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Sample records for angina unstable

  1. [Exercise tests in unstable angina suspects].

    Science.gov (United States)

    2012-01-01

    The review is devoted to exercise tests (ET) potential in patients with different forms of coronary heart disease (CHD) exacerbation and suspected unstable angina. It is well known that unstable angina untreated pharmacologically is a contraindication for ET. Of interest in clinical practice is diagnosis, risk assessment and treatment policy in patients with chest pain. The main focus is on ET conduction in unstable angina suspects with low and intermediate risk, on safety and validity of ET conduction in these patients.

  2. Coronary angioplasty for early postinfarction unstable angina

    NARCIS (Netherlands)

    P.J. de Feyter (Pim); P.W.J.C. Serruys (Patrick); A. Soward; M.J.B.M. van den Brand (Marcel); E. Bos (Egbert); P.G. Hugenholtz (Paul)

    1986-01-01

    textabstractCoronary angioplasty was performed in 53 patients in whom unstable angina had reoccurred after 48 hr and within 30 days after sustained myocardial infarction. Single-vessel disease was present in 64% of the patients and multivessel disease in 36%. The preceding myocardial infarction had

  3. Analysis of Plasma Homocysteine Levels in Patients with Unstable Angina

    Directory of Open Access Journals (Sweden)

    José Roberto Tavares

    2002-08-01

    Full Text Available OBJECTIVE - To determine the prevalence of hyperhomocystinemia in patients with acute ischemic syndrome of the unstable angina type. METHODS - We prospectively studied 46 patients (24 females with unstable angina and 46 control patients (19 males, paired by sex and age, blinded to the laboratory data. Details of diets, smoking habits, medication used, body mass index, and the presence of hypertension and diabetes were recorded, as were plasma lipid and glucose levels, C-reactive protein, and lipoperoxidation in all participants. Patients with renal disease were excluded. Plasma homocysteine was estimated using high-pressure liquid chromatography. RESULTS - Plasma homocysteine levels were significantly higher in the group of patients with unstable angina (12.7±6.7 µmol/L than in the control group (8.7±4.4 µmol/L (p<0.05. Among males, homocystinemia was higher in the group with unstable angina than in the control group, but this difference was not statistically significant (14.1±5.9 µmol/L versus 11.9±4.2 µmol/L. Among females, however, a statistically significant difference was observed between the 2 groups: 11.0±7.4 µmol/L versus 6.4±2.9 µmol/L (p<0.05 in the unstable angina and control groups, respectively. Approximately 24% of the patients had unstable angina at homocysteine levels above 15 µmol/L. CONCLUSION - High homocysteine levels seem to be a relevant prevalent factor in the population with unstable angina, particularly among females.

  4. Bypass surgery versus stenting for the treatment of multivessel disease in patients with unstable angina compared with stable angina

    OpenAIRE

    de Feyter, Pim; Heuvel, P.; Unger, Felix; Beyar, R; Lindeboom, Wietze; de Valk, Vincent; Milo, S; Simon, Rudiger; Tyers, Frank; Regensburger, D.; Crean, Peter; Penn, Ian; McGovern, E; Cauwelaert, C.; Serruys, Patrick

    2002-01-01

    textabstractBACKGROUND: Earlier reports have shown that the outcome of balloon angioplasty or bypass surgery in unstable angina is less favorable than in stable angina. Recent improvements in percutaneous treatment (stent implantation) and bypass surgery (arterial grafts) warrant reevaluation of the relative merits of either technique in treatment of unstable angina. Methods and Results- Seven hundred fifty-five patients with stable angina were randomly assigned to coronary stenting (374) or ...

  5. Breath markers of oxidative stress in patients with unstable angina.

    Science.gov (United States)

    Phillips, Michael; Cataneo, Renee N; Greenberg, Joel; Grodman, Richard; Salazar, Manuel

    2003-01-01

    Cardiac chest pain is accompanied by oxidative stress, which generates alkanes and other volatile organic compounds (VOCs). These VOCs are excreted in the breath and could potentially provide a rational diagnostic marker of disease. The breath methylated alkane contour (BMAC), a 3-dimensional surface plot of C4-C20 alkanes and monomethylated alkanes, provides a comprehensive set of markers of oxidative stress. In this pilot study, we compared BMACs in patients with unstable angina pectoris and in healthy volunteers. Breath VOCs were analyzed in 30 patients with unstable angina confirmed by coronary angiography and in 38 age-matched healthy volunteers with no known history of heart disease (mean age +/- SD, 62.7 +/- 12.3 years and 62.5 +/- 10.0, not significant). BMACs in both groups were compared to identify the combination of VOCs that provided the best discrimination between the 2 groups. Forward stepwise entry discriminant analysis selected 8 VOCs to construct a predictive model that correctly classified unstable angina patients with sensitivity of 90% (27 of 30) and specificity of 73.7% (28 of 38). On cross-validation, sensitivity was 83.3% (25 of 30) and specificity was 71.1% (27 of 38). We conclude that the breath test distinguished between patients with unstable angina and healthy control subjects.

  6. Unstable angina following intracavernous injection of alprostadil: a case study

    OpenAIRE

    Delongchamps, Nicolas Barry; Legrand, Guillaume; Zerbib, Marc; Peyromaure, Michael

    2009-01-01

    Intracavernous injection of alprostadil is the gold standard treatment for erectile dysfunction following radical prostatectomy. After surgery, low doses of alprostadil can be delivered for the sole purpose of penile rehabilitation. The only reported systemic side effects of such injections are arterial hypotension and headache. In the current report, a case of unstable angina immediately following an intracavernous injection of alprostadil is described.

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

    NARCIS (Netherlands)

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

    1995-01-01

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

  8. ENHANCED PLATELET AGGREGABILITY UNDER HIGH SHEAR STRESS IN CORONARY CIRCULATION OF PATIENTS WITH UNSTABLE ANGINA

    OpenAIRE

    Doi, Naofumi

    2000-01-01

    Mechanical forces, including high shear stress, have been found to cause platelet aggregation. Although increased platelet aggregation is also associated with the pathophysiology of unstable angina, it is not known whether platelet aggregation induced by high shear stress occurs in the coronary circulation of patients with unstable angina. We assayed high shear stress induced platelet aggregation (h-SIPA) in each of 25 patients with unstable angina and a severe stenotic lesion of the left cor...

  9. Effect of Glucose - Insulin - Potassium (Gik) Solution on Short Term Prognosis of Unstable Angina

    OpenAIRE

    A Azimi; Azimi; M Motafakker; M Sadr-Bafghi; A Andishmand

    2007-01-01

    Introduction: Unstable angina as a clinical condition includes a major group of patients manifested with acute coronary syndrome. Misdiagnosis of this clinical syndrome causes myocardial infarction (MI) and death. Conventional and advanced forms of treatment are used with the aim of rapid stabilization of unstable angina. Although infusion of glucose - insulin - potassium (GIK) solution has had good results in acute MI, no major trial has studied its effect in unstable angina. The main goal o...

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

    Directory of Open Access Journals (Sweden)

    Hanmant S Amane

    2011-01-01

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

  11. Bypass surgery versus stenting for the treatment of multivessel disease in patients with unstable angina compared with stable angina

    NARCIS (Netherlands)

    P.J. de Feyter (Pim); P. van den Heuvel; F. Unger (Felix); R. Beyar; W.K. Lindeboom (Wietze); V. de Valk (Vincent); S. Milo; R. Simon (Rudiger); G.F.O. Tyers (Frank); D. Regensburger; P.A. Crean (Peter); I.M. Penn (Ian); E. McGovern; C. van Cauwelaert; P.W.J.C. Serruys (Patrick)

    2002-01-01

    textabstractBACKGROUND: Earlier reports have shown that the outcome of balloon angioplasty or bypass surgery in unstable angina is less favorable than in stable angina. Recent improvements in percutaneous treatment (stent implantation) and bypass surgery (arterial grafts) warrant reevaluation of the

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

    Science.gov (United States)

    Albert, S; Flury, G

    1997-11-19

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

  13. 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.

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

    Science.gov (United States)

    Plotnik, G D; Fisher, M L; Carliner, N H; Becker, L C

    1980-08-01

    Among patients with unstable angina pectoris, those with crescendo angina seem to be at high risk for death and myocardial infarction. We reviewed the clinical, arteriographic, and hemodynamic findings in 218 consecutive catheterized patients with unstable angina. Unstable angina was defined as ischemic cardiac pain at rest associated with transient ECG changes but no evidence for acute myocardial infarction. Patients were divided into two groups according to the duration of symptoms: 134 patients with crescendo angina (new, or increasing, rest pain with previous ischemic symptoms present for more than three months) and 84 with recent onset angina (symptoms present for less than three months). Compared with patients with recent onset symptoms, patients with crescendo angina had more extensive coronary disease and lower ejection fractions, which may explain their poor prognosis.

  15. Unstable angina of crescendo pattern vs new onset: a clinical, coronary arteriographic and hemodynamic study.

    Science.gov (United States)

    Hussain, K M; Gould, L; Bharathan, T; Abdelsayed, G; Karpov, Y

    1995-06-01

    Unstable angina includes a variety of clinical presentations with a different level of risk for an unfavorable outcome. In this study the authors investigated the prognostic significance of crescendo angina and new-onset angina to discuss management strategies, paying attention to the relevance of baseline clinical characteristics, coronary artery lesions, and left ventricular function, as well as their alterations during atrial pacing. Accordingly coronary arteriographic anatomy and changes in left ventricular volumes and ejection fraction before and during atrial pacing were studied by means of digital subtraction ventriculography in 18 patients with crescendo angina and in 18 patients with new-onset angina. Triple-vessel disease was more frequently observed in crescendo angina (56%; P crescendo angina. The angiographic evidence of intracoronary thrombi was found in 33% (P crescendo angina and in 4% patients with new-onset angina. Compared with the patients with new-onset angina, patients with crescendo angina had higher end-diastolic and end-systolic volumes and lower ejection fraction at rest. At peak pacing, ejection fraction was significantly (P crescendo angina (0.48 +/- 0.06) than in new-onset angina (0.66 +/- 0.04). In crescendo angina, during pacing, the magnitude of velocity of circumferential fiber shortening was significantly decreased as compared with new-onset angina.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. Stable and unstable angina: Identifying novel markers on circulating leukocytes.

    Science.gov (United States)

    Brown, Angus; Lattimore, Jo-Dee; McGrady, Michele; Sullivan, David; Dyer, Wayne; Braet, Filip; Dos Remedios, Cristobal

    2008-01-01

    There is currently no blood-based test that can rapidly and objectively distinguish between chest pain which is initiated by increased myocardial oxygen demand (stable angina pectoris (SAP)) and chest pain initiated due to decreased coronary blood flow (unstable angina pectoris (UAP)). Since leukocytes play an active role in the progression of coronary artery disease (CAD), we hypothesize these can provide novel markers of SAP and UAP. Here we use a microarray of 82 cluster of differentiation (CD) antibodies (plus controls) to selectively immobilize peripheral blood mononuclear cells. We find that the pattern of leukocyte immobilization from patients with CAD significantly differs from healthy donors. Within the CAD group, 15 SAP patients exhibited significant (p<0.05) changes in 8 of 82 CD antibody spots compared to 19 age-matched healthy blood donors. An additional ten CD antigens differed between healthy donors and patients with UAP (p<0.05). Furthermore, seven CD antibody spots are significantly different between SAP and UAP patients. These preliminary data suggest it is now appropriate to undertake a larger clinical trial to test the hypothesis that these antibody microarrays can monitor the progression from SAP to UAP.

  17. Salvianolate injection in the treatment of unstable angina pectoris

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

    Weber, M; Hamm, C

    2007-04-01

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

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

    Science.gov (United States)

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

    2002-08-01

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

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

    Science.gov (United States)

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

    2000-11-01

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

  1. 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.

  2. Effect of Glucose - Insulin - Potassium (Gik Solution on Short Term Prognosis of Unstable Angina

    Directory of Open Access Journals (Sweden)

    A Azimi

    2007-12-01

    Full Text Available Introduction: Unstable angina as a clinical condition includes a major group of patients manifested with acute coronary syndrome. Misdiagnosis of this clinical syndrome causes myocardial infarction (MI and death. Conventional and advanced forms of treatment are used with the aim of rapid stabilization of unstable angina. Although infusion of glucose - insulin - potassium (GIK solution has had good results in acute MI, no major trial has studied its effect in unstable angina. The main goal of this study was evaluation of the effectiveness of GIK solution on prognosis of hospitalized unstable angina patients. Methods: This randomized clinical trial included patients with class II and III unstable angina (two groups of 94 patients, each with a mean age of 62.47±13.20 years and Female /Male ratio of 1.35 admitted in the CCU’s of Yazd from September 2003 to May 2004 . Results: There was no significant difference between the study and control groups regarding mean age, sex ratio and unstable angina class (P=0.15, P=0.77 and P=0.76. The study group had significant reduction in recurrent chest pain and duration of hospitalization (P=0.001 and P=0.02. The most common adverse effect of GIK solution was pain at infusion site. Conclusion: Use of GIK solution causes early stabilization of unstable angina patients without any significant or life threatening adverse effect.

