from the cardiac region are input into the Sp5C and then projected to the thalamus. PMID:27335881

  19. Diagnostic Value of Electrocardiographic T Wave Inversion in Lead aVL in Diagnosing Coronary Artery Disease in Patients with Chronic Stable Angina

    Directory of Open Access Journals (Sweden)

    Hatem L. Farhan

    2010-04-01

    Full Text Available Objectives: The clinical value of T wave inversion in lead aVL in diagnosing coronary artery disease (CAD remains unclear. This study aims to investigate the correlation between aVL T wave inversion and CAD in patients with chronic stable angina.Methods: Electrocardiograms (ECGs of 257 consecutive patients undergoing coronary angiography were analyzed. All patients had chronic stable angina. All patients with secondary T wave inversion had been excluded (66 patients. The remaining 191 patients constituted the study population. Detailed ECG interpretation and coronary angiographic findings were conducted by experienced cardiologists.Results: T wave inversion in aVL was identified in 89 ECGs (46.8% with definite ischemic Q-ST-T changes in different leads in 97 ECGs (50.8%. Stand alone aVL T wave inversion was found in 27 ECGs (14.1% while ischemic changes in other leads with normal aVL were identified in 36 ECGs (18.8%. The incidence of CAD was 86.3%. Single, two- and multi-vessel CAD were found in 38.8%, 28.5% and 32.7% of cases respectively. The prevalence of left main, left anterior descending, left circumflex and right coronary arteries were 4.7%, 61.2%, 29.3% and 44.5%, respectively. T wave inversion in aVL was found to be the only ECG variable significantly predicting mid segment left anterior descending artery (LAD lesions (Odds Ratio 2.93, 95% Confidence Interval 1.59-5.37, p=0.001.Conclusion: This study provides new information relating to T wave inversion in lead aVL to mid segment LAD lesions. Implication of this simple finding may help in bedside diagnosis of CAD typically mid LAD lesions. However, further studies are needed to corroborate this finding.

  20. Antianginal Actions of Beta-Adrenoceptor Antagonists

    OpenAIRE

    O'Rourke, Stephen T.

    2007-01-01

    Angina pectoris is usually the first clinical sign of underlying myocardial ischemia, which results from an imbalance between oxygen supply and oxygen demand in the heart. This report describes the pharmacology of β-adrenoceptor antagonists as it relates to the treatment of angina. The β-adrenoceptor antagonists are widely used in long-term maintenance therapy to prevent acute ischemic episodes in patients with chronic stable angina. Beta-adrenoceptor antagonists competitively inhibit the bin...

  1. Ranolazine: A New Approach to Treating an Old Problem

    OpenAIRE

    Reddy, Bharath M.; Weintraub, Howard S.; Schwartzbard, Arthur Z.

    2010-01-01

    Chronic angina pectoris affects millions of patients every year. During the past 2 decades, advances in medical therapy have led to substantial reductions in the symptoms of angina. Nonetheless, many patients continue to experience persistent angina that causes debilitating symptoms and lifestyle changes. Moreover, many current therapeutic agents cause side effects that can induce substantial morbidity on their own. In major clinical trials, the drug ranolazine has been shown to bring symptom...

  2. 24小时心率变异三角指数作为冠心病心绞痛、心肌梗死患者预后危险性分级的定量指标的研究%The Study of 24 Hours HR Variation Triangle Index as the Quantitative Index to Grade the Prognostic Hazard of the Patients with Angina Pectoris and Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    李厚荣; 李庆平; 张磅锁

    2006-01-01

    目的:24小时心率变异三角指数作为冠心病(CHD)心绞痛(AP)、心肌梗死(MI)患者预后危险性分级的定量指标的研究.方法:对CHD AP组62例,急性心肌梗死(AMI)80例,陈旧性心肌梗死(OMI)80例,正常组60例,均采用美国PI 200A型动态心电图进行心电实时监测,24小时心率变异三角指数和24小时高频成份的测定按ESC和NASP推荐的方法.融入加权、综合三角指数来衡量24小时心率变异三角指数对CHD AP、MI及其并发症患者与正常组进行对照分析.结果:①AMI组,OMI 组,AP组心率变异三角指数(HRV TI)显著低于正常对照组[(25.4±7.6)/(26.5±8.5)/(27.6±9.4)/(37.3±12),P<0.001].②AMI组:HRV TI前壁MI,低于下壁MI[(23.5±3.65)/(27.2±7.85),P<0.05];广泛前壁MI低于广泛下壁MI组[(22.4±6.1)/(28.5±8.5),P<0.01].③OMI组:前壁与下壁梗死、HRV TI的差异消失,然而多部位梗死HRV TI低于单一部位MI[(23.01±73.05)/(27.4±8.1),P<0.05].④32例合并心力衰竭的患者HRV TI明显低于68例无合并症的MI患者[(18.8±6.25)/(30.0±7.0),P<0.001].⑤48例合并室性心律失常的患者HRV TI低于38例无并发症MI患者,[(24.58±6.05)/(29.88±7.1),P<0.001].⑥按HRV TI>25为正常标准,≤25者预后不良发生率和猝死率分别为>25者8.8倍(24/90∶4/132和8.1倍(11/90∶2/132)的构成比,按HRV TI的降低的程度制定四级标准,即≤25轻度异常.≤20中度异常,≤15重度异常,≤10为极度异常.结论:HRV TI降低的AP、MI患者预后不良,HRV TI降低的程度与MI的部位、面积及合并症相关;且与高频成份降低有关.HRV TI≤25轻度异常.≤20中度异常,≤15重度异常,≤10为极度异常,提示CHD AP,MI患者迷走神经系统功能严重受损,易发生持续性室性心动过速,心室颤动和/猝死.

  3. A phase 3, randomized, double-blinded, active-controlled, unblinded standard of care study assessing the efficacy and safety of intramyocardial autologous CD34+ cell administration in patients with refractory angina: design of the RENEW study.

    Science.gov (United States)

    Povsic, Thomas J; Junge, Candice; Nada, Adel; Schatz, Richard A; Harrington, Robert A; Davidson, Charles J; Fortuin, F David; Kereiakes, Dean J; Mendelsohn, Farrell O; Sherman, Warren; Schaer, Gary L; White, Christopher J; Stewart, Duncan; Story, Kenneth; Losordo, Douglas W; Henry, Timothy D

    2013-06-01

    Preclinical trials indicate that CD34+ cells represent an effective angiogenic stem cell component. Early-phase clinical trials suggest that intramyocardial administration of autologous CD34+ cells may improve functional capacity and symptoms of angina. RENEW is a pivotal phase 3 trial designed to determine the efficacy of granulocyte colony-stimulating factor (G-CSF)-mobilized CD34+ stem cells for the treatment for patients with refractory angina and chronic myocardial ischemia. Patients (n = 444) receiving maximally tolerated antianginal therapies and lacking conventional revascularization options with Canadian Cardiovascular Society class III or IV angina and ischemia on stress testing will be randomized 2:1:1 to cell therapy (G-CSF-mediated stem cell mobilization, apheresis, and intramyocardial injection of 1 × 10(5) autologous CD34(+) cells/kg), active control (G-CSF-mediated stem cell mobilization, apheresis, and intramyocardial placebo injection), or open-label standard of care. The primary efficacy end point is change in exercise treadmill time in the treated vs active control patients, with 90% power to detect a 60-second difference in exercise time between cell-treated (n = 200) and active control (n = 100) patients. Key secondary end points include total number of anginal episodes per week and the incidence of independently adjudicated major adverse cardiac events and serious adverse events. RENEW will be the first adequately powered study aimed at definitively determining the efficacy of a cell therapy (intramyocardially delivered autologous CD34+ cells) for improvement of functional capacity in patients with refractory angina. PMID:23708155

  4. Characteristics, treatment and outcome of patients with non-ST-elevation acute coronary syndromes and multivessel coronary artery disease: observations from PURSUIT (Platelet Glycoprotein IIb/IIIa in unstable angina: receptor suppression using integreling therapy)

    OpenAIRE

    Breeman, Arno; Mercado, Nestor; Lenzen, Mattie; Harrington, Robert Alex; Califf, Robert; Topol, Eric; Simoons, Maarten; Brand, Marcel, van den; Boersma, Eric

    2002-01-01

    textabstractBACKGROUND: The 6-month clinical outcome of patients with multivessel disease enrolled in PURSUIT (Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy) is described. Patients with complete angiography data were included; multivessel disease was stratified according to the treatment strategy applied early during hospitalization, i.e. medical treatment, percutaneous coronary intervention (PCI) (balloon), PCI (stent), or coronary artery by...

  5. Does access to invasive examination and treatment influence socioeconomic differences in case fatality for patients admitted for the first time with non-ST-elevation myocardial infarction or unstable angina?

    DEFF Research Database (Denmark)

    Martensson, Solvej; Gyrd-Hansen, Dorte; Prescott, Eva;

    2016-01-01

    nominal equal access to health care, social inequality in case fatality after NSTEMI and unstable angina exists in Denmark. The patients with the shortest education waited longer for angiography; however, this did not seem to explain inequality in case fatality. This register-based study was approved by...... the Danish Data Protection Agency (Approval number 2010-41-5263). Register-based studies do not need approval by a medical ethics committee in Denmark....

  6. Facilitação e dominância dos sintomas sôbre a dor da angina de peito e causalgia

    Directory of Open Access Journals (Sweden)

    Nelson Pires

    1962-09-01

    Full Text Available O autor traz à consideração clínica a "facilitação" que Sherrington apreciou nos experimentos de neurofisiologia, e que explica aspectos clínicos importantíssimos em psicologia e em neurologia visceral. Pretende o autor explicar seus casos de dor (um de causalgia no membro superior e três de angina de peito em portadores de esclerose coronária. Ora a anestesia terapêutica no gânglio estrelado, ora na cadeia ganglionar torácica simpática, ora a radioterapia, ora a psicoterapia removeram a dor "facilitada" a tal ponto que se tornara "dominante", isto é, mesmo estímulos inadequados a provocavam. Os doentes eram inválidos e recuperaram-se. A neurofisiologia moderna autoriza a interpretação dessa terapêutica: suprimiu-se - com a anestesia, com a radioterapia e com a psicoterapia - o circuito neural auto-alimentado reverberante, hiperfuncionante em todo ou em parte de seu trajeto, quer aferente ao córtex quer aferente às coronárias. O autor discute o valor clínico dos acessos anginosos apontando fatos que documentam que o acesso "ilegítimo" (psicógeno deve ter como causa a estimulação das aferências vegetativas ao córtex em qualquer ponto (ganglionar, medular ou cortical. Os acessos "legítimos", produzindo lesões transitórias ou definitivas e até morte,, devem ser explicados pela atividade das eferências vagais que executam os efetôres espásticos das coronárias. A dor é apresentada como fenômeno de "gravação neural", aprendido, memorizado e automatizado, ativado em feed-back ora nas aferências vegetativas ao córtex, ora nas eferências, mais perigosas e mortais. Debate-se a superestimada psicogenia da angina de peito.

  7. ANALYSIS OF COST STRUCTURE FOR PHARMACOTHERAPY OF PATIENTS WITH STABLE ANGINA (THE CASE OF CARDIOLOGY DEPARTMENT OF TVER REGIONAL CLINICAL HOSPITAL

    Directory of Open Access Journals (Sweden)

    M. A. Demidova

    2015-12-01

    Full Text Available Aim. To analyze the cost structure for pharmacotherapy of patients with stable angina (SA, in particular, to compare the cost of pharmacotherapy with drugs, both included and not included into the official Standard of care (SC. Material and methods. Medical records of patients with SA (n=100 admitted to the cardiology department of Tver Regional Clinical Hospital in January-July 2010 were studied retrospectivelly. Costs of treatment with drugs specified in SC for patients with SA as well as drugs not included in SC were considered. Costs of pharmacotherapy and cost structure were determined. Pharmacoeconomical methods, especially ABC analysis, were partially used.  Results. Totally 65502.39 ruble was spent for pharmacotherapy of 100 patients with SA. Cost structure was the following: 32679.34 ruble was spent for drugs recommended by SC, 23698.18 ruble — for drugs not included in SC, and 9124.87 ruble — for drugs to treat concomitant diseases which are not taken into account by SC for patients with SA. Conclusion. SA pharmacotherapy counts 50% of the total cost for drugs recommended by SC, 36% — for drugs not included in SC but belonged to pharmacological class presented in SC, and 14% — drugs from pharmacological class not included in SC. In the process of new SC elaboration for SA patients it is necessary to take into account treatment costs of concomitant diseases especially diabetes mellitus which can account up to 9.5% of total treatment cost of SA patients.

  8. [Exercise-induced ST segment shift in vasospastic angina with special reference to comparisons between treadmill and bicycle ergometer exercise testings].

    Science.gov (United States)

    Kasai, A; Yamakado, T; Masuda, T; Aoki, T; Futagami, Y; Hamada, M; Nakano, T

    1991-01-01

    To assess the difference between cardiovascular responses to treadmill exercise (TM) and those to bicycle ergometer exercise (EM) in provoking coronary spasm, we compared the ST segment shifts (elevation or depression) during TM and EM in 67 patients with vasospastic angina. Coronary artery spasm was demonstrated on angiography. Both TM and EM were performed on the same day during a medication-free period. For both tests, multistage, symptom-limited exercise protocols were used; EM in the morning and TM in the afternoon. The results obtained were as follows: 1. Rate-pressure products at peak exercise during TM and EM were similar. Systolic blood pressure levels at peak exercise were higher during EM than during TM (p < 0.01). The patients' heart rates at peak exercise were higher during TM than during EM (p < 0.01). Diastolic blood pressure levels at peak exercise were higher during EM than during TM (p < 0.05). 2. Exercise-induced ST elevation occurred more frequently with TM than with EM (19% vs 9%, p < 0.05). 3. Exercise-induced ST depression was provided in 27 patients during TM and in 13 during EM (40% vs 19%, p < 0.01). Among 45 patients without significant lesions, ST depression occurred in 19 during TM, but in only 7 during EM (42% vs 16%, p < 0.01). In conclusion, coronary spasm seemed to occur more frequently with TM than with EM. The mechanism causing such difference remains to be elucidated, however, we speculate that the difference between TM and EM as to enhanced autonomous nervous system activity and coronary perfusion exercise may be related to the difference in the incidence of coronary spasm. PMID:1841908

  9. A Double-Blind, Randomized, Placebo-Controlled Study to Evaluate the Efficacy and Safety of STA-2 (Green Tea Polyphenols) in Patients with Chronic Stable Angina

    Science.gov (United States)

    Lee, Tsung-Ming; Charng, Min-Ji; Tseng, Chuen-Den; Lai, Ling-Ping

    2016-01-01

    Background Green tea intake has been shown to improve endurance capacity in animal studies, but whether it has a similar effect on humans remains unclear. A randomized, double-blinded, parallel-controlled study was conducted to evaluate the short-term effect of STA-2, a pharmaceutical preparation of green tea polyphenols, in patients with effort-induced angina and documented positive exercise tolerance test. Methods A total of 79 patients recruited from three medical centers were randomly assigned to receive 2 STA-2 250 mg capsules, each containing 100 mg green tea polyphenols, three times daily, or placebo for six weeks after two consecutive symptom-limited treadmill exercise tests to ascertain the reproducibility of exercise tolerance. Results There was no difference in total exercise tolerance time from baseline to Week 6 between two groups (p = 0.639). There were also no observed improvements in subgroup analyses stratified by age, gender, and BMI categories. However, a significant reduction in low-density lipoprotein levels was shown in patients in the STA-2 group (-8.99 ± 19.18 mg/dL) versus the placebo group (0.57 ± 19.77 mg/dL), p = 0.037, with greater benefits in patients not taking antihyperlipidemic drugs (STA-2: -9.10 ± 19.96 mg/dL vs. placebo: 4.42 ± 15.08 mg/dL, p = 0.037). Conclusions STA-2 treatment for 6 weeks did not increase exercise time as measured on a treadmill. However, this study also indicated that STA-2 treatment could have potential beneficial effects on LDL-cholesterol concentrations. PMID:27471357

  10. Anti-ischemic intervention as prognosis improvement in patients with coronary artery disease, with special focus on verapamil

    DEFF Research Database (Denmark)

    Jespersen, C M

    1996-01-01

    Angina pectoris is a significant risk predictor in patients with atherosclerotic heart disease. The major complications are myocardial infarction, heart failure, and arrhythmias. Plaque rupture turns stable angina pectoris into acute coronary syndrome by provoking platelet aggregation and thereby...... dysfunction, and thereby heart failure. In postinfarction patients intervention with verapamil significantly reduced the use of diuretics compared with placebo, indicating that anti-ischemic intervention may prevent heart failure. Ventricular arrhythmias are significantly associated with arrhythmic as well as......, supraventricular arrhythmias are significantly associated with myocardial ischemia and are prevented by verapamil. In patients with atherosclerotic heart diseases, angina pectoris is a significant risk predictor, but anti-ischemic intervention should be considered even in patients in whom the major problem is...

  11. Non-invasive method for recognition of coronary artery spasm

    International Nuclear Information System (INIS)

    For evaluation of coronary artery spasm 201thallium sequential scintigraphy of the myocardium after ergotamine provocation was performed in 10 patients with recurrent angina pectoris at rest and normal exercise ECG. In 9 out of the 10 patients ergotamine administration in the same dosage was repeated during the coronary angiography. A reversible defect in the 201thallium scintigram representative of regional myocardial ischaemia developed in 9 patients after ergotamine. Only in 4 out of the 9 patients angina pectoris and ST elevation were present at the same time. In all cases coronary spasm after ergotamine was demonstrable in the coronary angiogram; in the 4 patients with ergotamine-induced Prinzmetal angina pectoris it consisted of complete vascular occlusion, in the asymptomatic patients of incomplete vascular narrowing of a higher degree. In all cases the spasm could be relieved by ergotamine antidotes within a few minutes. (orig.)

  12. Temporal trends in patient-reported angina at one year following percutaneous revascularization in the stent era: a report from the NHLBI-sponsored 1997–2006 Dynamic Registry

    Science.gov (United States)

    Venkitachalam, Lakshmi; Kip, Kevin E.; Mulukutla, Suresh; Selzer, Faith; Laskey, Warren; Slater, James; Cohen, Howard A.; Wilensky, Robert L; Williams, David O; Marroquin, Oscar C; Sutton-Tyrrell, Kim; Bunker, Clareann H.; Kelsey, Sheryl F.

    2009-01-01

    Background Percutaneous coronary intervention (PCI) has witnessed rapid technological advancements resulting in improved safety and effectiveness over time. Little, however, is known about the temporal impact on patient-reported symptoms and quality of life following PCI. Methods and Results Temporal trends in post-PCI symptoms were analyzed using 8879 consecutive patients enrolled in the National Heart, Lung and Blood Institute-sponsored Dynamic Registry (wave 1: 1997(bare metal stents), wave 2: 1999 (uniform use of stents), wave 3: 2001 (brachytherapy), wave 4, 5: 2004, 2006 (drug eluting stents)). Patients undergoing PCI in the recent waves were older and more often reported comorbidities. However, fewer patients across the waves reported post-PCI angina at one year (wave 1–5: 24%, 23%, 18%, 20%, 20%; Ptrend:<0.001). The lower risk of angina in recent waves, however, was explained by patient characteristics including use of anti-anginal medications at discharge [relative risk (95% CI) for waves 2, 3, 4 vs 1: 1.0 (0.9–1.2), 0.9 (0.7–1.1), 1.0 (0.8–1.3), 0.9 (0.7–1.1)]. Similar trend was seen in the average quality of life scores over time (adjusted mean score for waves 1–5: 6.2, 6.5, 6.6 and 6.6; Ptrend: 0.01). Other factors associated with angina at one year included younger age, female gender, prior revascularization, need for repeat PCI and hospitalization for MI over one year. Conclusion Favorable temporal trends are seen in patient-reported symptoms following PCI in routine clinical practice. Specific subgroups, however, remain at risk for symptoms at one year and warrant closer attention. PMID:20031899

  13. Caracterización de los síntomas de angina en mujeres pos síndrome coronario agudo en el marco de la teoría de Lenz y col

    OpenAIRE

    Ochoa Larrota, Yamile

    2013-01-01

    muerte en la población femenina con un total 12, 962 casos reportados para el 2011, según informe del Departamento Administrativo Nacional de Estadística DANE, con tendiente feminización de la mortalidad; se prevé que estas cifras continuarán creciendo significativamente para el 2030, convirtiéndose así en el asesino silencioso de las mujeres representando el 65% del total de muertes en la población femenina1 . Este artículo expone la Caracterización de los síntomas de angina en mujeres que e...

  14. Levels of pregnancy-associated plasma protein-A in patients with coronary heart diseases and clinic significance

    International Nuclear Information System (INIS)

    Objective: To explore the relationship between pregnancy-associated plasma protein-A (PAPP-A) and occurance, development of cardiovascular diseases, and lipids. Methods: 75 patients with coronary disease were divided into acute myocardial infarction (n=32), unstable angina pectoris (n=22) and stable angina pectoris (n=21) groups, and 60 subjects without coronary diseases were used as controls. The serum PAPP-A, IL-6, IL-10, lipids were measured in all patients and controls by different methods of enzymatically amplified two-step sandwith- type immunoassay, double antibody radio-immunoassay, ABC-HRP, auto biochemistic analytist. Results: (1) The level of PAPP-A in acute coronary syndrome (ACS, including acute myocardial infarction and unstable angina pectoris) patients was significantly higher than that in stable angina pectoris patients and controls (P<0.05). (2) There were significantly associations between PAPP-A and serum totle cholesterol, ApoA1/ApoB (r=0.348, 0.420, P<0.05). (3) The levels of IL-6 and IL-10 in coronary heart disease patients were significantly higher than those in controls (P<0.05), and the variations among acute myocardial infarction, unstable angina pectoris, stable angina pectoris patients were significantly (P<0.05). There were significantly associations between PAPP-A, IL-6 and IL-10 (Spearman r 0.446, 0.523, P<0.05). Conclusion: PAPP-A is significantly associated with occurance and development of coronary heart disease, probablely as a marker of unstable plaque in coronary heart disease. (authors)

  15. Forsinkelse fra symptomdebut til ankomst på hospital blandt 5.978 patienter med akut myokardieinfarkt

    DEFF Research Database (Denmark)

    Ottesen, M M; Køber, L; Jørgensen, S;

    1998-01-01

    with male gender, increased age, diabetes mellitus, left ventricular systolic function (wall motion index), onset from midnight to 6 a.m., onset on a weekday, history of angina pectoris, chest pain as initial symptom, ventricular fibrillation or-tachycardia, Killip class > or = 3, presence of ST......-elevation and ST-depressions. In conclusion, patient delay continues to be disappointingly long. This also applies to patients with a high risk of acute myocardial infarction (notably history of diabetes mellitus and angina pectoris). Udgivelsesdato: 1998-Mar-9...

  16. The correlation between high sensitivity C-Reactive Protein level and the Extent of Coronary Lesion and Cardiac Systolic Function in Coronary Heart Disease

    OpenAIRE

    Miftah Suryadipradja; Sally A. Nasution; Dasnan Ismail; Yoga I. Kasjmir

    2003-01-01

    To determine the mean value of high sensitivity C-Reactive Protein (hs-CRP), association between plasma level of hs-CRP with extent of disease and systolic function. A cross sectional study had been conducted to 106 coronary artery disease patients (90 stable angina pectoris, 11 unstable angina pectoris and 5 acute myocardial infarction). Plasma quantitative level of hs-CRP with cor angiography to determine extent of disease and ejection fraction were measured. The mean of hs-CRP levels in pa...