  3. Benefit of abciximab in patients with refractory unstable angina in relation to serum troponin T levels.

    NARCIS (Netherlands)

    C.W. Hamm (Christian); C. Heeschen (Christopher); B. Goldmann (Britta); A. Vahanian (Alec); J. Adgey (Jennifer); C.M. Miguel (Carlos); W.R. Rutsch (Wolfgang); J. Berger (Jürgen); J.G. Kootstra (Jille); M.L. Simoons (Maarten)

    1999-01-01

    textabstractBACKGROUND: In patients with refractory unstable angina, the platelet glycoprotein IIb/IIIa-receptor antibody abciximab reduces the incidence of cardiac events before and during coronary angioplasty. We investigated whether serum troponin T levels identify patients most

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

    OpenAIRE

    Miltenburg-van Zijl, Addy

    1992-01-01

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

  5. Plasma endothelin in coronary venous blood from patients with either stable or unstable angina.

    OpenAIRE

    Stewart, J T; Nisbet, J A; Davies, M J

    1991-01-01

    STUDY OBJECTIVE--To test the hypothesis that the active coronary endothelial lesions in unstable angina raise the endothelin concentration in coronary venous blood. DESIGN--Systemic and coronary venous blood samples were obtained from unselected patients with the clinical syndromes of either stable or unstable angina at the time of cardiac catheterisation and coronary arteriography. Control venous blood samples were obtained from healthy laboratory workers and from patients with chronic renal...

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

    Science.gov (United States)

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

    1999-01-01

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

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

    Directory of Open Access Journals (Sweden)

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

    Science.gov (United States)

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

    1995-07-01

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

  9. Comparison of Results of Coronary Angioplasty in Patients with Unstable vs. Stable Angina

    Institute of Scientific and Technical Information of China (English)

    梅卫义; 杜志民; 罗初凡; 胡承恒; 李怡; 马虹

    2002-01-01

    Objectives To comparethe short and mid - term outcomes in cases of percuta-neous transluminal coronary angioplasty (PTCA) inpatients with unstable v stable angina. MethodsPatients selected for PTCA/stenting were divided into two groups, one with stable angina pectoris (SAgroup, n--92) and one with unstable angina pectoris(UA group, n = 112). The outcomes of coronary angiographies (CAG), initial (30-d) success of theprocedure, and follow- up status in the two groupswere compared. Results Baseline characteristicswere similar, although the patients with unstablesymptoms more females ( P< 0.05), and had a higheraverage CCS class ( P< 0.05) and a higher incidenceof postinfarction angina ( P< 0. 01 ). The frequency of"complex" stenosis in patients with unstable anginawas higher than that of patients with stable angina,33% v 20% (P<0.01). A total of 309 vessels accepted the procedure; including 210 stents were successfully delivered to 156 patients. 143 and 67 stentswere implanted in the UA and SA group, respectively(P< 0.01 ). No major complication occurred in thetwo groups, except 12 patients experienced reoccurring chest pain initially, 9 in UA group v 3 in SAgroup ( P< 0.05). The averaged six - month follow -up status was compared too. Only 3 cases developedmyocardial infarction, including 2 patients with unstable angina. 12 and 16 reoccurring chest pains werefound in the two groups, respectively (13% in SAgroup vs 14% in UA group). There were no significant differences between groups in rates of clinicalrestenosis, follow- up angina class, or overall clinicalsuccess. Conclusions Patients with unstable anginareceiving PTCA/stenting have similar complication,restenosis, and initial and midterm success rate ascompared to patients with stable symptoms with strictcases select and careful preparation.

  10. Comparison of results of intracoronary stenting in patients with unstable vs. stable angina.

    Science.gov (United States)

    Malosky, S A; Hirshfeld, J W; Herrmann, H C

    1994-02-01

    Percutaneous transluminal coronary angioplasty (PTCA) has higher complication and restenosis rates when performed in the setting of unstable angina. Balloon-expandable intracoronary stenting is a new technique with the potential to improve the results of PTCA. In order to determine whether stenting is associated with a poorer outcome in patients with unstable angina, we retrospectively examined our experience with the Palmaz-Schatz balloon-expandable intracoronary stent in 105 patients. Patients were divided into 2 groups on the basis of symptoms at the time of stent insertion: group I (n = 57) had stable angina pectoris, and group II (n = 48) had unstable angina defined as pain at rest despite antianginal therapy (Braunwald class II, III). Initial (30-d) and final (6-mo) success rates were defined as stent insertion without myocardial infarction, need for bypass surgery, death, and significant angina. Baseline characteristics were similar, although the patients with unstable symptoms were older, more likely to be female, and had a higher incidence of postinfarction angina. A total of 136 stents were successfully delivered to 97 target sites in 92% of patients. Major complications occurred in 4 patients (4%) and were due to subacute thrombosis in 3 of them. There were no differences in complication rates between patients receiving stents electively with stable vs. unstable symptoms (2% vs. 6%, p = NS). Six-mo. follow-up status was ascertained in 96% of patients and revealed overall clinical success in 83% with angiographic restenosis (> or = 50% stenosis) in 28% of patients. There were no significant differences between groups in rates of restenosis, follow-up angina class, or overall clinical success.(ABSTRACT TRUNCATED AT 250 WORDS)

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

    Institute of Scientific and Technical Information of China (English)

    谢小鲁; 王燕妮; 祝家庆; 袁祖贻

    2003-01-01

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

  12. Cardiologists' Use of clinical information for management decisions for patients with unstable angina: a policy analysis

    NARCIS (Netherlands)

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

    1997-01-01

    textabstractPrevious studies of management of unstable angina have revealed substantial differences in management between different hospitals, especially with respect to the use of coronary angiography. Physicians in a hospital with angiography facilities were more inclined to perform angiography th

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

    Institute of Scientific and Technical Information of China (English)

    贺敬波; 黄绵清; 张勤; 廖万柏; 王立军; 张玉英

    2004-01-01

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

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

    Science.gov (United States)

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

    1998-12-15

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

  15. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

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

    1996-11-15

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

  18. HEPARIN THERAPY IN PATIENT WITH NON-Q WAVE MYOCARDIAL INFARCTION AND UNSTABLE ANGINA

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    M.H EMAMI

    2000-03-01

    Full Text Available Introduction. This study was conducted to find that, is there any advantage from (5000 IU/6h in patient with non-Q wave MI and unastable angina. Methods. In a randomized clinical trial two group of patients with non-Q wave MI and unstable angina were compared about their prognosis and management outcomes. In interventional group (n= 145, heparin (5000 IU/6h was administered and in another group (n= 133 no treatment with heparin was used. Duration of chest pain, recurrent angina, intrahospital mortality were indices for patients outcome study. Findings. Anticoagulant complication was not report in any patient in interventional group. There is no significant difference between two groups about prognosis factors. Conclusion. Heparin administration (5000 IU/6h may have not any role in improving management outcome in patient with non-Q wave MI and unastable angina at least in acute phase. So, it is recommended that heparin have been administered to these patients in continuous regimen (1000-1500 U/hour continuously effusion.

  19. [The quality of life of the patient with unstable angina treated by spinal cord electrical stimulation].

    Science.gov (United States)

    González-Darder, J M; Vázquez, J L; Canela, P; González Martínez, V

    1990-12-01

    Quality of life was evaluated in patients with unstable angina before and after surgical therapy with spinal cord electrical stimulation (SCES). Overall 12 patients were evaluated, with quantification of the mean weekly number of anginal attacks, the degree of effort provoking them and the Nottingham Health Profile (NHP). The criteria of inclusion in the study were: angina grade IV, resistant to drug therapy and without indication of surgery. The mean follow-up period was 9.8 +/- 8.2 months. A significant reduction in the weekly number of anginal attacks (preoperative 30.9 +/- 14.5; postoperative 9.6 +/- 8.2; p less than 0.01); improvement in functional class (p less than 0.001), and significant improvement (p greater than 0.05) in the pain, energy, sleep, social isolation and emotional reactions areas of NHP were observed. It was concluded that SCES is a useful procedure in patients with unstable angina untreatable by other medical or surgical methods, as it reduces the number of anginal attacks and increases quality of life of the patients without additional risk.

  20. Unstable angina

    Science.gov (United States)

    ... nih.gov/pubmed/25260718 . Giugliano RP, Cannon CP, Braunwald E. Non-ST elevation myocardial infarction. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of ...

  1. [Prognostic value of high-sensitivity C-reactive protein in assessing intrahospital outcome of unstable angina].

    Science.gov (United States)

    Ben Halima, Afef; Kammoun, Ikram; Sdiri, Wissem; Bachraoui, Kaouther; Chine, Samira; Zoaoui, Walid; Châabène, Olfa; Gargouri, Sami; Keskes, Hend; Lefi, Abdellatif; Ben Ammar, Slim; Boujnah, M Rachid; Kachboura, Salem

    2003-01-01

    Inflammation has been shown to play an important role in the pathogenesis of unstable angina. CRP has been demonstrated to be a reliable marker of prognosis is unstable angina. The aim of this study was to investigate the prognostic value of CRP in assessing short outcome of unstable angina. Our study is a prospective double blinded one. We measured CRP in 33 consecutive patients admitted for unstable angina at the 24th and 48th hour. The mean age is 60 years (30 to 84 years). There were 22 men and 11 women. 8 patients were included in class I of Braunwald classification, 5 were in class II and 20 in class III. 14 patients presented cardiac events. The CRP mean value was significantly higher among these patients (12 mg/l vs 5 mg/l, p or = 3 mg/l have a higher risk of developing complications (66% vs 13%, p = 0.002). Elevation of CRP predicted poor outcome of intrahospital evolution with a sensitivity of 86%, a specificity 68%, a positive and negative predictive values of 66% and 86%. The CRP in our preliminary study is an independent risk factor of early outcome of unstable angina. In association with clinical scores and other cardiac markers will lead to a better identification of high risk patients.

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

    Science.gov (United States)

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

    2004-02-15

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

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  4. [Changes of fatty acids spectrum of plasma triglycerides and their pharmacological correction by statins in patients with unstable angina].

    Science.gov (United States)

    Lyzohub, V H; Artemchuk, O O; Dolynna, O V; Altunina, N V; Sharaieva, M L; Koniuk, T N

    2013-01-01

    The fatty acid composition of plasma triglycerides by gas chromatography, the dynamics of the segment ST, cardiac arrhythmia by daily monitoring of electrocardiogram in patients with unstable angina (progressive) and the effects of treatment with statins were studied. Revealed marked qualitative abnormalities of plasma triglycerides in patients with progressive angina manifest increase in the amount of saturated and reduction--of unsaturated fatty acids. High therapeutic effect of simvastatin and atorvastatin may be due to the identified strong correlation between the dynamics of the fatty acid components of plasma triglycerides and indicators of ischemia, ectopic activity in patients with progressive angina.

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

    Science.gov (United States)

    Börjesson, M

    1999-04-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-10-01

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

  7. Anomalous Origin of a Stenosed Left Circumflex Coronary Artery in a Patient Presenting with Unstable Angina: A Case Report

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    Vakili Hossein

    2016-12-01

    Full Text Available 73 year-old man presented to our emergency department with complaint of retrosternal chest pain since 2 day and admitted with diagnosis of unstable angina. He underwent diagnostic coronary angiography in which left circumflex artery (LCX was not visualized during injection of the left coronary artery; indeed, it was originated, with common origin with RCA, from right coronary sinus of Valsalva. This case report is one of the uncommon cases with aberrant coronary arteries who presented with unstable angina. Moreover, coronary angiography with following coronary angioplasty was performed for him in a challenging course and angle for coronary intervention.

  8. Direct evidence of endothelial injury in acute myocardial infarction and unstable angina by demonstration of circulating endothelial cells.

    Science.gov (United States)

    Mutin, M; Canavy, I; Blann, A; Bory, M; Sampol, J; Dignat-George, F

    1999-05-01

    Circulating endothelial cells (CECs) have been detected in association with endothelial injury and therefore represent proof of serious damage to the vascular tree. Our aim was to investigate, using the technique of immunomagnetic separation, whether the pathological events in unstable angina (UA) or acute myocardial infarction (AMI) could cause desquamation of endothelial cells in circulating blood compared with effort angina (EA) and noncoronary chest pain. A high CEC count was found in AMI (median, 7.5 cells/mL; interquartile range, 4.1 to 43.5, P chest pain as compared with controls (0; 0 to 0 cells/mL) and stable angina (0; 0 to 0 cells/mL). CEC levels in serial samples peaked at 15.5 (2.7 to 39) cells/mL 18 to 24 hours after AMI (P angina, confirming that these diseases have different etiopathogenic mechanisms.