  17. Diferencias en las características clínicas y en la evolución intrahospitalaria entre la angina inestable primaria y secundaria en ancianos

    Directory of Open Access Journals (Sweden)

    Mariano A. Giorgi

    2007-01-01

    Full Text Available IntroducciónLa angina inestable (AI se clasifica en primaria (AP y secundaria (AS sobre la base de la presencia o no de causas secundarias de isquemia. Estas condiciones son frecuentes en los ancianos y podrían influir en su pronóstico.ObjetivoEl presente trabajo se llevó a cabo con el objetivo de evaluar las características clínicas y la evolución intrahospitalaria de ancianos con AI primaria y secundaria.Material y métodosSe registraron 298 ancianos (edad ≥ 75 años con diagnóstico final de AI. La muestra se dividió, según la presencia de causas secundarias de isquemia (anemia, taquicardia, hipertensión no controlada, infección, hipertiroidismo, en dos grupos: AS y AP. Secompararon antecedentes, características clínicas al ingreso, tratamientos, procedimientos y la ocurrencia de muerte y muerte o infarto en la fase intrahospitalaria. Se identificaronpredictores univariados de mala evolución.ResultadosCincuenta y dos pacientes (17,45% tenían AS y 246 (82,5% padecían AP. Los pacientes con AS eran más añosos y tenían mayores registros de tensión arterial y de frecuencia cardíaca al ingreso. El tratamiento médico, la cinecoronariografía y la revascularización se utilizaron menos en el grupo AS. La mortalidad (7,7% versus 6,9% [p = 1,00; OR (IC 95 = 1,12 (0,36-3,48] AS y AP, respectivamente y la combinación de muerte o infarto (7,7% versus 9,7%[p = 0,79; OR (CI 95 = 0,77 (0,25-2,32] AS y AP, respectivamente fueron similares. Los predictores univariados de muerte o infarto fueron infradesnivel del ST y desarrollo de insuficiencia cardíaca para ambos grupos y la refractariedad y necesidad de coronariografía y revascularización para el grupo AP. ConclusiónLa AS es una causa común de isquemia en los ancianos y, pese a que requiere un manejo diferente, orientado a su etiología, tiene un pronóstico similar al de la AP.

  18. Effectiveness of Trimetazidine on Stable Angina Evaluated by Treadmill Exercise Test%运动平板试验评估曲美他嗪治疗稳定型心绞痛的疗效观察

    Institute of Scientific and Technical Information of China (English)

    戴红艳; 何涛; 姜陆民; 丁华民

    2012-01-01

    目的 通过运动平板试验(Treadmill Exercise Test,TET)观察曲美他嗪辅助治疗稳定型心绞痛的疗效.方法 选取80例明确诊断为稳定型心绞痛且运动平板试验为阳性患者,在传统药物治疗基础上,分为曲美他嗪治疗组及对照组.记录治疗前后运动平板试验阳性率、运动终止时诱发心绞痛率、运动时间、恢复时间、运动后2min ST段压低≥1.0mm的导联数及其ST段压低总和(∑ST),并进行统计分析.结果 曲美他嗪治疗后运动平板试验阳性率、运动终止时诱发心绞痛率、运动时间、恢复时间、运动后2minST段压低≥1.0mm的导联数及其ST段压低总和(∑ST)较治疗前及对照组均有显著改善,且差异具有统计学意义(P<0.05).结论 在传统药物治疗基础上联用曲美他嗪,可使稳定型心绞痛患者进一步获益.%Objective To evaluate the effectiveness of trimetazidine on stable angina by treadmill exercise test (TET). Methods 80 TET positive patients with stable angina were divided into 2 groups: the trimetazidine group and the control group. Before and after therapy, the positive rate, exercise-induced angina rate at the termination, exercise time, recovery time, the number of leads with ST-segment depression≥1.0mm 2 minutes after exercise and the sum of ST-segment depression)∑ST) were recorded and analyzed. Results After therapy with Trimetazidine, the positive rate, exercise-induced angina rate at the termination, exercise time, recovery time, the number of leads with ST-segment depression ≥1.0mm 2 minutes after exercise and the sum of ST-segment depression(∑ST) were all improved apparently compared with control group(P<0.05). Conclusion Patients with stable angina could benefit from the combined treatment with Trimetazidine on the basis of the traditional drug therapy.

  19. Cost analysis of different brands of antianginal drugs available in India

    OpenAIRE

    L. Akila; R. Jamuna Rani

    2015-01-01

    Background: Ischemic heart disease is the most common cardiovascular disease in developed countries such as United States and Angina pectoris is the most frequent among them. If not managed adequately angina results in significant morbidity and mortality too due to the complications. Antianginal therapy is lifelong. Therefore, analysis of the price of drugs used in ischemic heart disease will help to improve patient compliance. Methods: Prices of various antianginal drugs of different stre...

  20. Hubungan Kadar Gula Darah saat Masuk Rumah Sakit dengan Jenis Sindroma Koroner Akut di RS Dr. M. Djamil Padang

    OpenAIRE

    Willy Valerian; Masrul Syafri; Zelly Dia Rofinda

    2015-01-01

    AbstrakSindrom Koroner Akut (SKA) merupakan spektrum dari penyakit arteri koroner yang tidak stabil, mulai dari angina pektoris tidak stabil sampai infark miokardium. SKA terbagi atas Unstable Angina Pectoris (UAP), ST elevation myocardial infarction (STEMI), Non-ST elevation myocardial infarction (NSTEMI). Tujuan penelitian ini adalah untuk menentukan hubungan antara kadar gula darah saat masuk rumah sakit dan jenis SKA. Metode penelitian yang digunakan adalah cross sectional. Penelitian dil...

  1. Improved exercise myocardial perfusion during lidoflazine therapy

    International Nuclear Information System (INIS)

    Lidoflazine is a synthetic drug with calcium-channel blocking effects. In a study of 6 patients with severe classic angina pectoris, single-blind administration of lidoflazine was associated with improved myocardial perfusion during exercise as determined by thallium-201 stress scintigraphy. These studies demonstrate that lidoflazine therapy is associated with relief of angina, an increased physical work capacity, and improved regional myocardial perfusion during exercise

  2. Intervention effects of relaxation therapy on depressive state of patients with class angina%放松疗法对类心绞痛患者抑郁状态的干预

    Institute of Scientific and Technical Information of China (English)

    姚倩; 彭顺蓉; 夏丽娜

    2013-01-01

    Objective To investigate the intervention effect of relaxation therapy on the depressive state of patients with class angina. Methods 107 patients with class angina with the scores of self-rating depressive scale( SDS ) > 50 points from June 2008 to January 2012 were randomly divided into intervention group and control group. The intervention group received the nursing with relaxation therapy,and the control group received the conventional nursing. Comparison of the changes of SDS scores and physical signs after the treatment were made between the two groups. Results In the third to fourth week after the treatment, the SDS score of the intervention group significantly decreased compared with that of the control group( P < 0. 05 ), and the systolic pressure of the patients in intervention group also significantly decreased( P < 0. 01 ). Conclusion The relaxation therapy is conducive to the improvement of depressive state and the control of physical signs of patients with class angina.%目的 探讨放松疗法对类心绞痛患者抑郁状态的干预效果.方法 将2008年6月~2012年1月抑郁自评量表(SDS)评分>50分的114例类心绞痛患者随机分为干预组和对照组,干预组采用放松疗法进行护理,对照组采用常规护理,比较两组治疗后的SDS评分及体征指标变化.结果 放松疗法干预到第3~4 w时,干预组的SDS评分与对照组相比明显降低(P<0.05),收缩压也明显下降(P<0.01).结论 放松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.

  3. Different effects of calcium antagonist and beta-blocker therapy on left-ventricular diastolic function in ischemic heart disease. A direct comparison of the impact of mibefradil and atenolol

    DEFF Research Database (Denmark)

    Hassager, C; Thygesen, K; Grande, P;

    2001-01-01

    OBJECTIVE: To compare the effect of a calcium antagonist and a beta-blocker on left-ventricular diastolic function in patients with ischemic heart disease. METHODS: 138 patients with chronic stable angina pectoris were randomized in a multicenter, double-blind trial to treatment with either...

  4. Risk stratification of patients suspected of coronary artery disease

    DEFF Research Database (Denmark)

    Jensen, Jesper Møller; Voss, Mette; Hansen, Vibeke B;

    2012-01-01

    To compare the performance of five risk models (Diamond-Forrester, the updated Diamond-Forrester, Morise, Duke, and a new model designated COronary Risk SCORE (CORSCORE) in predicting significant coronary artery disease (CAD) in patients with chest pain suggestive of stable angina pectoris....

  5. Job strain and ischemic heart disease: a prospective study using a new approach for exposure assessment

    DEFF Research Database (Denmark)

    Bonde, Jens Peter; Munch-Hansen, Torsten; Agerbo, Esben;

    2009-01-01

    based on the average exposure level in minor work units. METHODS: Cohort study of 18,258 Danish public service workers in 1106 work units; 79% were women; 108 subjects with history of cardiovascular disease were excluded from the follow-up. The outcome was hospitalization due to IHD (angina pectoris or...... determinants for IHD among Danish predominantly female public service workers....

  6. A Case of Slow Coronary Flow Presented with Supraventricular Tachycardia and Troponin Positive Acute Coronary Syndrome

    Directory of Open Access Journals (Sweden)

    Mustafa Akçakoyun

    2009-12-01

    Full Text Available Slow coronary flow (SCF but normal epicardial coronary arteries phenomenon frequently have asymptomatic course, however, some reports have showed that this phenomenon may cause angina pectoris, myocardial ischemia and infarction. We described a patient presented with supraventricular tachycardia and Troponin elevation and whose coronary angiography’s had previously revealed slow flow in entire major epicardial coronary arteries.

  7. Predictive value of acute coronary syndrome discharge diagnoses in the Danish national patioent registry

    DEFF Research Database (Denmark)

    Joensen, Albert Marni; Jensen, Majken K.; Overvad, Kim; Dethlefsen, Claus; Schmidt, Erik Berg; Rasmussen, Lars Hvilsted; Johnsen, Søren Paaske

    Background: Updated data on the predictive value of acute coronary syndrome (ACS) diagnoses, including unstable angina pectoris, myocardial infarction and cardiac arrest, in hospital discharge registries are sparse. Design: Validation study. Methods: All first-time ACS diagnoses in the Danish...

  8. [Coronary subclavian steal syndrome: two cases after coronary artery bypass grafting

    DEFF Research Database (Denmark)

    Penninga, L.; Damgaard, S.

    2008-01-01

    Reverse flow in the internal mammary artery (IMA) graft due to stenosis or occlusion of the proximal ipsilateral subclavian artery causes coronary subclavian steal syndrome (CSSS). We describe two patients who were diagnosed with CSSS following CABG. Patient A presented with angina pectoris, was...

  9. Can preoperative myocardial perfusion scintigraphy predict changes in left ventricular perfusion and function after coronary artery bypass graft surgery?

    DEFF Research Database (Denmark)

    Eckardt, Rozy; Kjeldsen, Bo Juel; Johansen, Allan; Grupe, Peter; Haghfelt, Torben; Thayssen, Per; Andersen, Lars Ib; Hesse, Birger

    2012-01-01

    pectoris (and at least one occluded coronary artery) underwent MPS before, and 6 months after, undergoing CABG. The result of the MPS was kept secret from the surgeons.RESULTSBefore CABG, 90% of the patients had angina. After CABG, 97% of the patients were without symptoms. Overall graft patency was 84...

  10. L-arginine

    Science.gov (United States)

    ... pain (angina pectoris). Leg pain associated with poor blood flow (peripheral arterial disease). Research suggests that taking L-arginine by mouth ... by IV) for up to 8 weeks increases blood flow in people with peripheral arterial disease. However, long-term use (up to 6 months) ...

  11. Enhanced External Counterpulsation for Ischemic Heart Disease: A Look Behind the Curtain

    OpenAIRE

    Braith, Randy W.; Casey, Darren P.; Beck, Darren T.

    2012-01-01

    Enhanced external counterpulsation (EECP) is a non-invasive treatment for coronary artery disease (CAD) patients who have angina pectoris that is refractory to pharmacotherapy and revascularization. The popular concept is that EECP may promote collateral development and improve myocardial perfusion. We hypothesize that improvements in peripheral arterial function are responsible for the clinical benefits of EECP.

  12. [The clinical pharmacology and efficacy of the new Soviet calcium antagonist foridon].

    Science.gov (United States)

    Kukes, V G; Rumiantsev, A S; Gneushev, E T; Al'perovich, B R; Svetyĭ, L I; Nasyrov, M N; Taratuta, T V

    1990-01-01

    A total of 56 patients with coronary heart disease (CHD), angina pectoris of effort, functional classes II-III, were placed under observation. All the patients received 20 mg foridon (F), 20 mg corinfar (C), 80 mg anapriline (A). 24 patients were subjected to the continuous treatment with F (20 mg 4 times a day). The antianginal action of the drug was compared to the blood concentration on days 7, 14, 21, 28, 43 and 57 of the treatment with F. In 14 patients with angina pectoris and in 18 patients with essential hypertension, the efficacy of F and C was cross correlated. It has been demonstrated that F can be successfully used for the treatment of patients with CHD, angina pectoris of effort and (or) essential hypertension. The increase of the single dose of foridon from 20 to 40 mg does not result in the potentiation of its hypotensive effect. F and C provoke the highest rise of exercise tolerance with combined angina pectoris. Continuous concomitant administration of F and C with A leads to the potentiation of the antianginal action. PMID:2084878

  13. Early treatment of unstable angina in the coronary care unit: a randomised, double blind, placebo controlled comparison of recurrent ischaemia in patients treated with nifedipine or metoprolol or both. Report of The Holland Interuniversity Nifedipine/Metoprolol Trial (HINT) Research Group.

    OpenAIRE

    1986-01-01

    A multicentre, double blind, placebo controlled, randomised trial of nifedipine, metoprolol, and nifedipine and metoprolol combined was conducted in a group of 338 patients with unstable angina not pretreated with a beta blocker and of nifedipine in 177 patients pretreated with a beta blocker. The main outcome event was recurrent ischaemia or myocardial infarction within 48 hours. Trial medication effects were expressed as ratios of event rates relative to placebo. In patients not pretreated ...

  14. 小剂量降纤酶溶栓治疗不稳定型心绞痛的临床观察%Observation of the thrombolytic therapeutic effect of low-does defibrase on patients with unstable angina pectoric

    Institute of Scientific and Technical Information of China (English)

    周建; 王洪铎

    2001-01-01

    Objective: To observe the thrombolytic therapeutic effect of low-dose of defibraseon patients with unstable angina pectoric(UAP). Methods: In the article,36 patients with UAPwere randomly divided into two groups. The therapeutic group (A) and the control group (B), the A group (19case) was treated with low -dose defibrase,the control group (17case) was treated with the regular cure of anti-myocardiaiskemia. Results: The total effective rate of A group was superior to that of the control group (p<0.025) The rate of acute myocardial infarction (AMI) was obviously lower than the group B.(P<0.025) during 72hours,the same as the resulte after one year.Conclusions: The thrombolytic therapeutic effect of low-dose of defibrase on patients with unstable angina pectoric(UAP) is effective、 safety、and can improve the prognocis of the patients.%目的:观察小剂量降纤酶溶栓疗法对不稳定型心绞痛(UAP)的临床疗效。方法:随机将36例UAP分为A、B两组。A组(19例)常规抗心肌缺血治疗加小剂量降纤酶溶栓疗法;B组(17例)常规抗心肌缺血治疗。结果:A组72h内临床疗效显效率66.67%明显高丁B组2.5%(P<0.025);A组72h内急性心肌梗塞(AMl)发生率5.56%明显低于B组37.50%(P<0.025);随访一年间A组心脏猝死及AMI例数也明显低于B组。结论:该疗法高效、安全、能改善UAP患者近期预后。

  15. Tissue Doppler echocardiography reveals distinct patterns of impaired myocardial velocities in different degrees of coronary artery disease

    DEFF Research Database (Denmark)

    Hoffmann, Soren; Mogelvang, Rasmus; Olsen, Niels Thue; Søgaard, Peter; Fritz-Hansen, Thomas; Bech, Jan; Galatius, Soren; Madsen, Jan Kyst; Jensen, Jan Skov

    2010-01-01

    .86 +/- 0.24 vs. 1.00 +/- 0.28, P <0.05). Both regional and global s' was significantly reduced in patients with three-vessels disease. CONCLUSION: Colour TDI performed at rest in patients with stable angina and preserved ejection fraction reveals both diastolic and systolic dysfunction and the nature of......Aim To determine how the left ventricular wall motion assessed by echocardiographic Tissue Doppler Imaging (TDI) is affected by increasing severity of coronary artery disease (CAD) among patients with stable angina pectoris and preserved ejection fraction. METHODS AND RESULTS: This study comprises...... 82 patients with suspected angina pectoris, no previous cardiac history, and a normal ejection fraction, who were all examined with colour TDI prior to coronary angiography. Patients without significant stenoses (n = 35) constituted the control group and patients with significant stenoses (n = 47...

  16. Oral Administration of L-Arginine in Patients With Angina or Following Myocardial Infarction May Be Protective By Increasing Plasma Superoxide Dismutase and Total Thiols With Reduction in Serum Cholesterol and Xanthine Oxidase

    Directory of Open Access Journals (Sweden)

    Pratima Tripathi

    2009-01-01

    Full Text Available Administration of L-arginine has been shown to control ischemic injury by producing nitric oxide which dilates the vessels and thus maintains proper blood flow to the myocardium. In the present study attempt has been made to determine whether oral administration of L-arginine has any effect on oxidant/antioxidant homeostasis in ischemic myocardial patients [represented by the patients of acute angina (AA and acute myocardial infarction (MI]. L-arginine has antioxidant and antiapoptotic properties, decreases endothelin-1 expression and improves endothelial function, thereby controlling oxidative injury caused during myocardial ischemic syndrome. Effect of L-arginine administration on the status of free radical scavenging enzymes, pro-oxidant enzyme and antioxidants viz. total thiols, carbonyl content and plasma ascorbic acid levels in the patients has been evaluated. We have observed that L-arginine administration (three grams per day for 15 days resulted in increased activity of free radical scavenging enzyme superoxide dismutase (SOD and increase in the levels of total thiols (T-SH and ascorbic acid with concomitant decrease in lipid per-oxidation, carbonyl content, serum cholesterol and the activity of proxidant enzyme, xanthine oxidase (XO. These findings suggest that the supplementation of L-arginine along with regular therapy may be beneficial to the patients of ischemic myocardial syndromes.

  17. [THE EFFECTIVENESS OF THE CORRECTION OF ENDOTHELIAL DYSFUNCTION AND REMODELING OF THE BRACHIAL ARTERY WITH CONCENTRIC AND ECCENTRIC LEFT VENTRICULAR HYPERTROPHY IN PATIENTS WITH UNSTABLE ANGINA WITH COMORBID HYPERTENSION].

    Science.gov (United States)

    Denesiuk, E V

    2015-01-01

    The study involved patients with unstable angina (UA), comorbid hypertension (AH), myocardial infarction in 55.5% of cases. Systolic blood pressure was (163.2 ± 1.5) mm Hg. Art., diastolic blood pressure--(101.10 ± 0.67) mm Hg. Art., pulse pressure--(61.1 ± 17.0) mm Hg. Art. Examined patients underwent clinical studies, ECG in 12 conventional leads, echocardiography in M and B modes, Doppler ultrasonography of the brachial artery. To correct the detected change using standard combined therapy: perindopril 5-10 mg/day, bisoprolol--5-10 mg/day, atorvastatin--20 mg/day, acetylsalicylic acid--75-100 mg/day. Monitoring the treatment was carried out at 3; 6 and 12 months. Standard one-year comprehensive treatment of patients with UA with comorbid AH resulted in significant improvement of effective endothelial dysfunction in concentric and eccentric left ventricular hypertrophy in 3; 6 and 12 months, however, regression of hypertrophy brachial artery advancing much less mainly in concentric left ventricular hypertrophy. PMID:27089719

  18. Comparative effects of propranolol and verapamil alone and in combination on left ventricular function and volumes in patients with chronic exertional angina: a double-blind, placebo-controlled, randomized, crossover study with radionuclide ventriculography

    International Nuclear Information System (INIS)

    With the use of equilibrium radionuclide ventriculography the effects on left ventricular (LV) function of 160 mg oral propranolol daily and 360 mg verapamil daily alone and in combination were compared in 18 patients with chronic exertional angina. A randomized, double-blind, placebo-controlled, crossover protocol was used. The reduction in exercise rate-pressure product induced by the combination (118 +/- 28 mm Hg/min) was significantly greater than that by propranolol (135 +/- 27 mm Hg/min) or verapamil alone (163 +/- 28 mm Hg/min). In patients at rest, neither single nor combined therapy altered global or regional left ventricular ejection fractions (EFs). Verapamil, but not propranolol, increased cardiac volumes of resting subjects; used in combination, no further increase in LV volume occurred. With placebo, exercise global EF did not decrease from the level at rest and therefore no drug effect could be demonstrated for this parameter of LV function. By an evaluation of normalized regional EF measurements the combination was shown to reduce exercise-induced hypokinesis (placebo 52 +/- 20%, combination 61 +/- 23%. No significant improvement was noted with propranolol or verapamil alone; only the combination prevented a significant increase in end-systolic and end-diastolic volumes during exercise. Thus, propranolol and verapamil, used alone in moderate doses, exert no beneficial effect on exercise LV function as measured by EF and volume changes, and resting function deteriorates slightly with verapamil

  19. Research on the cardiac MRI in the diagnosis and treatment of unstable angina%核磁共振在不稳定型心绞痛诊治中的应用价值

    Institute of Scientific and Technical Information of China (English)

    李鹏; 亓燕

    2014-01-01

    Objective:To investigate the cardiac magnetic resonance technique in the diagnosis and treatment of unstable angina application value. Methods:The hospital diagnosed patients with unstable angina as research subjects, were given coronary angiography in patients (CAG) examination, ECG, echocardiography and cardiac MRI examination, recording the results and statistical analysis. Results:Cardiac MRI for>90%stenos is detected heart rate, and coronary angiography (CAG) showed no significant difference (x2=3.257, P>0.05), for0.05);cardiac MRI for cardiac function and cardiac structure determination is better than conventional echocardiography. Conclusion: Cardiac MRI technology to more accurately reflect changes in cardiac structure and function of the stenos is and effort ischemia detection rate with conventional inspection methods have better consistency.%目的:探讨核磁共振技术在不稳定心绞痛诊治中的应用价值。方法:选取经莱芜市人民医院确诊的不稳定心绞痛患者40例,分别给予冠状动脉造影(CAG)、心电图、超声心电图及心脏核磁共振检查,并对结果进行统计学分析。结果:核磁共振在心脏狭窄>90%的检出率高,与CAG间差异无统计学意义(x2=3.257,P>0.05),对<90%的狭窄检出率低,与CAG检查结果间差异有统计学意义(x2=17.267,x2=25.714;P<0.05);核磁共振对心脏狭窄程度高的患者的心肌缺血检出率高,与心电图检出率差异明显,有统计学意义(x2=4.65,P<0.05),但总检出率间差异不明显,无统计学意义(x2=0.251,P>0.05);核磁共振对于心功能及心脏结构的测定效果优于传统的超声心动图。结论:核磁共振技术能更准确的反应心脏结构和功能改变,对狭窄和心机缺血的检出率与传统检查方法有较好一致性。

  20. Reversal of segmental hypokinesis by coronary angioplasty in patients with unstable angina, persistent T wave inversion, and left anterior descending coronary artery stenosis. Additional evidence for myocardial stunning in humans

    International Nuclear Information System (INIS)

    To evaluate the significance of persistent negative T waves during severe ischemia, we prospectively studied 62 patients admitted for unstable angina without evidence of recent or ongoing myocardial infarction. A critical stenosis on the left anterior descending coronary artery (LAD), considered as the culprit lesion, was successfully treated by percutaneous transluminal coronary angioplasty (PTCA). The patients were divided into two groups according to the admission electrocardiogram: T NEG group (n = 32) had persistent negative T waves, and the T POS group (n = 30) had normal positive T waves on precordial leads. The two groups had similar baseline clinical, hemodynamic, and angiographic characteristics. All patients underwent a complete clinical and angiographic evaluation (coronary arteriography and left ventriculography) before undergoing PTCA and 8 +/- 3 months later. Left ventricular anterior wall motion was evaluated by the percent shortening of three areas (S1, S2, and S3) considered as LAD-related segments on left ventriculograms. Before PTCA, there was no significant difference in global ejection fraction between the two groups despite a significant depression in anterior mean percent area shortening in the T NEG compared with the T POS group (S1, 44 versus 54, p less than 0.01; S2, 39 versus 48, p less than 0.01; S3, 44 versus 50, NS). At repeated angiography, the anterior mean percent area shortening improved significantly in the T NEG group (S1, from 44 to 61, p less than 0.001; S2, from 39 to 58, p less than 0.001; S3, from 44 to 61, p less than 0.001)

  1. Angina - when you have chest pain

    Science.gov (United States)

    ... or having sex. How to treat your chest pain Sit, stay calm, and rest. Your symptoms will often go away soon after you stop activity. If you are lying down, sit up in bed. Try deep breathing to ...