  9. An Overview of Meta-Analyses of Danhong Injection for Unstable Angina

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    Xiaoxia Zhang

    2015-01-01

    Full Text Available Objective. To systematically collect evidence and evaluate the effects of Danhong injection (DHI for unstable angina (UA. Methods. A comprehensive search was conducted in seven electronic databases up to January 2015. The methodological and reporting quality of included studies was assessed by using AMSTAR and PRISMA. Result. Five articles were included. The conclusions suggest that DHI plus conventional medicine treatment was effective for UA pectoris treatment, could alleviate symptoms of angina and ameliorate electrocardiograms. Flaws of the original studies and systematic reviews weaken the strength of evidence. Limitations of the methodology quality include performing an incomprehensive literature search, lacking detailed characteristics, ignoring clinical heterogeneity, and not assessing publication bias and other forms of bias. The flaws of reporting systematic reviews included the following: not providing a structured summary, no standardized search strategy. For the pooled findings, researchers took statistical heterogeneity into consideration, but clinical and methodology heterogeneity were ignored. Conclusion. DHI plus conventional medicine treatment generally appears to be effective for UA treatment. However, the evidence is not hard enough due to methodological flaws in original clinical trials and systematic reviews. Furthermore, rigorous designed randomized controlled trials are also needed. The methodology and reporting quality of systematic reviews should be improved.

  10. 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.

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

    NARCIS (Netherlands)

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

    1987-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

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

    2004-01-01

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

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

    Science.gov (United States)

    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 asymptomatic episodes (silent ischaemia) in 6 patients with unstable angina. Blood samples were obtained at admission and when an asymptomatic alteration was detected and 10 minutes later. MAIN OUTCOME MEASURES--Comparisons of concentrations of tissue plasminogen activator, urokinase type plasminogen activator, tissue plasminogen activator inhibitor-1, cross-linked fibrin degradation products, von Willebrand factor, and thrombin-antithrombin III complexes in patients and controls at admission; same comparisons in patients with silent ischaemia at the start of an episode and 10 minutes later. RESULTS--Tissue plasminogen activator concentrations were raised at admission in patients with acute myocardial infarction (mean (SD) 14.2 (6) ng/ml) and in patients with unstable angina (10.1 (2.5) ng/ml) in comparison with controls (5.1 (2.7) ng/ml, p < 0.01 and < 0.05 respectively). There was no differences between the two groups of patients, however. Similar results were observed at the start of a silent ischaemic episode (9.8 (1.9) ng/ml) and 10 minutes later (10.5 (2.9) ng/ml) compared with controls (p < 0.05). Tissue plasminogen activator inhibitor-1 concentrations were raised in patients with acute myocardial infarction (45.1 (15) ng/ml) compared with volunteers (20.6 (16) ng/ml, p < 0.01). In patients with silent ischaemia tissue plasminogen activator inhibitor-1 concentrations were slightly but not significantly increased. Concentrations of cross-linked fibrin degradation products

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

  15. Clinical Practice Guidelines for Unstable Angina Treatment. Guía de práctica clínica para el tratamiento de la angina inestable.

    Directory of Open Access Journals (Sweden)

    Claudio Manuel González Rodríguez

    2009-03-01

    Full Text Available 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.Guía de práctica clínica para el tratamiento de la angina inestable. Definida como el dolor opresivo o malestar generalmente torácico atribuible a isquemia miocárdica transitoria. La guía enfoca aspectos principales como clasificación, diagnóstico, tratamiento dirigido a sus estrategias principales y estratificación de riesgos. Concluye con su guía de evaluación, enfocada en los aspectos más importantes a cumplir.

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

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    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.

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

    Institute of Scientific and Technical Information of China (English)

    Shi-Lian Chen; Sheng-Bing Huang

    2016-01-01

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

  18. Effects of Nicorandil on the Clinical and Laboratory Outcomes of Unstable Angina Patients after Coronary Angioplasty

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    Homa Falsoleiman

    2016-09-01

    Full Text Available Introduction: Ischemic preconditioning mediated by potassium channels is a physiological protective mechanism, . It is hypothesized that Nicorandil, which is a potassium channel activator, could protect the heart via preconditioning. Materials and Methods:This clinical trial was conducted on 162 patients undergoing percutaneous coronary intervention (PCI in Quem hospital, from Jan2013 to Jan 2014,patients  divided into two groups. The first group received standard treatment plus Nicorandil (10 mg, twice daily for three days before and after angioplasty. The second group received standard treatment after PCI. Results: Cardiac enzyme levels were significantly lower in the Nicorandil group at 6 and 12 hours after angioplasty,(p value=0.001 while no significant differences were observed in the symptoms and four-month prognosis of the study groups(p value=0.8. Conclusion:It is recommended that a randomized clinical trial be conducted for the close evaluation of the effects of Nicorandil on unstable angina patients.

  19. Optimizing Prescription of Chinese Herbal Medicine for Unstable Angina Based on Partially Observable Markov Decision Process

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    Yan Feng

    2013-01-01

    Full Text Available 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.

  20. 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.

  1. Screening and identification of microRNA involved in unstable angina using gene-chip analysis

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    Li, Si; Sun, Ya-Nan; Zhou, Yun-Tao; Zhang, Chun-Lai; Lu, Feng; Liu, Jia; Shang, Xiao-Ming

    2016-01-01

    Increasing evidence has suggested that microRNA (miRNA) may play a role in the pathogenesis of cardiovascular disease, which has led to a greater understanding of the complex pathophysiological processes underlying unstable angina (UA). The present study aimed to investigate changes in the miRNA expression profiles of patients with UA using gene-chip analysis, in order to further elucidate the pathogenesis of UA. Total RNA was extracted and purified from plasma samples collected from patients with UA and healthy controls. The samples underwent microarray analysis using an Exiqon miRCURY LNA™ microRNA Array. Differentially expressed miRNAs were identified by volcano plot filtering, and were validated using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). In addition, functional annotation of the differentially expressed miRNAs involved gene ontology analyses. Among the 212 miRNAs differentially expressed between the two groups, 82 were upregulated and 130 were downregulated. Notably, the results of the RT-qPCR were consistent with the gene-chip results. The miRNAs identified in the present study may be potential novel biomarkers for the prevention and early diagnosis of UA. Furthermore, the results of the present study suggested that UA occurs as a result of complex and dynamic processes regulated by numerous factors, including multiple miRNAs.

  2. CLINICAL EFFECTIVENESS AND SAFETY OF IVABRADINE USE IN PATIENTS WITH UNSTABLE ANGINA AND DIABETES MELLITUS TYPE 2

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    A. I. Kondratiev

    2011-01-01

    Full Text Available Aim – to estimate the clinical and pharmacological effects of ivabradine in complex treatment of patients with acute coronary syndrome anddiabetes mellitus type 2 (DM 2.Materials and methods. The study included 36 patients with acute coronary insufficiency (unstable angina and acute left ventricular failure(Killip class I–III during concomitant type 2 diabetes.Results. Prescribing ivabradine in treatment of unstable angina pectoris complicated by type 2 diabetes led to decrease in clinical symptoms,heart rate and reduce in number of myocardial ischemia episodes. Patients treated with ivabradine, showed a significant tendency to increase left ventricular ejection fraction (12.3 %. Mo adverse reactions were recorded, including hypotensive complications.Conclusion. Ivabradine therapy was characterized by high ischemic and antianginal efficacy, good tolerability, did not lead to the developmentof tolerance and was not accompanied by the appearance of withdrawal syndrome.

  3. CLINICAL EFFECTIVENESS AND SAFETY OF IVABRADINE USE IN PATIENTS WITH UNSTABLE ANGINA AND DIABETES MELLITUS TYPE 2

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    A. I. Kondratiev

    2014-07-01

    Full Text Available Aim – to estimate the clinical and pharmacological effects of ivabradine in complex treatment of patients with acute coronary syndrome anddiabetes mellitus type 2 (DM 2.Materials and methods. The study included 36 patients with acute coronary insufficiency (unstable angina and acute left ventricular failure(Killip class I–III during concomitant type 2 diabetes.Results. Prescribing ivabradine in treatment of unstable angina pectoris complicated by type 2 diabetes led to decrease in clinical symptoms,heart rate and reduce in number of myocardial ischemia episodes. Patients treated with ivabradine, showed a significant tendency to increase left ventricular ejection fraction (12.3 %. Mo adverse reactions were recorded, including hypotensive complications.Conclusion. Ivabradine therapy was characterized by high ischemic and antianginal efficacy, good tolerability, did not lead to the developmentof tolerance and was not accompanied by the appearance of withdrawal syndrome.

  4. Anomalous Origin of a Stenosed Left Circumflex Coronary Artery in a Patient Presenting with Unstable Angina: A Case Report

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    Vakili Hossein; Khaheshi Isa; Memaryan Mehdi; Naderian Mohammadreza

    2016-01-01

    73 year-old man presented to our emergency department with complaint of retrosternal chest pain since 2 day and admitted with diagnosis of unstable angina. He underwent diagnostic coronary angiography in which left circumflex artery (LCX) was not visualized during injection of the left coronary artery; indeed, it was originated, with common origin with RCA, from right coronary sinus of Valsalva. This case report is one of the uncommon cases with aberrant coronary arteries who presented with u...

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

    NARCIS (Netherlands)

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

    1996-01-01

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

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

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    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.

  7. 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.

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

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    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.

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

    Institute of Scientific and Technical Information of China (English)

    董红晶

    2014-01-01

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

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

    Science.gov (United States)

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

    2014-11-01

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

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

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    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.

  12. Troca de gases prejudicada em pacientes com angina instável Deterioro del intercambio gaseoso en pacientes con angina inestable Impaired gas exchange in patients with unstable angina

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    Dayane Horta Rocha

    2009-09-01

    evaluados, lo que refuerza la importancia de aplicar medidas de prevención para la obtención de un mejor pronóstico en la asistencia a los pacientes con angina.The identification of nursing diagnosis Impaired Gas Exchange in the assistance to the patients with angina is visualized routinely, however, it is necessary a deepening of this thematic. With the goal of analyzing the occurrence nursing diagnosis Impaired Gas Exchange in bearers of Unstable Angina we perform a cross-sectional study, with a descriptive and exploratory character, with patient put into in a specialized hospital. The data were obtained through interview, physical exam and consultation to records. The diagnosis Impaired Gas Exchange was absent in our sample, however, the variables breathing depth, systolic arterial pressure, sleepiness and sodium seric were pledged, what indicates aggravation risk. We visualize some relation among obtained results and characteristics of patients' lifestyle evaluated, what reinforces the importance of preventive measures for the obtainment of a better prognosis in the assistance to the patients with angina.

  13. Correlation between Serum High Sensitivity CRP Level and Inhospital Cardiac Events in the Patients with Unstable Angina

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    H. Kazerani

    2007-10-01

    Full Text Available Introduction & Objective: Several studies have been performed to evaluate correlation of serum high sensitivity CRP (hs-CRP level with the prognosis of the patients with diagnosis of unstable angina, and by now different results were reported. The aim of this study was to assess correlation between serum hs-CRP level and inhospital prognosis and cardiac events in the patients with unstable angina. Materials & Methods: This descriptive analytic study was performed from Sep 2004 till Feb 2006 in Shahid Beheshti hospital. Kermanshah, Iran. Sera were collected from 250 patients for hs-CRP measurement. Exclusion criteria were: acute ST elevation MI, non ST elevation MI, patients with history of recent infection, patients with recent trauma and patients with serum high sensitive CRP level more than 10 mg/lit. Patients were divided into two groups, first group whose serum hs-CRP level was less than 3 mg/lit and second group whose serum hs-CRP level was between 3 and 10 mg/lit. They were followed for recurrent chest pain, arrhythmias, pulmonary edema, acute myocardial infarction and in hospital death. Results were analyzed using x² and t-test. Results: Mean age were 57±7.8 and 58±11.5 years in first group and second group respectively. There was statistically significant difference in some cardiac complications such as dyspnea, duration of hospitalization, recurrent chest pain, CCU admission (p<0.001 and in hospital myocardial infarction (p=0.03, between two groups. Some complications did not have significant difference such as pulmonary edema, cardiogenic shock, arrhythmia, S3, S4 and pulmonary rates .There was no mortality in both groups. Conclusion: According to the results, we can use serum hs-CRP level for risk stratification in the patients with diagnosis of unstable angina. Obviously the patients with high serum hs-CRP level need more attention whether early invasive management help these patients, may be the matter of later studies.

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

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    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.

  15. 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.

  16. 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.

  17. 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.