  2. Debate: Unstable angina - When should we intervene?

    Directory of Open Access Journals (Sweden)

    Kereiakes Dean J

    2000-07-01

    Full Text Available Abstract The prognosis of patients who present with non-ST segment elevation acute coronary syndromes (ACS is guarded. These patients can be risk-stratified on the basis of symptom complex, electrocardiographic ST segment depression, obvious hemodynamic compromise and particularly on the basis of serum troponin level. An elevated troponin level determines risk and also predicts the degree of benefit from treatment with either low molecular weight heparin or platelet glycoprotein (GP IIb/IIIa blockade. Higher risk patients should undergo early coronary angiography and myocardial revascularization as indicated and feasible. Although studies performed before the advent of coronary stenting and adjunctive platelet GP IIb/IIIa blockade suggested increased hazard for patients undergoing early intervention, recent experience cited herein supports an in-hospital and long-term clinical benefit for the aggressive approach. Here, I propose an algorithm for risk stratification and triage of appropriate patients for adjunctive pharmacotherapy and early revascularization.

  3. Bilateral ostial coronary stenosis and rheumatic aortic valve stenosis.

    Science.gov (United States)

    Sorokin, Alexeyi; Weich, Hellmuth; Doubell, Anton; Moolman, Johannes A

    2006-01-01

    A 49-year-old patient presented with angina pectoris and clinical findings of aortic valve stenosis and regurgitation. Rheumatic aortic valve stenosis and regurgitation was diagnosed on echocardiography. Coronary angiography findings showed severe calcification in the aorta root with right coronary ostial occlusion, and were suggestive of left main ostial stenosis and proximal main stem stenosis, which was confirmed on CT angiography. Curvilinear calcification of the aorta was present on CT angiography. The findings suggested syphilitic aortitis. Syphilis serology was positive (RPR titre 1/16). The angina was caused by severe coronary ostial disease likely due to syphilitic aortitis and exacerbated by the rheumatic aortic valve stenosis and regurgitation. PMID:16885079

  4. Tissue Doppler echocardiography reveals distinct patterns of impaired myocardial velocities in different degrees of coronary artery disease

    DEFF Research Database (Denmark)

    Hoffmann, Soren; Mogelvang, Rasmus; Olsen, Niels Thue;

    2010-01-01

    82 patients with suspected angina pectoris, no previous cardiac history, and a normal ejection fraction, who were all examined with colour TDI prior to coronary angiography. Patients without significant stenoses (n = 35) constituted the control group and patients with significant stenoses (n = 47.......86 +/- 0.24 vs. 1.00 +/- 0.28, P <0.05). Both regional and global s' was significantly reduced in patients with three-vessels disease. CONCLUSION: Colour TDI performed at rest in patients with stable angina and preserved ejection fraction reveals both diastolic and systolic dysfunction and the nature of...

  5. [Effect of hypothermia on the metabolism and post-ischemia restoration of myocardial function].

    Science.gov (United States)

    Chernikov, V S; Bakuleva, N P; Kostava, V T; Bogonatov, B N

    1989-01-01

    Our studies have revealed a prognostically poor course in postinfarction angina pectoris patients on conservative medicamentous treatment. The mortality rate within the first year of this syndrome onset was 19.8 per cent among conservatively treated patients. Surgical management of these patients had a significantly better prognosis. Despite the fact that there was a great difference in survival rates between the studied groups at the hospital stage, the survival rate was significantly higher at subsequent stages in surgical patients compared to that in the conservatively treated group, and correlated with that in a larger population of matched age. In addition, surgical treatment was found to substantially improve the quality of life in patients with postinfarction angina pectoris which implies lowered frequency of attacks, increased exercise tolerance, and improved working capacity. PMID:2629376

  6. Determinants of delay between symptoms and hospital admission in 5978 patients with acute myocardial infarction. The TRACE Study Group. Trandolapril Cardiac Evaluation

    DEFF Research Database (Denmark)

    Ottesen, M M; Køber, L; Jørgensen, S;

    1996-01-01

    of angina pectoris (OR = 1.198, P = 0.02), chest pain as initial symptom (OR = 1.293, P = 0.02), ventricular fibrillation (OR = 0.562, P = 0.0001), ventricular tachycardia (OR = 0.620, P = 0.0001), Killip class > or = 3 (OR = 0.709 P = 0.002), presence of ST elevation (OR = 0.810, P = 0.01) and ST...... depressions (OR = 0.847, P = 0.01). All these variables, except history of diabetes mellitus, angina pectoris, and chest pain as an initial symptom were also associated with a delay of more than 6 h. Thrombolytic therapy was administered to 55.8% of patients admitted within 2 h of an acute myocardial...

  7. Myocardial perfusion and left ventricular function early after successful PTCA in 1-vessel coronary artery diseases

    International Nuclear Information System (INIS)

    Myocardial perfusion (201Tl-ECT) and contractile function (99mTc-ventriculography) were studied during exercise and rest 3 to 6 days after PTCA in 20 patients (11 with stable and 9 with unstable angina pectoris). All patients had single vessel disease and no previous myocardial infarction. During exercise after PTCA the ejection fraction increased for 3 to 5% and no regional wall motion abnormalities, ST-segment depression or perfusion defects occurred (with exception in one patient with very early restenosis). Therefore, perfusion and wall motion were completely normalized at test and during exercise within days after technically successful PTCA even in patients with previously unstable angina pectoris. Pathological stress test results after this time should thus be attributed to other causes e.g. early restenosis, multivessel disease, false positive tests) and are not due to the specific situation early after PTCA. (orig.)

  8. Suspension properties of whole blood and its components under glucose influence studied in patients with acute coronary syndrome

    Science.gov (United States)

    Malinova, Lidia I.; Simonenko, Georgy V.; Denisova, Tatyana P.; Dovgalevsky, Pavel Y.; Tuchin, Valery V.

    2004-05-01

    The protocol of our study includes men with acute myocardial infarction, stable angina pectoris of II and III functional classes and unstable angina pectoris. Patients with arterial hypertension, disorders in carbohydrate metabolism were excluded from the study. Blood samples taken under standardized conditions, were stabilized with citrate sodium 3,8% (1:9). Erythrocytes and platelets aggregation activity under glucose influence (in vitro) was studied by means of computer aided microphotometer -- a visual analyzer. Erythrocyte and platelets were united in special subsystem of whole blood. Temporal and functional characteristics of their aggregation were analyzed by creation of phase patterns fragments. The received data testify to interrelation of erythrocytes and platelets processes of aggregation under conditions of increasing of glucose concentration of the incubatory environment, which temporal and functional characteristics may be used for diagnostics and the prognosis of destabilization coronary blood flow at an acute coronary syndrome.

  9. Effects of tongxinluo on C-reactive protein and clinical prognosis in patients after coronary stenting

    International Nuclear Information System (INIS)

    Objective: To investigate the effects of Tongxinluo on C reactive protein(CRP)and clinical prognosis in patients after coronary stenting. Methods: From January 2003 to December 2004, 132 patients in our department diagnosed as coronary artery disease (including acute myocardial infarction, unstable angina pectoris and stable angina pectoris)were divided into two groups: Tongxinluo group and control group. The control group received routine treatment, while Tongxinluo group based on routine treatment was administrated with Tongxinluo capsule in combination for 6 months. Results: CRP level was much lower in Tongxinluo group together with apparent decrease of the major adverse cardiac event (MACE)rate in 6 months' follow-up than those of the control group, but showing no difference in coronary arterial restenosis between the two groups at 6 months after coronary stenting. Conclusion: Tongxinluo has favorable effects to decrease the CRP level and improve clinical efficiency together with prognosis for patients after coronary stenting. (authors)

  10. 异舒吉治疗不稳定型心绞痛的临床疗效观察

    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 signilicandy 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 significandy better than the control group. Conclusion It is effective and safe to treat the patients with unstable angina pectoris with intravenous Isoket.

  11. Development and validation of LC/MS/MS method for the simultaneous determination of montelukast, gliclazide, and nifedipine and its application to a pharmacokinetic study

    OpenAIRE

    Ezzeldin, Essam; Abo-Talib, Nisreen F; Tammam, Marwa H; Shahat, Abdelaaty A.

    2014-01-01

    Background Montelukast is a leukotriene receptor antagonist for treatment of asthma, gliclazide is an oral hypoglycemic antidiabetic agent, and nifedipine is a calcium channel blocker used for treatment of angina pectoris and hypertension. These drugs may be prescribed to patients suffering from these chronic diseases. A survey of the literature reveals that there is no reported method for the simultaneous determination of montelukast, gliclazide, and nifedipine in pharmaceutical preparations...

  12. Functional role of peripheral opioid receptors in the regulation of cardiac spinal afferent nerve activity during myocardial ischemia

    OpenAIRE

    Fu, Liang-Wu; Longhurst, John C.

    2013-01-01

    Thinly myelinated Aδ-fiber and unmyelinated C-fiber cardiac sympathetic (spinal) sensory nerve fibers are activated during myocardial ischemia to transmit the sensation of angina pectoris. Although recent observations showed that myocardial ischemia increases the concentrations of opioid peptides and that the stimulation of peripheral opioid receptors inhibits chemically induced visceral and somatic nociception, the role of opioids in cardiac spinal afferent signaling during myocardial ischem...

  13. The influence of hypertension on in-hospital outcome in patients with acute myocardial infarction

    OpenAIRE

    Davor Miličić; Bojan Jelaković; Zrinka Ivanuša; Mario Ivanuša

    2009-01-01

    Aim To examine the differences in the frequency of risk factors,clinical presentations on admission and in-hospital outcome in hypertensiveand normotensive patients treated for acute myocardialinfarction (AMI).Methods In hypertensive and normotensive patients with AMI weretrospectively analyzed risk factors (age, gender, smoking habits,diabetes, blood lipids, history of angina pectoris, previous myocardialinfarction, previous stroke and family history of atherothromboticdisease), admission Ki...

  14. ENDOTHELIAL DYSFUNCTION IN ISCHEMIC HEART DISEASE

    OpenAIRE

    N. E. Zakirova; R. G. Oganov; A. N. Zakirova; M. P. Plotnikova; G. M. Salakhova

    2016-01-01

    Aim. To assess the role of endothelial vasodilating, vasoconstrictive and adhesive dysfunction in the development of angina pectoris (AP) in patients with ischemic heart disease (IHD).Material and methods. 83 patients with IHD were included in the study. 30 patients had AP of functional class (FC)-II, 27 patients - FC-III and 26 patients - FC-IV. The control group consisted of 25 healthy persons. Bicycle ergometry, daily ECG monitoring and echocardiography were used for verification of IHD. E...

  15. A Review on Packaging Materials with Anti-Counterfeit, Tamper- Evident Features For Pharmaceuticals

    OpenAIRE

    A. Kailash Kumar; N. Vishal Gupta; P. Lalasa; Sudeepgoud Sandhil

    2013-01-01

    Problems related to safety, efficacy & quality of medicines exists in many places around the world today, not just developing countries but in developed countries as well. Counterfeiting can apply to both branded and generic products and counterfeit products include products with correct ingredients or with fake packaging. Counterfeit drugs may lead to death in severe cases such as heart attack, epilepsy, angina pectoris, in such condition anti-counterfeit drugs acts as weapon to avoid traged...