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

    Science.gov (United States)

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

    2002-04-01

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

  19. The evaluation of B-type Natriuretic Peptide and Troponin I in acute myocardial infarction and unstable angina

    Directory of Open Access Journals (Sweden)

    Nafija Serdarevic

    2014-09-01

    Full Text Available Introduction: The diagnostic utility of B-type natriuretic peptide (BNP has prompted interest in its use as an aid in the detection of early heart failure and assessment of diseases. The first objective of this study was measurement of BNP and troponin I (TnI blood levels in patients with acute myocardial infarction (AMI and unstable angina. The second objective of this study was to find a correlation between TnI and BNP in blood.Methods: The concentrations of BNP and TnI in 150 blood levels were determined using CMIA (chemiluminescent microparticle immunoassay Architect and 2000 (Abbott diagnostics. The retrospective study included 100 patients who were hospitalized at the Department of Internal Medicine of the University Clinical Center Sarajevo and 50 healthy control. The reference blood range of BNP is 0-100 pg/mL and TnI is 0.00-0.4 ng/mL.Results: In the patients with AMI the mean value of BNP is 764.48 ± 639.52 pg/mL and TnI is 2.50 ± 2.28ng/mL. The patients with unstable angina have BNP 287.18 ± 593.20 pg/mL and TnI 0.10 ± 0.23 ng/mL. Our studies have shown that the correlation between BNP and TnI was statistically significant for p< 0.05 using Student t test with correlation coefficient r = 0.36. Conclusions: BNP and TnI levels can help to identify the patients with a high risk for cardiovascular diseases.

  20. Coronary angioplasty for unstable angina: immediate and late results in 200 consecutive patients with identification of risk factors for unfavorable early and late outcome

    NARCIS (Netherlands)

    P.J. de Feyter (Pim); H. Suryapranata (Harry); P.W.J.C. Serruys (Patrick); K.J. Beatt (Kevin); M.J.B.M. van den Brand (Marcel); J.J. Tijssen; A.J. Azar (Aida); P.G. Hugenholtz (Paul); R.T. van Domburg (Ron)

    1988-01-01

    textabstractTwo hundred patients (mean age 56 years, range 36 to 74) with unstable angina (chest pain at rest, associated with ST-T changes) underwent coronary angioplasty. In 65 patients with multivessel disease, only the "culprit" lesion was dilated. The initial success rate was 89.5% (179 of 200

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

    Institute of Scientific and Technical Information of China (English)

    田学峰

    2013-01-01

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

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

    NARCIS (Netherlands)

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

    2010-01-01

    Background Myeloperoxidase (MPO) is a leucocyte enzyme that catalyses the formation of a number of reactive oxidant species. Objective The purpose of this study is to evaluate the relationship between angiographic coronary plaque morphology in patients with unstable angina pectoris (UAP) or stable a

  3. Side effects of using nitrates to treat heart failure and the acute coronary syndromes, unstable angina and acute myocardial infarction.

    Science.gov (United States)

    Thadani, Udho; Ripley, Toni L

    2007-07-01

    Nitrates are potent venous dilators and anti-ischemic agents. They are widely used for the relief of chest pain and pulmonary congestion in patients with acute coronary syndromes and heart failure. Nitrates, however, do not reduce mortality in patients with acute coronary syndromes. Combination of nitrates and hydralazine when given in addition to beta-blockers and angiotensin-converting enzyme (ACE) inhibitors reduce mortality and heart failure hospitalizations in patients with heart failure due to left ventricular systolic dysfunction who are of African-American origin. Side effects during nitrate therapy are common but are less well described in the literature compared with the reported side effects in patients with stable angina pectoris. The reported incidence of side effects varies highly among different studies and among various disease states. Headache is the most commonly reported side effect with an incidence of 12% in acute heart failure, 41-73% in chronic heart failure, 3-19% in unstable angina and 2-26% in acute myocardial infarction. The reported incidence of hypotension also differs: 5-10% in acute heart failure, 20% in chronic heart failure, 9% in unstable angina and < 1-48% in acute myocardial infarction, with the incidence being much higher with concomitant nitrate therapy plus angiotensin-converting enzyme inhibitors. Reported incidence of dizziness is as low as 1% in patients with acute myocardial infarction to as high as 29% in patients with heart failure. Severe headaches and/or symptomatic hypotension may necessitate discontinuation of nitrate therapy. Severe life threatening hypotension or even death may occur when nitrates are used in patients with acute inferior myocardial infarction associated with right ventricular dysfunction or infarction, or with concomitant use of phosphodiesterase-5 inhibitors or N-acetylcysteine. Despite the disturbing observational reports in the literature that continuous and prolonged use of nitrates may lead to

  4. Comparision of high sensitivity C-reactive protein and matrix metalloproteinase 9 in patients with unstable angina between with and without significant coronary artery plaques

    Institute of Scientific and Technical Information of China (English)

    WANG Li-xin; L(U) Shu-zheng; ZHANG Wei-jun; SONG Xian-tao; CHEN Hui; ZHANG Li-jie

    2011-01-01

    Background Inflammation within vulnerable coronary plaques may cause unstable angina by promoting rupture and erosion. C-reactive protein (CRP) is the most reliable and accessible test method for clinical use for identifying coronary artery disease event. Matrix metalloproteinase 9 (MMP-9) is highly over-expressed in the vulnerable regions of a plaque.Our aim was to evaluate the plasma levels of MMP-9 and hsCRP in subjects with both unstable angina and coronary plaques, as well as in those with unstable angina without coronary plaques.Methods Patients with newly diagnosed unstable angina pectoris from clinical presentation and ECG, who were undergoing coronary angiography from April 2007 to April 2009, were included in this study. A total of 170 subjects were enrolled in the study. Before angiography, the baseline clinical data (mainly including conventional risk factors) was collected.These patients were divided into two groups, a non-plaque group (G1) which included 55 patients with no significant stenosis or less than 20% stenosis in at least one of the major coronary artery branches, and a plaque group (G2) which included 115 patients with at least one of the major coronary artery branches unstable angina pectoris with at least 50% stenosis of one major coronary artery. The patients presenting with calcified nodules of a major coronary artery were excluded from this study.We examined the serum levels of MMP-9 for all cases by multi-effect enzyme-linked immunosorbent assay.Results There was a significant difference in the serum levels of MMP-9 between the two groups (P<0.001). The percentage of patients with hypertension, diabetes and current smokers were significantly different between the two groups (P=0.034, P=0.031, and P=0.044 respectively). The univariate Logistic regression analyses of risk factors showed that smoking was the main risk factor for angina in the non-plaque group with the OR being 1.95 (95% Cl 1.02-3.75).Hypertension, diabetes mellitus

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

    Science.gov (United States)

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

    2016-02-01

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

  6. 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.

  7. 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

    2012-01-01

    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.

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

    Science.gov (United States)

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

    2002-10-15

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

  9. 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

  10. Association between ACE Gene I/D Polymorphism and Unstable Angina in Uzbek Patients with Family History of Coronary Heart Disease

    Directory of Open Access Journals (Sweden)

    Feruza M. Bekmetova*, PhD

    2012-12-01

    Full Text Available Objective: To study the distribution of I/D polymorphic marker of the ACE gene in Uzbek patients with unstable angina, depending on the presence of family history of CHD compared with healthy individuals. Materials and methods: There were examined 125 Uzbek patients with unstable angina (class IIB by E. Braunwald et al., 1989. In patients with unstable angina 63 patients (the 1st group had and 62 patients (the 2nd group had no a family history of CHD. Control group included 45 healthy Uzbek subjects without CHD and family history of CHD. The genomic DNA was isolated from the peripheral blood lymphocytes following standard protocol using the DiatomTM DNA Prep 200 kit (produced by LLC "Laboratory IsoGene". I/D polymorphism of the ACE gene was detected according to Cambian F. et al. (1992. Results: In a comparative analysis of both groups, patients showed similarity in the baseline clinical, hemodynamic and biochemical parameters; however, the 1st group had significant higher IMC thickness of the carotid arteries and hsCRP levels. Simultaneously, patients with a family history of CHD, compared with the healthy group of individuals, were noted to have a significantly higher prevalence of the D/D genotype [OR: 3.46 (95% CI: 1.18-8.11; P=0.035] and "damaging" D-allele [OR: 2.47 (95% CI: 1.40-4.34; P=0.002]. Conclusion: The presence of a family history of the coronary heart disease among Uzbek patients with unstable angina was associated with the higher frequency of the "damaging” D-allele of the ACE I/D gene polymorphism, accompanied by an increase in the thickness of the intima-media complex of the carotid arteries and level of high-sensitivity C-reactive protein.

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

    Institute of Scientific and Technical Information of China (English)

    Ke-Tong Liu; Xin Wang; Di Zhao

    2016-01-01

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

  12. 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.

  13. 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.

  14. Treatment Realize of 45 Cases of Unstable Angina%45例不稳定性心绞痛治疗体会

    Institute of Scientific and Technical Information of China (English)

    韩威

    2014-01-01

    目的:探讨不稳定性心绞痛患者的药物治疗。方法选取临床2013年6月~2014年6月收治的45例不稳定性心绞痛患者药物治疗方法资料进行分析。结果45例患者经治疗,无心绞痛发作26例,心绞痛发作次数或胸痛持续时间减少17例,无效2例,总有效率95.55%。结论立即开始抗心肌缺血治疗,急性期应卧床休息,在治疗发生效应时,可适当放宽病人的活动。%Objects Medication of the patients with unstable angina is to be investigated.Methods The medication data of 45 cases of patients with unstable angina who were treated in this hospital from June of 2013 to June of 2014 were selected for analysis.Results After treatment, among 45 cases of patients, there are 26 cases without angina attacks, 17cases in which the frequency of angina or the duration of chest pain reduced and 2 ineffective cases, with total effective rate of 95.55%.Conclusions The treatment of anti-myocardial ischemia should be adopted immediately. During the acute period, the patients should rest in bed. When the treatment starts its effect, activity area can be relaxed for the patients.

  15. Angina Pectoris (Stable Angina)

    Science.gov (United States)

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

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

    Institute of Scientific and Technical Information of China (English)

    ZHANGWen-gao; MENG-Xian-zhongtffu

    2003-01-01

    Objective:To observe the clinical effect and protection of vascular endotelium of Zhixin-kang 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 ca-ses)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 ca-ses) and control group treated with Yixintong(17 cases).The changes of clinical symptoms and laborato-ry 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 con-tent 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 lipo-protein-cholesterol(LDL-C),lipoprotein(a)[Lp(a)],ET, oxidized low density lipoprotein,MDA,arte-riosclerotic 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 effectively resist myocardial ische

  17. 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

  18. 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

    AIMS: Our aim was to investigate whether there is social inequality in access to invasive examination and treatment, and whether access explains social inequality in case fatality in a nationwide sample of patients admitted for the first time with unstable angina or non-ST-elevation myocardial...... infarction (NSTEMI) in Denmark. METHODS AND RESULTS: All patients admitted for the first time with NSTEMI (n=16,625) or unstable angina (n=8,800) from 2001 to 2009 in Denmark were included. We measured time from admission to coronary angiography (CAG), percutaneous coronary intervention (PCI) or coronary...... artery bypass graft (CABG). The outcomes were 30-day and one-year case fatality. We found social inequality in access to CAG and one-year case fatality for both NSTEMI and unstable angina patients, but the time waited for CAG did not explain the social inequality in case fatality. CONCLUSIONS: Despite...

  19. Different edge effects of paclitaxel-and sirolimus-eluting stents on proximal and distal edges in patients with unstable angina:serial intravascular ultrasound analysis

    Institute of Scientific and Technical Information of China (English)

    CHEN Shao-liang; YE Fei; ZHANG Jun-jie; LIU Zhi-zhong; SHAN Shou-jie; SUN Xue-wen; ZHANG Ai-ping; CHEN Jing-guo; XU Ya-wei; YANG Song; CHEN Feng; LUO Weng-ping

    2009-01-01

    Background It is unclear whether edge segments have different responses to paclitaxel eluting stent (PES) and sirolimus eluting stent (SES) implantation in patients with unstable angina. This study aimed to compare the different vascular edge responses in patients with unstable angina and single de novo coronary lesion treated with SES and PES. Methods Two hundred and fifty-five patients with unstable angina and single de novo lesion were randomly assigned to PES and SES groups. Serial volumetric intravascular ultrasound (IVUS) images were taken immediately after stenting and at an eight-month follow-up. Five-mm edge segments proximal and distal to the stents were analyzed. Results Baseline characteristics were comparable between the two groups. At proximal-edge segment, the vessel area decreased and the plaque area increased significantly in the PES group as compared with the SES group. A significant net loss of lumen area was found in the PES group (from (11.10±3.12) mm2 at baseline to (9.92+3.59) mm2 at the follow-up, P <0.001). At the distal-edge segment, the net loss of lumen area in the PES group (from (7.71±2.81) mm2 at baseline to (6.66±2.29) mm2 at the follow-up, P <0.001) was attributed to a significant increase of plaque area. Proximal-edge stenosis was commonly seen in the PES group (20.0%) as compared with the SES group (5.0%, P=0.001). This correlated with the higher incidence of target lesion revascularization in the PES group (P=-0.03). Subsegmentally, the smallest A lumen area was located at 2 mm proximally in both groups, at 0 mm distally in the PES group, and at 1 mm distally in the SES group. Conclusions The two groups demonstrated negative remodeling of edge segments. PES was less effective than SES in inhibiting the growth of plaque within the first 1-mm length proximal to the stent.

  20. Simvastation Treatment of Unstable Angina pector Clinical Analysis%辛伐他汀治疗不稳定性心绞痛的临床分析

    Institute of Scientific and Technical Information of China (English)

    陈哲

    2012-01-01

      目的:探讨辛伐他汀治疗不稳定性心绞痛的临床效果.方法:将我院自2010年1月~2012年1月收治的不稳定型心绞痛患者50例随机分为治疗组和对照组各25例,对照组仅给予常规药物治疗,治疗组在常规药物治疗的基础上给予辛伐他汀治疗,比较2组患者的临床疗效.结果:治疗组的总有效率为100%,对照组的总有效率为76%,治疗组的总有效率显著高于对照组,2组对比发现,差异具有统计学意义(P0.05).结论:辛伐他汀治疗不稳定性心绞痛,能显著控制炎症反应,减少新病灶及全堵塞的形成,改善血糖和血脂,延长运动导致的心绞痛发作时间,疗效确切、安全可靠,值得临床推广应用.%  Objective:Discussion simvastation Unstable angina pector treatment of the clinical effect. Methods: Will our hospital from January 2010 to January 2012 were Unstable angina pector 50 patients were randomly divided into the treatment group and control group every 25 cases and control only give regular drug therapy, the treatment group on the basis of routine therapy to give simvastation treatment, compared with two groups of patients with clinical curative effect. Results: The total effective rate of the treatment group were 100%and the total effective rate is 76%and the total effective rate of the treatment group was significantly higher than the control group, the two groups s found that a statistically significant difference (P 0.05). Conclusions: Simvastation treatment of Unstable angina pector can significantly control inflammation, reduce new lesions and the formation of the jam, improve blood sugar and blood fat, extend the movement of heart attacks in time, definite effect, safe and reliable, and clinical application.

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

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

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

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

    Science.gov (United States)

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

    2000-07-15

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

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

    Science.gov (United States)

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

    2002-08-01

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

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

    Science.gov (United States)

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

    2006-08-01

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

  5. Comparison of signs and symptoms of myocardial infarction and unstable angina in male and female hospitalizedpatients in coronary care units of Kerman Medical University hospital, 2004-2005

    Directory of Open Access Journals (Sweden)

    S. Sabzevari

    2007-01-01

    Full Text Available Abstract Background and purpose: Coronary Artery Disease (CAD is one of the most common causes of mortality and disability in the world. The results of some studies show that there are differences in signs and symptoms of CAD between male and female.Materials and Methods: This research was done to compare males and females for these signs and symptoms in 600 hospitalized patients in coronary care units of Kerman Medical University from December 2004 to July 2005. For data collection a questionnaire was used which was designed in five sections: demographic characteristics, disease variables, pictures for determining the points of chest pain, Visual Analog Scale for determining the intensity of pain and measures taken by patients after the beginning the signs and symptoms. This questionnaire was completed by two nurses in different shifts by interviewing the patients. For data analysis T test, χ2, Fisher exact and Man-Whitney U were used.Results: The results showed that the women were older than men (p<0.001. Most women had unstable angina and men had myocardial infarction (P<0.05. There were no significant differences between the chest pain in both genders but neck pain, back pain, fatigue, decrease of appetite, flushing, dizziness, tiredness, visual disturbances, suffocation feeling, palpitation and restlessness were experienced in women more than men (p<0.05. Also dyspenea during the heart attack was seen in most women (44.7% vs 29.4% but there was no significant difference between two genders for intensity of pain.Conclusion: This study showed that atypical signs and symptoms of unstable angina and myocardial infarction were seen in female more than male. Furthermore this may be followed by some problems in diagnosis and then delay in referring the patients to medical centers. On the other hand, health care workers may not pay enough attention to these atypical signs and symptoms, in women with normal ECG so they might not receive nessaceery

  6. Understanding factors that influence the use of risk scoring instruments in the management of patients with unstable angina or non-ST-elevation myocardial infarction in the Netherlands: a qualitative study of health care practitioners’ perceptions.

    NARCIS (Netherlands)

    Engel, J.; Heeren, M.J.; Wulp, I. van der; Bruijne, M.C. de; Wagner, C.

    2014-01-01

    Background Cardiac risk scores estimate a patient’s risk of future cardiac events or death. They are developed to inform treatment decisions of patients diagnosed with unstable angina or non-ST-elevation myocardial infarction. Despite recommending their use in guidelines and evidenc

  7. 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

    OBJECTIVE: To investigate trends in time to invasive examination and treatment for patient with first time diagnosis of non-ST elevation myocardial infarction (NSTEMI) and unstable angina during the period from 2001 to 2009 in Denmark. DESIGN: From 1 January 2001 to 31 December 2009 all first time...

  8. 不稳定型心绞痛院前急救临床观察%Clinical observation of unstable angina pre-hospital emergency intervention

    Institute of Scientific and Technical Information of China (English)

    郭华林

    2008-01-01

    目的 总结不稳定型心绞痛院前急救治疗的经验.方法 对院前胸痛患者,采集病史,体格检查,描记ECG并对其做出低中高危的评估,应用硝酸甘油、阿司匹林、使用β-受体阻滞剂、钙拮抗剂、转换酶抑制剂及肝素治疗,基础生命支持与监护.结果 留观期间:心绞痛症状缓解,有效98例(81.7%),加重21例(17.5%),收住院,其中因心绞痛发生顽固性心肌缺血4例,发展为严重心绞痛心律失常心房颤动6例,心源性休克4例,急性心力衰竭5例,非ST段抬高心肌梗死2例.院前猝死1例(0.8%).结论 不稳定型心绞痛患者院前急救措施的开展具有积极作用,早期识别、干预控制冠心病的危险因素,使心肌缺血症状改善,可减轻劳力性心绞痛的发作及改善患者的生活质量.%Objective To sum up unstable angina pre-hospital treatment interventions,clinical observation and assessment guide for emergency treatment.MethodsFor chest pain patients,collecting history,doing physical examination,checking ECG and making risk assessment,then,treating them with nitroglycerin,aspirin,beta-blocker,calcium antagonists,converting enzyme inhibitors,heparin therapy,and basic life support and monitor.Results During detention,there are 98 cases(81.7%)effective with angina symptoms subsided and discharged,21 cases (17.5%)aggravating and hospitalization,in which there are four cases get myocardial ischemia because of refractory angina,six cases of serious arrhythmia AF,four cases of cardiogenic shock,five cases of acute heart failure,and two cases of non.ST-segment elevation myocardial infarction.Also,there is one case(0.8%)of sudden death before prehospital treatment.Conclusion Pre-hospital treatment of unstable angina played a positive role in early identification,intervention and control of the risks of coronary artery disease,it also helps improving the symptoms of myocardial ischemia,reducing angina attack,and improving the life quality of the

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

    Science.gov (United States)

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

    2015-09-15

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

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

    Institute of Scientific and Technical Information of China (English)

    刘磊磊

    2013-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    梁启权; 曾胜宏

    2009-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    易慧芳

    2014-01-01

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

  13. PCI for Unstable Angina in Elderly Patients%PCI 治疗高龄不稳定性心绞痛的疗效

    Institute of Scientific and Technical Information of China (English)

    涂晓文; 苏涛; 黄国明; 王洪如; 乔怀宇

    2015-01-01

    目的:探讨经皮冠状动脉介入(PCI)治疗高龄不稳定性心绞痛的临床疗效。方法将118例不稳定性心绞痛患者按是否行 PCI 治疗分为2组:PCI 组(65例)和 ODT 组(53例)。PCI 组患者采用 PCI 治疗,术后采用阿司匹林肠溶片、硫酸氢氯吡格雷治疗。ODT 组患者采用阿司匹林肠溶片、硫酸氢氯吡格雷治疗,同时采用单纯优化药物治疗。观察2组患者治疗6个月后血清肾素活性(PRA)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)、去甲肾上腺素(NE)、肾上腺素(E)、肌酐(Cr)及左心室舒张内径(LVDD)、左心室射血分数(LVEF)差值,胸痛缓解率、生存率、再次住院率和主要不良心血管事件(非致死性心肌梗死、脑卒中)。结果PCI 组患者治疗6个月后血清 PRA、Ang Ⅱ、ALD、NE、E 及 LVEF 差值、再次住院率均明显低于 ODT 组,LVDD 差值、胸痛症状缓解率均明显高于 ODT 组(均P <0.05)。结论PCI 较 ODT 能够显著降低高龄不稳定性心绞痛患者心脏相关神经内分泌因子的水平,PCI 的治疗疗效明显优于单纯优化药物治疗。%ABSTRACT:Objective To investigate the clinical efficacy of percutaneous coronary intervention (PCI)for unstable angina in elderly patients.Methods A total of 118 elderly patients with unsta-ble angina were divided into two groups.Patients in PCI group(n=65)were given PCI and post-operative treatment with enteric-coated aspirin tablets and clopidogrel bisulfate.Patients in ODT group(n=53)were treated with enteric-coated aspirin tablets,clopidogrel bisulfate and optimal drug therapy(ODT).Serum renin activity,angiotensin Ⅱ (AngⅡ),aldosterone(ALD),norepi-nephrine(NE),epinephrine(E),creatinine(Cr),left ventricular diastolic inner diameter(LVDD) difference,left ventricular ejection fraction(LVEF)difference,chest pain remission rate,survival rate,readmission rate,and incidence of adverse

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

    Institute of Scientific and Technical Information of China (English)

    姚冲; 姚金; 杨水新; 张书伟

    2013-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    马丽红; 阮英茆; 焦增绵; 李晓惠

    2004-01-01

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

  16. Correlation between turbidimetric and nephelometric methods of measuring C-reactive protein in patients with unstable angina or non-ST elevation acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Correia Luis C. L.

    2003-01-01

    Full Text Available OBJECTIVE: To evaluate the performance of the turbidimetric method of C-reactive protein (CRP as a measure of low-grade inflammation in patients admitted with non-ST elevation acute coronary syndromes (ACS. METHODS: Serum samples obtained at hospital arrival from 68 patients (66±11 years, 40 men, admitted with unstable angina or non-ST elevation acute myocardial infarction were used to measure CRP by the methods of nephelometry and turbidimetry. RESULTS: The medians of C-reactive protein by the turbidimetric and nephelometric methods were 0.5 mg/dL and 0.47 mg/dL, respectively. A strong linear association existed between the 2 methods, according to the regression coefficient (b=0.75; 95% C.I.=0.70-0.80 and correlation coefficient (r=0.96; P<0.001. The mean difference between the nephelometric and turbidimetric CRP was 0.02 ± 0.91 mg/dL, and 100% agreement between the methods in the detection of high CRP was observed. CONCLUSION: In patients with non-ST elevation ACS, CRP values obtained by turbidimetry show a strong linear association with the method of nephelometry and perfect agreement in the detection of high CRP.

  17. 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.

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

    Institute of Scientific and Technical Information of China (English)

    朱国安

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    赵有翼; 田东霞

    2012-01-01

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

  20. 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.

  1. Treatment of Unstable angina with emergent coronary stenting installing%急诊冠状动脉内支架置入治疗不稳定性心绞痛

    Institute of Scientific and Technical Information of China (English)

    冯毅; 王振兴; 徐标; 张丽容; 李殿富; 刘乃丰

    2001-01-01

    Objective To investigate the effect of the treatment on unstable angina with emergency coronary stent installing. Methods Having treated 53 patients suffering from unstable angina in recent 3 years. We treated the patients with angiography to illuminate the features of lesions and proceeded with PTCA+stenting when the angina was not completely controlled. Results We implanted 56 stents in 53 lesions. 34 patients had no symptom of angina after the procedure, and 9 patients had untypical chest pain which disappeared in 1-2 days. There were no death patients and cases which needed emergent CABG. After follow-up in 3 months to 3 years, there are 6 patients who had restenosis confirmed by coronary angiography. Through another PTCA process 5 patients symptom disappeared. 1 patient needed CABG when he still had angina after PTCA. No death in follow-up period. Conclusion This is an effective and safe method to treat unstable angina according to short or long period results.%目的 探讨在不稳定性心绞痛病人症状未缓解状态下行急诊冠状动脉内支架置入的疗效及安全性。方法 对53例不稳定性心绞痛病人在心绞痛反复发作时即行冠状动脉造影,明确病变后行冠状动脉支架置入术。结果 53处病变置入56个支架,术中无严重并发症,34例心绞痛消失;9例有不典型胸痛,症状在1~2天内消失,无急诊冠状动脉搭桥及死亡。随访3个月~3年,6例冠脉造影证实再狭窄,5例行再次PTCA术后症状消失,1例行PTCA后仍有症状行冠状动脉旁路移植术(CABG),无死亡病例。结论 冠状动脉内支架置入治疗急性冠状动脉综合征近期及远期效果较好,治疗成功率及安全性较高。

  2. 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; Chung, Vincent C.H.; 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...