  16. Influence of insulin resistance on long-term outcomes in patients with coronary artery disease after sirolimus-eluting stent implantation

    Institute of Scientific and Technical Information of China (English)

    ZHAO Liang-ping; L(U) An-kang; SHEN Wei-feng; LIU Hai-feng; MA Xiao-ye; FAN Xiao-ming; ZHANG Qi

    2010-01-01

    Background Insulin resistance(IR)is significantly associated with coronary artery disease and cardiovascular events in patients with or without type 2 diabetes mellitus.This study aimed to evaluate the influence of IR on long-term outcomes of patients undergoing percutaneous coronary intervention(PCI)with sirolimus-eluting stent(SES)implantation.Methods A total of 467 consecutive patients undergoing SES-based PCI were divided into lR group(n=104)and non-IR group(n=363).The patients were followed up for one year.The rate of major adverse cardiac events(MACEs) including death, non-fatal myocardial infarction and recurrent angina pectoris was compared by the log-rank test,and the independent risk factors were identified by the Cox regression analysis.Results MACEs occurred more frequently,and cumulative survival rate was lower in the IR group than in the non-IR group during the follow-up (all P<0.05).IR was an independent risk factor for the occurrence of cardiac death and non-fatal myocardial infarction(OR=2176,95% CI=1.35-5.47,P=0.034).Old age,diabetes,and multi-vessel disease were determinants for recurrent angina pectoris after PCI(P<0.05).Subgroup analysis revealed that IR(OR=3.35,95% CI=1.07-13.59,P=0.013)and multi-vessel disease(OR=2.19,95%CI=1.01-5.14,P=0.044)were independent risk predictors for recurrent angina pectoris in patients with diabetes after PCI.Conclusions IR is associated with reduced MACE-free survival and remains an independent predictor for recurrent angina pectoris after PCI with SES implantation.

  17. Toxic shock syndrome: A rare complication to enhanced external counterpulsation

    OpenAIRE

    Jørgensen, Peter Godsk; Lindberg, Jens; May, Ole

    2010-01-01

    Enhanced external counterpulsation (EECP) is known to reduce angina pectoris in patients in whom revascularization is not possible. The therapy is associated with few adverse effects. A case with a previously unknown complication – toxic shock syndrome – that occurred twice in an EECP-treated patient is described. Toxic shock syndrome initially resembles the state of septic shock. Early recognition of the syndrome and initiation of therapy is of vital importance to prevent rapid progression a...

  18. Reduced serum levels of autoantibodies against monomeric C-reactive protein (CRP) in patients with acute coronary syndrome

    OpenAIRE

    Wetterö, Jonas; Nilsson, Lennart; Jonasson, Lena; Sjöwall, Christoffer

    2009-01-01

    Introduction: Inflammation is pivotal in atherosclerosis. Minor C-reactive protein (CRP) response reflects low-grade vascular inflammation and the high-sensitivity CRP test with levels >= 3.0 mg/l predicts coronary vascular events and survival in angina pectoris as well as in healthy subjects. We and others recently reported autoantibodies against monomeric CRP (anti-CRP) in rheumatic conditions, e.g. systemic lupus erythematosus (SLE), and a connection between anti-CRP and cardiovascular ...

  19. Trimetazidine modulates AMPA/kainate receptors in rat vestibular ganglion neurons.

    OpenAIRE

    DAYANITHI, GOVINDAN; Desmadryl, Gilles; Travo, Cécile; Chabbert, Christian; Sans, Alain

    2007-01-01

    Trimetazidine (1[2,3,4-trimethoxy-benzyl] piperazine, 2 HCl) is an anti-ischemic agent frequently administered as a prophylactic treatment for episodes of angina pectoris and chorioretinal disturbances. It is also employed as a symptomatic treatment of vertigo but its mechanism of action is yet to be defined. Using Fura-2 fluorescence photometry and whole-cell patch-clamp recordings we investigated the effect of trimetazidine on the [Ca(2+)](i) and current responses induced by the application...

  20. Trimetazidine in Practice: Review of the Clinical and Experimental Evidence

    OpenAIRE

    Dézsi, Csaba A.

    2016-01-01

    All of the following traditional agents for the management of stable angina pectoris include the symptomatic treatment with heart rate–lowering agents such as β-blockers or non-dihydropyridine Ca-channel blockers, or ivabradine—the first selective sinus node If channel inhibitor—vasodilatators and preventive use of angiotensin-converting enzyme inhibitors affect the parameters of circulation directly. Trimetazidine exerts its anti-ischemic action by modulating cardiac metabolism without alter...

  1. Trimetazidine and liver preservation against ischaemia-reperfusion injury

    OpenAIRE

    Mosbah, Ismail Ben; Abdennebi, Hassen B.; Zaouali, Mohamed A.; Padrissa-Altés, Susagna; Peralta, Carmen; Roselló-Catafau, Joan

    2007-01-01

    Trimetazidine is an anti-ischaemic drug used for angina pectoris treatment. Recently, it has been shown that trimetazidine protects against hepatic ischaemia reperfusion injury. Several hypotheses have been proposed to explain the exact hepatoprotective mechanisms but they still remain unclear. This review assesses the possible mechanisms responsible for the increase of the liver's tolerance against ischaemia-reperfusion injury with special emphasis on: (1) the prevention of oxidative stress ...

  2. Formulation and Evaluation of Trimetazidine Dihydrochloride Extended Release Tablets by Melt Congealing Method

    OpenAIRE

    Javeer, S. D.; Pandit, Reshma; Jain, S. P.; Amin, Purnima

    2010-01-01

    Trimetazidine dihydrochloride, a cellular antiischemic agent indicated in the management and prophylaxis of angina pectoris is given as 20 mg thrice daily in the conventional dosage regimen. The purpose of the present study was to formulate and evaluate twice a day extended release tablets containing 30 mg trimetazidine dihydrochloride. The method developed to formulate these extended release tablets was melt congealing followed by wet granulation which exhibited uniform sustained release act...

  3. Subclinical atherosclerosis: what it is, what it means and what we can do about it

    OpenAIRE

    Toth, P P

    2008-01-01

    Atherosclerosis is a chronic, progressive, inflammatory disease with a long asymptomatic phase. Disease progression can lead eventually to the occurrence of acute cardiovascular events such as myocardial infarction, unstable angina pectoris and sudden cardiac death. While the disease is still in a subclinical stage, however, the presence of atherosclerosis can be identified by several methods, including coronary angiography, intravascular ultrasonography, B-mode ultrasonography, computed tomo...

  4. Formulation and Evaluation of Mucoadhesive Buccal Films of Enalapril Maleate

    OpenAIRE

    Semalty A; Semalty Mona; Nautiyal U

    2010-01-01

    Enalapril maleate is used in the treatment of hypertension and angina pectoris. It shows low bioavailability due to high hepatic first pass metabolism. Hence the present work was undertaken to formulate mucoadhesive buccal films of enalapril maleate with an objective to improve therapeutic efficacy, patient compliance and the bioavailability. In the present study ten formulations of mucoadhesive drug delivery system of enalapril maleate were prepared as buccal films, by solvent casting techni...

  5. Nursing of Laser Intravascalar Radiation%激光血管内照射的护理

    Institute of Scientific and Technical Information of China (English)

    杨淑琼

    2002-01-01

    With the development of science and technology the medical laser has been applied in clinics. Since the lowintensity laser intravascular radiator was introduced into our department such chronic Senile diseases as hypertention cerebralinfarction, apoplexy sequel, coronary heart disease and angina pectoris have been treated with some cared and other improved.The theropy shortened greatly the time of hospitalization and raised the utilization and turnover rate of the bed and the economicand social benefits.

  6. Influence of Psychosocial Work-Related Factors on Conventional Risk Factors of Ischemic Heart Disease and Homocysteine in Slovenian Male Workers

    OpenAIRE

    Ratkajec, Tihomir; Bilban, Marjan; Starc, Radovan

    2008-01-01

    The influence of psychosocial work-related factors on the conventional risk factors of ischemic heart disease (IHD), particularly on the lipid changes and their effect on homocysteine is studied in this paper. Employed males aged 35 to 55 with angina pectoris or a myocardial infarction (IHD group) were compared to a group of individuals without ischemic heart disease (Control Group). Psychosocial factors were assessed using a Swedish Theorell questionnaire. The IHD Group was found...

  7. Symptomatic relief precedes improvement of myocardial blood flow in patients under spinal cord stimulation

    OpenAIRE

    Koulousakis Athanassios; Weber Michael; Theissen Peter; Zobel Carsten; Diedrichs Holger; Schicha Harald; Schwinger Robert HG

    2005-01-01

    Abstract Background Spinal cord electrical stimulation (SCS) has shown to be a treatment option for patients suffering from angina pectoris CCS III-IV although being on optimal medication and not suitable for conventional treatment strategies, e.g. CABG or PTCA. Although many studies demonstrated a clear symptomatic relief under SCS therapy, there are only a few short-term studies that investigated alterations in cardiac ischemia. Therefore doubts remain whether SCS has a direct effect on myo...

  8. Effects of tedisamil, atenolol and their combination on heart andrate-dependent QT interval in healthy volunteers

    OpenAIRE

    Démolis, Jean-Louis; Martel, Christine; Funck-Brentano, Christian; Sachse, Alisia; Weimann, Hans-Joseph; Jaillon, Patrice

    1997-01-01

    Aims Tedisamil is a new blocker of K+ currents in cardiac tissues, exerts bradycardic effects and has shown clinical efficacy in angina pectoris. Theoretically, when coadministered with a &bgr;-adrenoceptor blocker the tedisamil combination could induce dangerous bradycardia and QT interval prolongation. Therefore, the aim of this study was to evaluate the effects of tedisamil and atenolol alone and in combination, on heart rate and QT interval duration at rest and during exercise tests.

  9. Usefulness of Serum Cathepsin L as an Independent Biomarker in Patients With Coronary Heart Disease

    OpenAIRE

    Liu, Yingxian; Li, Xiangping; Peng, Daoquan; Tan, Zheng; Liu, Hongmin; Qing, Yingnan; Xue, Yanqiong; Shi, Guo-Ping

    2008-01-01

    Higher levels of cysteinyl cathepsin L were detected in human atherosclerotic lesions than in healthy aortas. However, a link between human coronary heart disease (CHD) and systemic cathepsin L levels remains unknown. A total of 137 volunteers with diagnosed acute and previous myocardial infarction (MI) and stable and unstable angina pectoris in addition to 48 controls were asked to undergo coronary angiography. Serum cathepsin L, high-sensitivity C-reactive protein, fasting glucose, and lipi...

  10. C-Reactive Protein in Angiographically Documented Stable Coronary Disease

    OpenAIRE

    MJ Zibaee Nezhad; P. Ghanbari; B Shahryari; K Aghasadeghi

    2009-01-01

    Background: The association between C-reactive proteins (CRP), a marker of inflammation, and major coronary risk factors has been highlighted in several investigations. CRP is associated with acute cardiac events and can predict their occurrence. The aim of this study was to evaluate the association between CRP serum level and coronary artery disease (CAD) along with it’s major risk factors, in patients with stable angina pectoris.Patients and Methods: In a cross-sectional case control study,...

  11. Arterial indications for the low molecular weight heparins

    OpenAIRE

    Ageno Walter; Huisman Menno V

    2001-01-01

    Abstract Antithrombotic treatment is of proven importance in patients with acute coronary syndromes. There is now accumulating evidence from several clinical trials in patients with unstable angina pectoris that the low molecular weight heparins (LMWHs) are at least as effective as unfractionated heparin. The LMWHs are easier to use, with the potential to facilitate long-term outpatient treatment. The results of the trials have actually failed to show any clear advantage, however, of the LMWH...

  12. Do general practitioners act consistently in real practice when they meet the same patient twice? Examination of intradoctor variation using standardised (simulated) patients.

    OpenAIRE

    Rethans, J.J.; Saebu, L.

    1997-01-01

    OBJECTIVE: To assess the variation within individual general practitioners facing the same problem twice in actual practice under unbiased conditions. DESIGN: General practitioners were consulted during normal surgery hours by a standardised patient portraying a patient with angina pectoris. Six weeks later the same general practitioners were consulted again by a similar standardised patient portraying a similar case. The patients reported on the consultations. SETTING: Trondheim, Norway. SUB...

  13. Percutaneous Septal Ablation in Hypertrophic Obstructive Cardiomyopathy: From Experiment to Standard of Care

    OpenAIRE

    Lothar Faber

    2014-01-01

    Hypertrophic cardiomyopathy (HCM) is one of the more common hereditary cardiac conditions. According to presence or absence of outflow obstruction at rest or with provocation, a more common (about 60–70%) obstructive type of the disease (HOCM) has to be distinguished from the less common (30–40%) nonobstructive phenotype (HNCM). Symptoms include exercise limitation due to dyspnea, angina pectoris, palpitations, or dizziness; occasionally syncope or sudden cardiac death occurs. Correct diagnos...