  3. 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

  4. 曲美他嗪治疗不稳定型心绞痛56例临床观察%Effect of trimetazidine on unstable angina

    Institute of Scientific and Technical Information of China (English)

    欧家满; 谭海涛; 鲁桓

    2009-01-01

    Objective To explore the effect of trimetazidine in patients with unstable angina(UA).Methods One hundred and sixteen UA cases were randomly divided into control group (n=60)and trimetazidine group(n=56). All patients were treated by routine therapy such as isosorbide dinitrate,anticoagulant, β-ntblock receptor agent,calcium antagonists,blood lipid-lowering,reducing hypertension and antiplatelet. trimetazidine 20 mg after each of the three meals was taken in trimetazidine group,the total period of treatment was 4 weeks.Results Terimezidiue was effective in 56 cases and LVEF increased.No severe side effects were found during the treatment related to the trimezidine. Conclusion For patients with UA, trimetazidine is effective and improves the heart function.The drug is safe and well torelated by patients.%目的 探讨曲美他嗪对不稳定型心绞痛的临床疗效.方法 将116例不稳定型心绞痛病患者完全随机分为治疗组56例和对照组60例,2组均予硝酸异山梨酯、抗凝、β受体阻滞剂或钙拮抗剂、调脂、降血压和抗血小板等药物常规治疗;治疗组56例在常规治疗的基础上,加用曲美他嗪,4周后评价临床疗效,对比2组心脏超声检查结果.结果 治疗组治疗不稳定型心绞痛临床有效率为78.6%,对照组为60.0%,2组比较有统计学意义(P<0.05),治疗组左心室射血分数增加,未发现明显药物不良反应.结论 常规治疗的基础上加用曲美他嗪对不稳定型心绞痛临床治疗有效率提高,心功能改善,而且安全易耐受.

  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. 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

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

    Institute of Scientific and Technical Information of China (English)

    周小明; 刘如秀; 李敏; 阚杰

    2011-01-01

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

  8. 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

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

    Institute of Scientific and Technical Information of China (English)

    庄严

    2014-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    范宗鹏; 吴玉姣

    2013-01-01

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

  11. Neurostan Treatment of Unstable Angina and Depression Disorders Clinical Observation%路优泰治疗不稳定型心绞痛伴抑郁障碍患者临床观察

    Institute of Scientific and Technical Information of China (English)

    金星; 张明

    2011-01-01

    目的:观察抗抑郁药路优泰(圣·约翰草提取物)对冠心病-不稳定型心绞痛(UA)合并抑郁症状患者治疗的疗效.方法:将62例不稳定型心绞痛合并抑郁症状的患者随机分为观察组和对照组.观察组在常规药物治疗基础上给予路优泰300mg,日3次口服;对照组给予单纯常规药物治疗.于治疗后4周观察两组间心前区疼痛和心电图的变化情况,并采用SDS、HAMD抑郁量表进行动态评估.结果:观察组4周内抑郁情绪及心前区疼痛症状明显改善,与对照组比较有显著性差异(P<0.05).结论:路优泰能有效的减轻冠心病患者的抑郁情绪,改善不稳定型心绞痛患者心前区疼痛症状,这种治疗更有利于冠心病的控制.%Objective:To observe antidepressants Neurostan ( St. ? John Wort extract )on coronary-heart disease-unstable angina (UA)patients with depressive symptoms combined effect. Method:62 patients with unstable angina pain combined depression were randomly divided into two groups. Study group on the basis of conventional drug treatment given Neurostan 300mg, tid, po; control group received routine treatment alone. 4 weeks after the treatment were observed between chest pain and ECG changes, and using SDS, HAMD depression scale for dynamic assessment. Results:Group 4 weeks, depression and chest pain symptoms improved, compared with the control group there was significant difference ( P<0.05) .Conclusion :Neurostan can effectively relieve depression in patients with coronary heart disease, Improvement in patients with unstable angina chest pain symptoms, this treatment is more conducive to coronary heart disease control.

  12. 护理干预在不稳定型心绞痛中的应用研究%Analysis of Nursing Intervention Application in Treatment of Unstable Angina

    Institute of Scientific and Technical Information of China (English)

    尹贞顺

    2015-01-01

    目的:探究不稳型性心绞痛患者采用护理措施的效果。方法选取2013年4月~2014年8月收治的35例不稳定型心绞痛患者进行护理,随机分组,实验组19例患者采用综合护理,对照组16例患者选择常规护理,对比患者的护理效果。结果实验组患者护理有效率为94.74%,对照组患者护理有效率为75.0%,差异具有统计学意义(P<0.05)。结论不稳定型心绞痛患者在治疗中采用综合护理,可提高治疗效果,减轻病痛,保持良好心态,效果显著。%ObjectiveTo explore nursing intervention effect in treatment of unstable angina.Methods Choose 35 patients with unstable angina that were treated in hospital from April 2014 to August 2014 and separated them into two groups at random,19 patients in study group were given comprehensive nursing,while 16 patients in control group were given conventional nursing and then compared nursing effects between two groups.ResultsPatients’ nursing efficacy in study group was 94.74%,while patients’ nursing efficacy in control group was 75.0%,there was a great differential of nursing effects between two groups and such a differential had statistic value(P< 0.05).Conclusion Comprehensive nursing is of efficacy in treatment of unstable angina,it is conducive to increasing treatment efficacy,relieving patients’ pain and assisting patients to be in a mood.

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

    Institute of Scientific and Technical Information of China (English)

    奚悦文; 范维琥

    2001-01-01

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

  14. Cervical Angina

    Science.gov (United States)

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

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    邓应忠; 曹晨; 郑兴萍

    2011-01-01

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

  16. Unstable angina early after aortic valve replacement surgery in a female patient with normal coronary arteries preoperatively – a case report

    Directory of Open Access Journals (Sweden)

    Schwarz Christian

    2009-07-01

    Full Text Available Abstract Background Angina pectoris early after aortic valve replacement surgery in patients with previously normal coronary arteries may be life threatening and has to be assessed immediately. Case report 12 weeks after aortic valve replacement surgery, a 60-year-old female patient was referred for evaluation of recent onset of severe chest pain on mild exertion and at rest. Coronary angiography showed severe stenosis nvolving the left coronary ostium and the left main stem. The patient was urgently referred for bypass surgery and had an uneventful postoperative recovery. Conclusion A high degree of suspicion is needed for early recognition and aggressive management of this rare but serious complication.

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

    Institute of Scientific and Technical Information of China (English)

    裘健

    2011-01-01

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

  18. 稳心颗粒联合瑞舒伐他汀治疗不稳定型心绞痛的疗效观察%Clinical observation of Wenxin Granule combined with rosuvastatin in treatment of unstable angina

    Institute of Scientific and Technical Information of China (English)

    库德热提·艾比布拉

    2015-01-01

    Objective To investigate the clinical effect of Wenxin Granule combined with rosuvastatin in treatment of unstable angina. Methods Patients (280 cases) with unstable angina in Chest Hospital of Xinjiang Uygur Autonomous Region from January 2012 to February 2014 were randomly divided into control and treatment groups, and each group had 140 cases. The patients in the control group were po administered with Rosuvastatin Calcium Tablets on the basis of conventional treatment, 10 mg/time, once daily. The patients in the treatment group were po administered with Wenxin Granule on the basis of the control group, 9 g/time, three times daily. Two groups were treated for 24 weeks. After treatment, the efficacy was evaluated, and the changes of blood rheology indexes such as red blood cells deposited, whole blood viscosity, fibrinogen and C-reactive protein (CRP) in two groups were compared. At the same time, unstable angina frequency and duration in the two groups were compared. Results After treatment, the efficacies in the control and treatment groups were 82.14% and 92.86%, respectively, and there was difference between two groups (P < 0.05). After treatment, red blood cells deposited, whole blood viscosity, fibrinogen, and CRP in two groups were significantly reduced, and the difference was statistically significant in the same group (P<0.05). And these indicators in treatment group improved better than those in the control group, with significant differences between two groups (P<0.05). Unstable angina frequency and duration in two groups were significantly lower, and the difference was statistically significant in the same group (P < 0.05). And these indicators in treatment group improved better than those in the control group, with significant differences between two groups (P<0.05). Conclusion Wenxin Granule combined with rosuvastatin has good clinical efficacy in treatment of unstable angina, and can significantly reduce blood rheology indexes, also can

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

    Institute of Scientific and Technical Information of China (English)

    王亚新

    2014-01-01

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

  20. Effect of Nicorandil on unstable angina patients with persistent weak positive for troponin-I%尼可地尔在持续性肌钙蛋白I弱阳性心绞痛患者中的作用

    Institute of Scientific and Technical Information of China (English)

    朱元州; 胡量子; 卢思稼; 杜雄兵; 常超; 田莉; 冯义柏

    2014-01-01

    目的:探讨尼可地尔在持续性肌钙蛋白 I (TnI)弱阳性不稳定型心绞痛患者中的作用。方法:选择伴有持续性肌钙蛋白 I (TnI)弱阳性的不稳定性心绞痛患者111例,随机分为对照组(55例,接受常规治疗)和干预组(56例,在常规治疗基础上加用尼可地尔片(5mg,3次/d);观察,比较两组患者治疗1周内胸痛缓解情况,3个月内因胸痛加重的再住院情况,1年内心源性死亡情况。结果:与对照组比较,干预组1周内两组症状缓解率显著上升(63.6%比91.1%,χ2=11.97,P=0.0005);3个月内胸痛加重再发住院显著减少(56.4%比19.6%,χ2=15.91,P=0.0001);但1年内两组心源性死亡率无显著差异(5.5%比8.9%,χ2=0.50,P=0.4792)。结论:尼可地尔可明显改善持续性TnI弱阳性不稳定型心绞痛患者的症状,而且减少患者因心绞痛加重的再住院率,但一年内死亡率两组没有明显差别。%Objective:To discuss effect of nicorandil on unstable angina patients With persistent Weakly positive for troponin I (TnI).Methods:A total of 111 unstable angina patients With persistent Weakly positive for TnI Were randomly divided into control group (received routine treatment,55 cases) and intervention group (received nic-orandil 5mg,3 times/d based on routine treatment,56 cases).The relief of chest pain in one Week,the recurrent hospitalization for chest pain aggravation in 3 months and the cardiac mortality rate in one year betWeen tWo groups Were observed in tWo groups. Results:Compared With control group,the relief of angina pectoris in one Week (63.6% vs. 91.1%,χ2=11.97,P=0.0005)significantly increased,re-hospitalization for chest pain aggravation in three months (56.4% vs.19.6%,χ2=15.91,P=0.0001)significantly decreased in intervention group;but cardiac mortality rate during one year betWeen tWo groups Was no significant difference (5.5% vs. 8.9%,χ2

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

    Institute of Scientific and Technical Information of China (English)

    柳青; 李慧芳; 刘丽凤; 董瓅瑾

    2012-01-01

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

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

    OpenAIRE

    Hutagalung, Adit Muhammad Prasetya

    2016-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    王建民

    2011-01-01

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

  4. cTnI与老年UAP患者心肌损伤及心脏事件关系的临床研究%The Clinical Research of the Relationship between Troponin I and Unstable Angina Elderly Patients' Myocardial Injury and Heart Events

    Institute of Scientific and Technical Information of China (English)

    赵思义; 李伟; 杨松

    2012-01-01

    Objective To investigate the relationship between serum cardiac troponin I ( cTnl) and unstable angina elderly patients' myocardial injury and heart events. Methods The serum cTnl of the 35 unstable angina elderly patients( UAP) ,22 stable angina patients( SAP) and 25 healthy men were measured, the occurrence of cardiac events of the 35 unstable angina elderly patients ( UAP) in hospital within one month was observed and the relationship between unstable angina elderly patients' (UAP) serum level and cardiac events was analyzed. Results The serum cTnl-positive rate of the UAP group was 37. 14% , which was higher than that of the SAP group(4.54% ) and the healthy group(0). The difference was significant(P <0.01 ) ,and among unstable angina elderly patients,Braunwald Ⅱ ' s serum cTnI positive rate was 41.66% and Braunwald Ⅲ' s serum cTnI positive rate was 55.55% ,which was significantly higher than that of Braunwald I group(14. 28% ) ,P <0. 01; Within one month after admission,35 serum cTnI positive unstable angina elderly patients' heart event rate(46. 15% ) is significantly higher than serum cTnl negative unstable angina elderly patients' heart event rate (4. 54% ) ( P < 0. 01). Conclusion The measurement of serum cTnl reflected the sensitivity and specific indicator of myocardial cell injury and predicted the degree of myocardial injury of unstable angina elderly patients(UAP) and recent prognosis.%目的 探讨血清肌钙蛋白1(cTnI)与老年不稳定型心绞(UAP)痛患者心肌损伤及心脏事件的关系.方法 对35例老年UAP患者、22例稳定性心绞痛(SAP)患者及26例健康对照组分别进行血清cTnI测定,对35例老年UAP患者住院后1个月内心脏事件发生情况进行观察,分析老年UAP患者血清cTnI高低与心脏事件的关系.结果 UAP组的血清cTnI阳性率37.14%高于SAP组的4.54%和健康组的0%,差异有统计学意义(P<0.01),且在UAP患者中BraunwaldⅡ、Ⅲ级组血清cTnI阳性率分别为41.66

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

    Institute of Scientific and Technical Information of China (English)

    王隽书; 林珊珊; 佘其美; 董亚苒

    2013-01-01

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

  6. 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.

  7. Practical implementation of the guidelines for unstable angina/non-ST-segment elevation myocardial infarction in the emergency department: a scientific statement from the American Heart Association Council on Clinical Cardiology (Subcommittee on Acute Cardiac Care), Council on Cardiovascular Nursing, and Quality of Care and Outcomes Research Interdisciplinary Working Group, in Collaboration With the Society of Chest Pain Centers.

    Science.gov (United States)

    Gibler, W Brian; Cannon, Christopher P; Blomkalns, Andra L; Char, Douglas M; Drew, Barbara J; Hollander, Judd E; Jaffe, Allan S; Jesse, Robert L; Newby, L Kristin; Ohman, E Magnus; Peterson, Eric D; Pollack, Charles V

    2005-05-24

    In the United States each year, >5.3 million patients present to emergency departments with chest discomfort and related symptoms. Ultimately, >1.4 million individuals are hospitalized for unstable angina and non-ST-segment elevation myocardial infarction. For emergency physicians and cardiologists alike, these patients represent an enormous challenge to accurately diagnose and appropriately treat. This update of the 2002 American College of Cardiology/American Heart Association Guidelines for the Management of Patients with Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction (UA/NSTEMI) provides an evidence-based approach to the diagnosis and treatment of these patients in the emergency department, in-hospital, and after hospital discharge. Despite publication of the guidelines several years ago, many patients with UA/NSTEMI still do not receive guidelines-indicated therapy.

  8. The research on the comprehensive nursing points of patients with unstable angina%不稳定性心绞痛病人综合护理要点探究

    Institute of Scientific and Technical Information of China (English)

    王晓燕; 金玲利

    2015-01-01

    Objective: To analyze the comprehensive nursing points and the effect of nursing for patients with unstable an-gina.Methods:92 patients with unstable angina pectoris treated in our hospital from January 2013 to January were randomly divided into two groups, experimental group and control group, 46 cases in each group. The control group received routine nurs-ing care, the experimental group received comprehensive nursing intervention, and the pain degree of pain was scored by using pain assessment method after nursing.Results: After treatment, the pain of two groups of patients have significantly improved, which patients in the experimental group the pain score for (0.9 + 0.13), significantly lower than the control group the pain score (2.3+0.21) points, the difference between the two groups has statistical significance (P<0.05).Conclusion:The comprehensive nursing intervention for patients with unstable angina can effectively reduce the pain of chest pain, and it has important clinical significance, it is worth to promote the use of.%目的:分析探讨对不稳定性心绞痛病人的综合护理要点以及护理效果。方法选取我院2013年1月至2014年1月收治的不稳定性心绞痛患者92例随机分成两组,实验组和对照组,每组46例。对照组患者给予常规护理方式进行护理,实验组给予综合护理干预,护理后使用疼痛评定法对患者的胸痛的疼痛程度进行评分。结果经护理后,两组患者的疼痛程度都有了明显的改善,其中实验组患者的疼痛程度评分为(0.9±0.13)分,显著低于对照组的疼痛评分(2.3±0.21)分,两组间比较差异具有统计学意义(P<0.05)。结论对不稳定心绞痛病人进行综合护理干预,可以有效减少患者的胸痛疼痛程度,具有重要的临床意义,值得推广使用。

  9. 256层ICT探测冠状动脉钙化在不稳定心绞痛与稳定心绞痛患者中的对比%Detection of Coronary Artery Calcification Score and Compare it in Patients Diagnosed Clinically as Stable and Unstable Angina by 256 ICT

    Institute of Scientific and Technical Information of China (English)

    朱大光

    2013-01-01

    目的:探讨256层ICT在探测冠状动脉钙化积分中的意义。方法:采用256层ICT对2组患者进行冠状动脉钙化积分扫描,钙化积分由工作站软件自动获得,132例患者分为2组,55例稳定心绞痛,77不例稳定心绞痛。结果:不稳定心绞痛患者的钙化积分要显著大于稳定心绞痛患者(p<0.05),不稳定心绞痛患者的血管钙化数目要明显多于稳定心绞痛组。结论:不稳定心绞痛患者的钙化更明显,因此预测冠状动脉情况冠状动脉钙化积分可以作为重要指标。%Objective:To detect Coronary calcification score and compare it in patients diagnosed clinically of having stable and unsta -ble angina and they being more prone for cardiovascular risk .Methods:Coronary artery calcification was scanned and its scores ( CACS) were measured through 256-slice ICT in 132 patients diagnosed of having stable and unstable angina .(55 stable and 77 unstable angi-na).the result were analyzed statistically by 2-grouped test.Also some associated risk factors were also taken into concideraton (HTN, total cholesterol ,Triglycerides etc ) .Results:The calcification scores in patients with unstable angina were comparatively more than those with patients having stable angina (p<0.05).Also it found that 3-vesssel calcification was more significant with unstable angina ,where as 1-vesssel calcification was more significant with stable angina cases .Conclusion:Coronary artery calcification scores is of great value in predicting cardiovascular enets .

  10. 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

    -diabéticos con AI, lo que indica que ese cuadro clínico puede equilibrar la actividad inflamatoria entre los dos grupos y aumentar la concentración de marcadores inflamatorios de fase aguda, independientemente del estado metabólico.BACKGROUND: Studies comparing inflammatory activity between diabetic and non-diabetic individuals with acute coronary syndrome are scarce, and none including only patients with unstable angina (UA has been published to date. OBJECTIVE: We compared serum C-reactive protein (CRP, and interleukin-6(IL-6 between diabetic and non-diabetic patients with unstable angina (UA to determine if difference in inflammatory activity is responsible for a worse prognosis in diabetic patients. We also evaluated the correlation between inflammatory markers and the metabolic profile in diabetic patients and the correlation between inflammatory response and in-hospital outcomes: death, acute myocardial infarction, congestive heart failure, and length of stay in hospital. METHODS: A prospective cohort study of 90 consecutive patients admitted to a chest pain unit with UA and divided into two groups, diabetic and non-diabetic. Serum CRP, IL-6, metabolic profile and leukocyte count were measured at hospital arrival. RESULTS: Forty-two patients (47% were diabetic (age 62±9 vs. 48 (53% non-diabetic (age 63±12. No differences between median C-reactive protein (1.78 vs. 2.23mg/l,p=0.74 and interleukin-6 (0 vs. 0pg/ml,p=0.31 were found between the two groups. There was a positive correlation between CRP and total cholesterol (rs = 0.21,p = 0.05, CRP and LDL-cholesterol (rs=0.22,p=0.04 and between CRP and leukocyte count (rs = 0.32, p = 0.02 in both groups. No associations were found between inflammatory markers and in-hospital outcomes. CONCLUSION: We found no difference in inflammatory activity between diabetic and non-diabetic patients with UA, suggesting that this clinical condition may result in balanced inflammatory activity between the two groups and increase acute

  11. 300例含不稳定性心绞痛的中医症候及聚类情况分析%TCM Syndrome and Clustering Analysis of 300 Cases of Unstable Angina

    Institute of Scientific and Technical Information of China (English)

    白桦; 王静; 刘法

    2014-01-01

    目的:探讨不稳定性心绞痛患者中医证候及证型分布特点,为临床的诊疗提供参考。方法:记录所有患者身高、体重等一般情况;同时采用设计的中医证候问卷,采集四诊资料,累计积分,进行聚类分析,结合临床归纳出主要证型。结果:300例纳入调查的患者中,出现频数最多的十项症状依次为:胸痛(96.0%),心胸闷重(81.7%),痰多气短(73.3%),舌苔白腻(67.0%),形体肥胖(60.0%),心悸(57.3%),自汗(55.3%),咳吐痰涎(46.7%),舌体胖大(45.3%),舌质紫暗(43.3%)。聚类分析结果:在300例患者中以痰浊痹阻(180例)、心血瘀阻(80例)、寒凝心脉(40例)为主。结论:不稳定性心绞痛是一个本虚标实之证,其中痰浊痹阻多见。%Objective:To explore characteristics of TCM syndrome and syndrome types in patients with unstable angina , and to provide basis for clinical treatment application .Methods:The general information of patients was recorded including height and weight ;a TCM questionnaire was adopted to collect information on four diagnostic and calculate the scores .A cluster analysis was conducted to summa-rize main syndrome types .Results:Among the 300 cases of patients involved in the symptom survey , the top 10 most frequents symp-toms were as follows: chest pain(96.0%), heavy heart stuffy(81.7%), expectoration and air hunger (73.3%), white and greasy tongue coating(67.0%),obesity(60.0%), heart palpitations(57.3%),perspiration(55.3%),cough spit saliva(46.7%),bulgy tongue(45.3%),tongue dark purple(43.3%).Cluster analysis showed that among the 300 cases of patients, 180 cases were the type of accumulation of phlegm debility patients ,80 cases were the type of heart blood stasis debility patients , 40 cases were type of heart stasis due to cold resistance .Conclusion:Unstable angina is a disease with root deficiency and tip

  12. Characteristics of urine metabonomics in patients with blood stasis syndrome of CHD unstable angina%冠心病不稳定心绞痛血瘀证患者尿液代谢组学特征的研究

    Institute of Scientific and Technical Information of China (English)

    王娟; 李中峰; 赵慧辉; 陈建新; 陈婵; 柴欣楼; 王伟

    2012-01-01

    目的 利用磁共振波谱代谢学方法研究冠心病不稳定心绞痛血瘀证患者和健康志愿者尿液代谢物的变化.方法 通过临床横断面调查研究,收集冠心病不稳定心绞痛血瘀证患者和健康志愿者的一般资料和尿液样品,采用磁共振(NMR)和模式识别技术对磁共振氢谱进行分析,对谱图去水峰后采用0.01化学位移分段积分和归一化处理.所得数据输入SIMCA-P软件,采用偏最小二乘-判别分析法(PLS-DA)对结果进行分析.结果 冠心病不稳定心绞痛血瘀证患者尿液中脯氨酸、丙氨酸、异亮氨酸、葡萄糖、缬氨酸、组氨酸、马尿酸等物质的含量升高;柠檬酸、肌酸酐、牛磺酸等物质的含量下降.结合PLS-DA对尿液样品的分析结果显示冠心病患者与健康人在代谢组学方面存在差异,且化合物分布在性别方面也有差异.结论 研究表明尿液样品中柠檬酸、脯氨酸、异亮氨酸、牛磺酸等代谢物的改变构成了冠心病不稳定性心绞痛血瘀证患者的代谢组学特征,从而为疾病的诊断和治疗以及中医证候研究提供了新思路和新方法.%Objective To study the changes of urine metabolites in patients with blood stasis syndrome of unstable angina of coronary heart disease ( CHD) and health volunteers by applying metabonomics method of nuclear magnetic resonance ( NMR). Methods The general materials and urine samples were collected from the patients (CHD group) and health volunteers (health group) through clinical cross-section survey, and then magnetic resonance spectrogram (MRS) was analyzed with techniques of NMR and pattern recognition technique. The spectrogram after removing water peak was treated with 0. 01ppm segmented integral and normalization. All data were imputed into SIMCA-P + software (v11. 5 , Umetrics, Sweden) and the results were analyzed by using partial least square-discriminant analysis (PLS-DA). Results The content of proline, alanine

  13. The effect of early treatment by cerivastatin on the serum level of C-reactive protein, interleukin-6, and interleukin-8 in the patients with unstable angina and non-Q-wave myocardial infarction.

    Science.gov (United States)

    Ostadal, Petr; Alan, David; Hajek, Petr; Horak, David; Vejvoda, Jiri; Trefanec, Jiri; Mates, Martin; Vojacek, Jan

    2003-04-01

    The aim of our study was to evaluate whether a single dose of cerivastatin at the time of admission of patients with unstable angina pectoris (UAP) or non-Q-wave myocardial infarction (NQMI) can influence the serum level of C-reactive protein (CRP), interleukin-6 (IL-6) and interleukin-8 (IL-8) 24 h later. Forty-four patients with rest chest pain and subendocardial ischemia on ECG were randomized to receive cerivastatin 0.3 mg at the time of admission (group C+) to standard therapy or to remain just on standard therapy (group C-). Blood samples for determination of troponin I (TI), CRP, IL-6 and IL-8 were collected at admission (entry level) and 24 h later (final level). Patients with non-physiological baseline levels of TI, as well as patients with progression to Q wave MI were excluded. All baseline, clinical and demographic data and final values of TI were comparable in the two groups. In patients treated with cerivastatin (group C+, n = 13) we observed decrease in the CRP level (-6.73 +/- 3.93 mg/L); on the other hand, in group C- (n = 17) the CRP level increased (+7.92 +/- 2.77 mg/L, p = 0.004). Similar differences were observed also in IL-6: in group C+ the level was significantly reduced as compared with the increase in group C- (-0.76 +/- 0.52 vs. 4.58 +/- 1.49 ng/L, p = 0.005). The level of IL-8 was not affected. Our results suggest that early treatment with cerivastatin can decrease the serum level of CRP and IL-6 in patients with UAP/NQMI; this might positively influence their prognosis. Nevertheless, further studies are needed to support this hypothesis.