  14. Inadequate medical treatment of patients with coronary artery disease by primary care physicians in Germany

    OpenAIRE

    Bischoff, Bernhard; Silber, Sigmund; Richartz, Barbara M.; Pieper, Lars; Klotsche, Jens; Wittchen, Hans-Ulrich

    2013-01-01

    Aims: The DETECT study was performed to obtain representative data about the frequency, distribution, and treatment of patients with coronary artery disease (CAD) in the primary care setting in Germany. Methods and results: The DETECT study was a cross–sectional clinical– epidemiological survey of a nationally representative sample of 3795 primary care offices and 55 518 patients. Overall, 12.4% of patients were diagnosed with CAD. Stable angina pectoris and myocardial infarction were the...

  15. FORMULATION AND EVALUATION OF METAPROLOL SUCCINATE EXTENDED RELEASE PELLETS

    OpenAIRE

    Ahishek Perumalla; Manivannan, R.; Nelluri Rama Rao; M. Radhakrishna; Devareddy Sandeep

    2012-01-01

    The aim and of the present study is to develop a pharmaceutically stable and quality improved formulation of Metoprolol succinate extended release pellets. To achieve this goal various prototype formulation trials were formulated and the evaluated with respect to the various quality controls such as dissolution, assay and stability studies will be under taken. Metoprolol succinate is used in the treatment of hyper tension, angina pectoris (chest pain) and myocardial infarction. The study was...

  16. FORMULATION AND EVALUATION OF METOPROLOL SUCCINATE PULSATILE DRUG DELIVERY SYSTEM FOR CHRONO BIOLOGICAL DISORDER: ANTI HYPERTENSION

    OpenAIRE

    A. Anil Kumar et al

    2012-01-01

    The objective of the present study was to develop and evaluate an oral pulsatile drug delivery system to mimic the circadian rhythm of the disease by releasing the drug with a distinct predetermined log time of 5 hrs (+ 0.25 hrs). The basic design of the pulse in cap formulation of metoprolol provides time controlled release to treat the nocturnal symptoms of hypertension and angina pectoris. The pulsincap formulation of Metoprolol provides time controlled release to treat the nocturnal sympt...

  17. FORMULATION AND EVALUATION OF METOPROLOL SUCCINATE CONTROLLED RELEASE TABLETS USING NATURAL AND SYNTHETIC POLYMER

    OpenAIRE

    A. Sathyaraj

    2012-01-01

    The objective of the present study to develop controlled release tablets of Metoprolol succinate using Natural polymer, guar gum and synthetic polymer, carbopol as a rate controlling polymers.. It was also desired to study the effect of polymer concentration. Metoprolol succinate, β1- selective adrenergic receptor- blocking agent used in the management of hypertension, angina pectoris, cardiac arrthymias, myocardial infarction, heart failure, hyperthyroidism and in the prophylactic treatment ...

  18. A controlled trial of community based coronary rehabilitation.

    OpenAIRE

    Bethell, H J; Mullee, M A

    1991-01-01

    Two hundred patients who had suffered an acute myocardial infarction 4-6 weeks before entered a randomised controlled trial of exercise treatment at a community sports centre supervised by a general practitioner. Eighty one per cent of the treatment group continued to exercise until they returned to work and 73% completed three months' exercise. There were no serious complications of the exercise course. The prevalence of angina pectoris fell by 10% in the treatment group but rose by 60% in t...

  19. An unusual cause of chest pain: Acute coronary syndrome following administration of ergotamine tartrate

    OpenAIRE

    Okutucu, Sercan; Karakulak, Ugur Nadir; Kabakcı, Giray; Aytemir, Kudret

    2012-01-01

    For many years, ergotamine has been used for the acute treatment of migraine. Ergotamine may produce coronary vasospasm, which is often associated with ischemic electrocardiography changes and angina pectoris. A 62-year-old woman who was admitted to the emergency department because of chest pain is described. She had a history of severe migraine attacks and started to use ergotamine tartrate 0.75 mg daily the day before. Electrocardiography revealed sinus tachycardia with left anterior hemibl...

  20. Significance of Cardiac Troponin T Release in Detecting Minor Myocardial Injury After Percutaneous Transluminal Coronary Angioplasty

    OpenAIRE

    ALPER, Gülinnaz

    1999-01-01

    Cardiac Troponin T (TnT) 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. This study was designed to evaluate the diagnostic efficiency of TnT enzyme immunoassay in detecting myocardial damage in patients with stable angina pectoris undergoing visually successful percutaneous transluminal coronary angioplasty (PTCA) and to compare this newly developed test with t...

  1. Comparison of usefulness of exercise testing versus coronary computed tomographic angiography for evaluation of patients suspected of having coronary artery disease

    DEFF Research Database (Denmark)

    Ovrehus, Kristian A; Jensen, Jesper K; Mickley, Hans;

    2010-01-01

    -segment changes > or =1 mV measured 80 ms from the J-point, angina pectoris, ventricular arrhythmia (the occurrence of > or =3 premature ventricular beats), and > or =20 mm Hg decrease in systolic blood pressure during the test. Positive results on CTA were defined as a coronary lumen reduction of > or =50%. In...... performance of CTA for the detection and exclusion of significant CAD might favor CTA as the first-line diagnostic test in patients suspected of having CAD....

  2. Spontaneous Remission of Epstein-Barr Virus-Positive Diffuse Large B-Cell Lymphoma of the Elderly

    OpenAIRE

    Mizuno, T; Ishigaki, M.; K. Nakajima; Matsue, T; Fukushima, M.; Minato, H.; Nojima, N.; Atsushi, Saito; Ishigami, K; Atsumi, H.; Ito, T.; Iguchi, M.; Usuda, D.; Okamura, H; Urashima, S.

    2013-01-01

    A 94-year-old female patient presented with anorexia and left axillar lymphadenopathy on admission. Her past history was angina pectoris at 83 years of age and total gastrectomy due to gastric cancer at 87 years. The family history revealed that her son had had a malignant lymphoma, the histopathological diagnosis of which was diffuse large B-cell lymphoma. A physical examination showed both cervical, axillar, and inguinal lymphadenopathy without tenderness. She had elevated lactate dehydroge...

  3. A New and Practical Synthetic Method for the Synthesis of 6-O-Methyl-scutellarein: One Metabolite of Scutellarin in Vivo

    OpenAIRE

    Hang Lin; Wei Zhang; Ze-Xi Dong; Ting Gu; Nian-Guang Li; Zhi-Hao Shi; Jun Kai; Cheng Qu; Guan-Xiong Shang; Yu-Ping Tang; Fang Fang; He-Min Li; Jian-Ping Yang; Jin-Ao Duan

    2015-01-01

    Scutellarin (1) has been used for the treatment of angina pectoris, cerebral infarction and coronary heart disease with a large market share in China. Pharmacokinetic studies on scutellarin showed that scutellarin (1) is readily converted into its metabolites in vivo. In this paper, a new and practical synthetic method for the synthesis of 6-O-methyl-scutellarein (3) (one metabolite of scutellarin in vivo) is reported. The benzyl bromide was firstly used to selectively replace the acetyl gro...

  4. Proton Dependent Inhibition of the Cardiac Sodium Channel Nav1.5 by Ranolazine

    OpenAIRE

    PeterCRuben; SridharanRajamani

    2013-01-01

    Ranolazine is clinically approved for treatment of angina pectoris and is a potential candidate for antiarrhythmic, antiepileptic and analgesic applications. These therapeutic effects of ranolazine hinge on its ability to inhibit persistent or late Na+ currents in a variety of voltage-gated sodium channels. Extracellular acidosis, typical of ischemic events, may alter the efficiency of drug/channel interactions. In this study, we examined pH modulation of ranolazine’s interaction with the ca...

  5. Effect of Ranolazine on A1C and Glucose Levels in Hyperglycemic Patients With Non-ST Elevation Acute Coronary Syndrome

    OpenAIRE

    Chisholm, Jeffrey W.; Goldfine, Allison B.; Dhalla, Arvinder K.; Braunwald, Eugene; Morrow, David A.; Karwatowska-Prokopczuk, Ewa; Belardinelli, Luiz

    2010-01-01

    OBJECTIVE We determined the relationships between glycemia at randomization, concurrent antidiabetic therapy, and change in A1C and fasting plasma glucose (FPG) in patients with diabetes receiving standard treatment for diabetes and randomized to ranolazine or placebo within the MERLIN-TIMI-36 (MERLIN) study. Ranolazine is a novel first-in-class drug approved for treating angina pectoris. RESEARCH DESIGN AND METHODS Randomization and 4-month glycemic and antidiabetes drug usage data from MERL...

  6. Proton-dependent inhibition of the cardiac sodium channel Nav1.5 by ranolazine

    OpenAIRE

    Sokolov, S.; Peters, C. H.; Rajamani, S; Ruben, P C

    2013-01-01

    Ranolazine is clinically approved for treatment of angina pectoris and is a potential candidate for antiarrhythmic, antiepileptic, and analgesic applications. These therapeutic effects of ranolazine hinge on its ability to inhibit persistent or late Na+ currents in a variety of voltage-gated sodium channels. Extracellular acidosis, typical of ischemic events, may alter the efficiency of drug/channel interactions. In this study, we examined pH modulation of ranolazine's interaction with the ca...

  7. Switching from Nitrate Therapy to Ranolazine in Patients with Coronary Artery Disease Receiving Phosphodiesterase Type-5 Inhibitors for Erectile Dysfunction

    OpenAIRE

    Udeoji, Dioma U; Ernst R. Schwarz

    2014-01-01

    Coronary artery disease (CAD) and erectile dysfunction (ED) frequently coexist. The introduction of phosphodiesterase type-5 (PDE-5) inhibitors has revolutionized medical management of organic ED; however, in patients with angina pectoris, a common symptom of CAD, coadministration of PDE-5 inhibitors and nitrates has been implicated in CAD-related deaths following sexual activity. The mechanism of action of PDE-5 inhibitors results in a potential cumulative drop in blood pressure (BP); thus, ...

  8. Ranolazin: nova mogućnost i novi mehanizam u liječenju kronične stabilne angine pektoris.

    OpenAIRE

    Krstačić, Goran

    2011-01-01

    In treatment of chronic angina pectoris in the last few years, besides the medicines with antianginal effect (adrenergic receptor beta blockers, calcium antagonists and nitrates) even ranolazine may be applied. This innovative drug having effect on pathological process that occurs at a very early stage of ischemia, may block harmful effects that occur in cascade process. Ranolazine is the first antianginal metabolic modulator that has appeared in the last 25 years of treatme...

  9. Effects of physical training on myocardial ischaemia in patients with coronary artery disease.

    OpenAIRE

    Raffo, J A; Luksic, I Y; Kappagoda, C T; Mary, D. A.; Whitaker, W; Linden, R J

    1980-01-01

    The effects of a simple physical training programme were investigated in a prospective and randomised trial in patients with stable angina pectoris using a modified exercise test. Twenty-four patients with ischaemic heart disease and an ischaemic response to conventional exercise electrocardiography were randomised into two groups: 12 patients took part in a training programme and 12 patients were allocated to a control group (no training). Exercise testing was performed sequentially at entry...

  10. Inhibition of collagen synthesis by select calcium and sodium channel blockers can be mitigated by ascorbic acid and ascorbyl palmitate

    OpenAIRE

    Ivanov, Vadim; Ivanova, Svetlana; KALINOVSKY, TATIANA; NIEDZWIECKI, ALEKSANDRA; RATH, MATTHIAS

    2016-01-01

    Calcium, sodium and potassium channel blockers are widely prescribed medications for a variety of health problems, most frequently for cardiac arrhythmias, hypertension, angina pectoris and other disorders. However, chronic application of channel blockers is associated with numerous side effects, including worsening cardiac pathology. For example, nifedipine, a calcium-channel blocker was found to be associated with increased mortality and increased risk for myocardial infarction. In addition...

  11. Prognostic significance of endothelial dysfunction in patients undergoing percutaneous coronary intervention in the era of drug-eluting stents

    OpenAIRE

    KUBO, Motoki; Miyoshi, Toru; Oe, Hiroki; Ohno, Yuko; Nakamura, Kazufumi; Ito,Hiroshi

    2015-01-01

    Background Endothelial function is a prognostic predictor in patients undergoing percutaneous coronary intervention (PCI). However, in an era with widespread use of drug-eluting stents, the clinical relevance of endothelial dysfunction on restenosis in patients undergoing PCI has not been fully evaluated. Methods This study included 80 patients with stable angina pectoris. Flow-mediated dilation (FMD) of the brachial artery was examined 1 week after PCI. Patients were retrospectively followed...

  12. Usefulness of Serum Cathepsin L as an Independent Biomarker in Patients With Coronary Heart Disease

    Science.gov (United States)

    Liu, Yingxian; Li, Xiangping; Peng, Daoquan; Tan, Zheng; Liu, Hongmin; Qing, Yingnan; Xue, Yanqiong; Shi, Guo-Ping

    2009-01-01

    Higher levels of cysteinyl cathepsin L were detected in human atherosclerotic lesions than in healthy aortas. However, a link between human coronary heart disease (CHD) and systemic cathepsin L levels remains unknown. A total of 137 volunteers with diagnosed acute and previous myocardial infarction (MI) and stable and unstable angina pectoris in addition to 48 controls were asked to undergo coronary angiography. Serum cathepsin L, high-sensitivity C-reactive protein, fasting glucose, and lipid protein profiles were measured. Serum cathepsin L levels were significantly higher in patients with CHD than in those without CHD (p <0.001). The significance persisted after adjusting for most major confounders. Patients with unstable angina pectoris had higher serum cathepsin L levels than those with stable angina pectoris (p = 0.02). Of patients with acute coronary syndrome, those with acute MI had higher serum cathepsin L levels than those with unstable angina pectoris (p <0.05) and patients with previous MI had the highest levels. Importantly, serum cathepsin L associated positively with number of coronary branch luminal narrowings (R = 0.38, p <0.001), Gensini scores (R = 0.44, p <0.001), high-sensitivity C-reactive protein (R = 0.32, p <0.001), fasting glucose (R = 0.16, p <0.03), and cigarette smokers (R = 0.27, p <0.001), but inversely with high-density lipoprotein (R = -0.23, p = 0.002) and apolipoprotein A1 (R = -0.19, p = 0.01) in all subjects. In conclusion, after adjusting for these confounders, we found that serum cathepsin L correlated positively and independently with Gensini score, suggesting that serum cathepsin L serves as a novel and independent biomarker for CHD. PMID:19195505

  13. Behavioural responses in rats; modulation with beta-lactam antibiotics and antioxidants

    OpenAIRE

    ŞAVLI, Evren

    2014-01-01

    N-Acetylcysteine (NAC) has been in clinical practice for several decades as a mucolytic agent and has been used also for the treatment of paracetamol intoxication, doxorubicin- induced cardiotoxicity, stable angina pectoris, ischemia-reperfusion cardiac injury, acute respiratory distress syndrome bronchitis, chemotherapy-induced toxicity, HIV/AIDS, radio contrastinduced nephropathy, heavymetal toxicity and psychiatric disorders including schizophrenia, bipolar disorder and addiction. It has b...

  14. EVALUATION OF EFFICACY OF KARSHANIYA YAVAGU (AN AYURVEDIC PREPARATION) IN MANAGEMENT OF OBESITY

    OpenAIRE

    Patil Y. R.; Sawant R. S.

    2012-01-01

    Obesity is the most common metabolic disorder in affluent societies caused by excessive eating, lack of exercise and is a direct result of the modernization combined with lifestyle changes. It is the main underlying cause of life threatening diseases like Diabetes mellitus, Hypertension, Angina Pectoris, and Myocardial Infarction etc. In this study 60 patients were divided in two groups namely A and B. Group A was given Karshaniya Yavagu and Group B was given Placebo (Starch capsule) for 90 d...

  15. Erythrocyte sedimentation rate as a marker for coronary heart disease

    Directory of Open Access Journals (Sweden)

    Yayan J

    2012-04-01

    Full Text Available Josef YayanDepartment of Internal Medicine, Vinzentius Hospital, Landau, GermanyBackground: Patients with angina pectoris or myocardial infarction frequently present without evidence of cardiac-specific heart enzymes by laboratory analysis or specific pathologic electrocardiogram findings. The current study analyzed the efficacy of the erythrocyte sedimentation rate as an additional potential indicator for coronary heart disease, the aim being to enable quicker identification of patients with angina pectoris or myocardial infarction so that they can be more rapidly treated.Methods: Patients with angina pectoris or myocardial infarction who had undergone a heart catheter examination were included in the study. The diagnosis of acute coronary heart disease was made by the physician who performed coronary angiography. Patients without coronary heart disease were used as a control group. The erythrocyte sedimentation rate was measured in all patients. Patients with angina pectoris or myocardial infarction and an inflammatory or tumor disease were excluded.Results: The erythrocyte sedimentation rate was prolonged in 79 (58.09% of 136 patients; 69 (50.74% patients (95% confidence interval ±8.4%, 42.34%–59.14% had coronary heart disease and a prolonged erythrocyte sedimentation rate. The erythrocyte sedimentation rate was prolonged in ten (7.35% patients (95% confidence interval ±4.39%, 2.96%–11.74% without coronary heart disease by coronary angiography. The specificity of the erythrocyte sedimentation rate for coronary heart disease was 70.59% and the sensitivity was 67.65%.Conclusion: Erythrocyte sedimentation rate may be a useful additional diagnostic criterion for coronary heart disease.Keywords: erythrocyte sedimentation rate, coronary heart disease, myocardial infarction, coronary angiography

  16. Studies on Tl-201 single photon emission computed tomography (SPECT) of myocardium in patients with ischemic heart disease

    International Nuclear Information System (INIS)

    Seventy-six patients with IHD were divided into 2 groups, A) angina pectoris (n=50) and B) previous myocardial infarction(n=26). Each group was classified into three subgroups, without considering hypertension, that is 1) without complication, 2) with hypercholesterolemia, and 3) with diabetes mellitus. We studied and compared the findings of ECG, Echocardiogram (ECHO) and Emission CT (ECT) in these patients at rest. In the previous myocardial infarction group (Group B), we could find 100% ischemic patterns on ECG, 100% asynergy of either IVS or the posterior wall on ECHO and higher percentages of various grade of perfusion defects on ECT compared with group A. In group A, the percentages of perfusion defects were similar in three subgroups. But interestingly, in the hypercholesterolemic group, we could find diffuse moth-eaten like low perfusion areas on ECT. Further study is required whether this finding is peculiar for angina pectoris with hypercholesterolemia or an artifact on ECT. The percentage of ischemic patterns on ECG was lower than in the other groups. In angina pectoris with diabetes mellitus, asynergy in ECHO finding was a significantly higher percentage, compared with other groups. We believe, that ECG, ECHO and ECT are of compensatory importance in the diagnosis of patients with IHD. (author)

  17. Significance of 99mTc-MIBI myocardial SPECT imaging in diagnosis of syndrome X

    International Nuclear Information System (INIS)

    To assess the value of myocardial imaging in the diagnosis of syndrome X, the study was performed with 99mTc-MIBI myocardial SPECT imaging in 64 patients. The patients were divided into three groups: group 1 had 21 patients diagnosed as syndrome X, group 2 had 17 patients with chest pain and normal coronary arteries without ST segment depression during exercise, group 3 had 26 patients with the angina pectoris and coronary stenoses≥50%. The myocardial SPECT imaging of the three groups was compared qualitatively and semi-quantitatively. Myocardial imaging identified 11 cases of myocardial ischemia from 21 patients with syndrome X. The ischemic score of myocardial imaging was 1.1 +- 0.3 for syndrome X and 1.8 +- 0.7 for patients with coronary heart disease (CHD) angina pectoris (t = 3.1746, P<0.01). Myocardial imaging may partly show myocardial ischemia in patients with syndrome X. The extent of ischemia in patients with syndrome X was significantly less than that in patients with CHD angina pectoris

  18. Study on plasma C-reactive protein and IL-6 levels in patients with acute coronary syndrome

    International Nuclear Information System (INIS)

    Objective: To explore the difference between the plasma C-reactive protein (CRP) and serum interleukin 6(IL-6) levels of patients with acute coronary syndrome (ACS) and patients with stable angina pectoris (SAP). Methods: Plasma CRP (with immunoturbidometry) and serum IL-6 (with RIA) levels were determined in the following subjects: 1) 57 patients with ACS including 21 with acute myocardial infarction (AMI) and 36 with unstable angina pectoris (UAP; Braunwald grade I 11, grade II 10, grade III 15), 2) 48 patients with stable angina pectoris (SAP) as controls. Results: Plasma levels of CRP and serum level IL-6 in patients with AMI and patients with UAP were significantly higher than those in the controls (P0.05). Plasma CRP levels were correlated positively to IL-6 in all these three groups (rAMI=0.569, rUAP=0.413, rSAP=0.475, P<0.01, P<0.05). Conclusion: Plasma levels of CRP and IL-6 were higher in patients with ACS, indicating the important role played by inflammation in the pathogenesis. (authors)

  19. Response of left ventricular volume to exercise in man assessed by radionuclide equilibrium angiography

    International Nuclear Information System (INIS)

    To assess the effects of exercise on left ventricular volumes we studied 10 normal men, 15 patients with coronary disease who developed angina pectoris during exercise, and 10 patients with known coronary disease who did not develop angina during exercise. Each subject performed supine bicycle exercise under a mobile, single-crystal scintillation camera until angina or fatigue occurred. Technetium-99m bound to human serum albumin was the imaging agent. Data were collected at rest and during the last 2 minutes of each 3-minute stage of exercise and for 10 minutes after exercise. Volumes were calculated by a new radionuclide technique that correlated well with cineangiography and is expressed in nondimensional units. In normal subjects, the end-diastolic volume (EDV) at rest was not different from that a peak exercise. The end-systolic volume (ESV) decreased at peak exercise. ESV decreased progressively in all but two of 30 exercise periods. Angina patients had a larger EDV at rest and during chest pain than normals. Angina patients increased their ESV during chest pain resulting in a decreased ejection fraction (EF). All angina patients had a higher ESV during chest pain than during the exercise stage before chest pain. As a group, patients who did not develop angina had a lower EDV at rest and peak exercise than those who did develop angina. We conclude: that the EF increases during exercise due to a decrease in ESV; that the EF in patients with angina decreases because of an increase in ESV; and that the EF in coronary disease patients without angina shows no change because there is no significant change in the ESV. Radionuclide equilibrium angiography may prove useful for assessing EF and volume changes in patients with coronary artery disease

  20. Trial Study on DENG Tie-tao's Coronary Heart Disease Capsules in Improving Patients' Quality of Life

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Objective: To assess the efficacy of the Coronary Heart Disease (CHD) Capsules worked out by Prof. Deng--in improving quality of life of CHD patients of qi deficiency with phlegm and blood stasis syndrome. Method: According to the WHO's diagnosis criteria of CHD, a total of 93 stable angina patients were divided into 3 groups using the single blinded method. The groups were evenly distributed into CHD Capsule treated group (CHDC), isosorbide dinitrate control group (ID), and Compound Prescription Danshen Droplet Pills control group (CPDDP). Two courses of treatment lasting for 6 months were given. During the courses of treatment, the following parameters were observed: clinical symptoms of angina pectoris, ECG change, treadmill exercise test, 36 items in short form of health survey (SF-36) and Seattle Angina Questionnaire (SAQ) scale. Results: After 6 months of treatment, all the three groups showed good curative effect in angina pectoris, ECG and treadmill exercise test, differences between them had no statistical significance.The CHDC group showed a better result in nitro-glycerine stopping or alleviation rate and in improving symptoms than the other groups (P<0.05). The general health, vitality, role-emotional, mental health and reported health transition in the CHDC group were significantly better than those in the control groups (P<0.05). The scores in physiological functioningrole, physiological function and pain alleviation were not different among the three groups. Conclusion: Prof. DENG Tie-tao's CHDC is effective in treating CHD with qi deficiency, phlegm and blood stasis and also in improving the quality of life. CHDC is more suitable to be used in long-term treatment than isosorbide dinitrate. The SF-36 and SAQ can be used to appraise the curative effect of traditional Chinese medicine agents for CHD angina pectoris.