  14. The Correlation Between Serum Level of Cystatin C and the Severity of Unstable Angina%血清胱抑素C水平与不稳定型心绞痛严重程度的相关性

    Institute of Scientific and Technical Information of China (English)

    刘涛; 刘宗涛

    2014-01-01

    目的探讨血清胱抑素C水平与不稳定型心绞痛(unstable angina,UA)严重程度的相关性.方法 选取本院不稳定型心绞痛患者147例作为观察组(按Braunwald分级分为三个亚组),选取同期非冠心病患者50例作为对照组,对四组的血清胱抑素C水平进行检测,并进行比较分析.结果 观察组各亚组血清胱抑素C水平及阳性率明显高于对照组;观察组亚组中血清胱抑素C水平及阳性率,BraunwaldⅢ级组患者明显高于BraunwaldⅡ级组和Ⅰ级组患者,BraunwaldⅡ级组患者亦明显高于Braunwald Ⅰ级组患者,差异均有统计学意义(P<0.05).结论 血清胱抑素C水平随着不稳定型心绞痛严重程度的加重而升高,检测血清胱抑素C对不稳定型心绞痛严重程度具有一定的预测价值,有助于判断病情,指导治疗.

  15. [Ludwig's angina].

    Science.gov (United States)

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

    2000-06-01

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

  16. 不稳定型心绞痛患者血清细胞因子与基质金属蛋白酶-2的关系%Relation between inflammatory cytokines and matrix metalloproteinase-2 in patients with unstable angina

    Institute of Scientific and Technical Information of China (English)

    何亚菲; 夏大胜; 魏民新; 刘清华

    2011-01-01

    Objective: To elucidate the relationship among pro-inflammatory cytokine (IL-1, IL-6, TNF-a), anti-inflammatory cytokine (IL-10) and MMP-2 and their effects on the stability of plaque in unstable angina. Methods-. The concentrations of IL-1, IL-6, TNF-a, IL-10, MMP-2 and TIMP-2 were analyzed using ELISA in 170 patients and 30 healthy control subjects. Patients were divided into two groups, stable angina (n = 35) and unstable angina (n = 135). Results; The serum levels of IL-1, IL-6, TNF-a, IL-10, MMP-2 and TIMP-2 were significantly higher in UAP group and SAP group compared with the healthy control group ( P < 0. 05 ) , and so were the ratio of MMP-2/TIMP-2 and( IL-1 + IL-6 + TNF-a)/IL-10 (P < 0. 05). The levels of above mentioned cyto-kines and ratios in patients with unstable angina were significantly higher than those with stable angina (P < 0. 05). Correlation analysis revealed the level of MMP-2 was positively related to the levels of IL-1, IL-6, IL-10 and TNF-a. In multiple linear regression analysis, significant positive correlations were found between MMP-2 and IL-10, (IL-1 +IL-6 + TNF-a) /IL-10 and fasting blood glucose separately in patients with unstable angina. Conclusion; The imbalance of proinflammation/anti-inflammation could lead to unstability of the plaque through the regulation of MMP-2, which could trigger unstable angina.%目的:探讨不稳定型心绞痛(UAP)患者血清致炎因子(IL-1、IL-6、TNF-α)、抗炎因子(IL-10)水平与基质金属蛋白酶-2(MMP-2)及其抑制剂(TIMP-2)的关系.方法:选择UAP患者135例(UAP组)、稳定型心绞痛(SAP)患者35例(SAP组)、对照组30例,应用ELISA法检测血清IL-1、IL-6、TNF-α、IL-10、MMP-2、TIMP-2水平.结果:UAP组患者血清IL-1、IL-6、TNF-α、IL-10、(IL-1 +IL-6+TNF-a)/IL-10、MMP-2、TIMP-2、MMP-2/TIMP-2水平高于对照组及SAP组(P均<0.05);Spearson相关分析显示,UAP患者血清MMP-2活性与IL-1、IL-6、IL-10、TNF-α水平正相关(P<0.05);多元

  17. Nifedipine and metoprolol in suspected unstable angina

    NARCIS (Netherlands)

    J.G.P. Tijssen (Jan); Interuniversitair Cardiologisch Instituut Nederland

    1987-01-01

    textabstractIt is now well accepted that the role of newly developed drugs used in the clinical management of patients needs to be evaluated in properly designed randomised clinical trials. In 1980, the Interuniversity Cardiology Institute of the Netherlands initiated the Holland Interuniversity Nif

  18. 不稳定性心绞痛冠状动脉造影病变与临床的相关性%Correlation of coronary angiographic morphology with clinical presentation in unstable angina

    Institute of Scientific and Technical Information of China (English)

    刘现亮; 崔志澄; 胡大一; 李田昌

    2001-01-01

    Objective To seek the relation between clinical presentation (Braunwald classification) or electrocardiogram(ECG) and angiographic morphology in patients with unstable angina (UA) and to determine which clinical markers could reliably predict unstable lesions and in-hospital cardiac events. Methods  120 hospitalized patients with a clinical diagnosis of UA and an abnormal angiograms(≥50% diameter stenosis) were selected .Patients were classified according to Braunwald criteria before cardiac catheterization was performed.Coronary arteriograms were reviewed.The lesion morphology (including simple lesion,complex lesion and intracoronary thrombus[ICT])and in-hospital events (including acute myocardial infarction,cardiac death and prompt revascularization) were observed.Logistic regression was used to evaluate the ability of clinical markers(Braunwald classification or an abnormal ST segment of ECG) to predict unstable lesions and cardiac events. Results There were more complex lesions in classⅢ group(61%,or 20 of 33) than in classⅠgroup(30%,or 13 of 43,P<0.05) and more ICT in classⅢ group(18%,or 6 of 33) than in classⅡgroup (2%,or 1 of 44,P<0.05).The rate of cardiac events was higher in class Ⅲ patients(58%,or 19 of 33) than in classⅠpatients(19%,or 8 of 43,P=0.01 ) or classⅡpatients (25%,or 11 of 44,P<0.01). Logistic regression analysis demonstrated that an abnormal ST segment of ECG or Braunwald class Ⅲ were highly predictive of the presence of complex lesion morphology (P<0.01,OR 4.9;P<0.01,OR 3.3,respectively).An abnormal ECG was the single predictive clinical indicator of triple vessel disease (P<0.01,OR 3.9) and cardiac events (P<0.001,OR 4.8). Conclusion Complex lesion can be best identified by the clinical feature of recent onset refractory angina at rest and abnormal ST segment of ECG in UA patients. Patients with abnormal ST segment represents a high risk of triple vessel disease and cardiac events.%目的分析

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

    Institute of Scientific and Technical Information of China (English)

    刘光先

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    刘莉

    2015-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    谢平

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    廖永红

    2014-01-01

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

  3. 低分子肝素钠联用丹红治疗不稳定型心绞痛的临床疗效分析%Clinical observation on low molecular weight heparin sodium combined with Danhong injection in the treatment of unstable angina

    Institute of Scientific and Technical Information of China (English)

    樊晓洋

    2014-01-01

    Objective To analyze the clinical efficacy of low molecular weight heparin combined with Danhong injection in the treatment of unstable angina. Methods The study group were treated with low molecular weight heparin combined with Danhong treated control group were given low molecular weight heparin. Results The total effective rate was significantly higher, the difference was statistically significant (P<0.05). Conclusion The effect of low molecular weight heparin combined with Danhong injection in the treatment of unstable angina was significantly better than with low molecular weight heparin with less adverse reaction, so it is worthy of clinical application.%目的:分析研究低分子肝素钠联用丹红治疗不稳定型心绞痛的临床疗效。方法观察组患者给予低分子肝素钠联用丹红治疗,对照组仅给予低分子肝素钠治疗。结果观察组总有效率显著高于对照组,两组比较差异有统计学意义(P<0.05)。结论低分子肝素钠联用丹红治疗不稳定型心绞痛的疗效明显优于单用低分子肝素钠,且不良反应少,值得临床应用。

  4. 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

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

    Institute of Scientific and Technical Information of China (English)

    王伟; 任国成; 高志广; 张晓莉; 宝凤梅

    2014-01-01

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

  6. 心肌肌钙蛋白T和C-反应蛋白与不稳定型心绞痛的关系%Relationship between unstable angina and cardiac troponin T and C-reactive protein

    Institute of Scientific and Technical Information of China (English)

    苗霞

    2013-01-01

    Objective To detect the levels of cardiac troponin T (cTnT),C-reactive protein (CRP),creatine kinase isoenzyme (CK-MB) and lactate dehydrogenase isoenzymes (LDH1) in unstable angina (UA) patients and investigate their clinical value for the diagnosis of UA.Methods The levels of cTnT,CK-MB and LDH1 were detected with biochemical analyzer; CRP was detected with specific protein analyzer.Results The elevated cases of cTnT,CK-MB,LDH1 and CRP were 23 cases(18.3%),26 cases(20.6%),41 cases(32.5%) and 73 cases(57.9%),respectively.Sixteen cases were attacked by acute myocardial infarction (AMI) and 3 cases suffered from sudden cardiac death in the five months.The incidence of AMI in the above elevated groups was significantly higher than that in the normal control group (P <0.01).The elevated levels of three index (cTnT,LDH1 and CRP),old myocardial infarction and numbers of chest pain were independent risk factors by multivariate Logistic regression analysis.Conclusions cTnT,LDH1 and CRP have important clinical significance for the early treatment and prognosis of patients with UA,which may be routine tests for these patients.%目的 检测血清心肌肌钙蛋白T (cTnT)、C-反应蛋白(CRP)、肌酸激酶同工酶(CK-MB)和乳酸脱氢酶同工酶(LDH1)在不稳定型心绞痛(UA)患者中的变化,探讨各指标对UA的诊断价值.方法 126例UA患者分别用生化分析仪检测cTnT、CK-MB和LDH1,特定蛋白分析仪检测CRP.结果 cTnT升高23例(18.3%),CK-MB升高26例(20.6%),LDH1升高41例(32.5%),CRP升高73例(57.9%).5个月内发生急性心肌梗死(AMI) 16例,心源性猝死3例.其中上述各指标升高组AMI发生率明显高于正常对照组(P<0.01).多因素Logistic回归分析cTnT、LDH1、CRP升高、陈旧性心肌梗死和胸痛次数是预测近期AMI和心源性猝死的独立危险因素.结论 cTnT、LDH1和CRP对UA患者的早期治疗和预后判断有重要临床意义,可作为UA患者的常规检测指标.

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

    Institute of Scientific and Technical Information of China (English)

    隋春兴; 刘文民; 周旭晨; 郑晓群

    2009-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    林培森

    2012-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    司清霞

    2012-01-01

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

  11. 阿托伐他汀对不稳定型心绞痛患者血浆C-反应蛋白和血脂的影响%Effects of atorvastatin on C-reactive protein and blood lipid levels in patients with unstable angina

    Institute of Scientific and Technical Information of China (English)

    王莉

    2014-01-01

    目的 分析阿托伐他汀对不稳定型心绞痛(UA)患者血浆C-反应蛋白和血脂的影响.方法 将200例UA患者随机分为治疗组和对照组,每组100例,两组均采用常规治疗,治疗组在此基础上给予阿托伐他汀20 mg/d,疗程12周,观察两组研究对象血脂以及炎症因子C-反应蛋白的差异,并比较两组治疗前后血脂和血浆C-反应蛋白的变化.结果 与对照组比较,治疗组可明显降低血脂及C-反应蛋白水平,差异有统计学意义(P<0.01).结论 UA患者早期应用阿托伐他汀治疗可以降低患者血浆CRP的浓度,降低胆固醇、甘油三酯和低密度脂蛋白,减轻炎症反应,稳定动脉粥样硬化斑块.%Objective To analyze the effect of atorvastatin on C-reactive protein and blood lipid levels in patients with unstable angina(UA).Methods Two hundred patients with unstable angina were randomly divided into treatment group and control group.The patients in the two groups were all given conventional treatment,and the patients in treatment group were given atorvastatin 20 mg/d,the course was 12 weeks.The levels of blood fat and C-reactive protein before and after treatment in the two groups were observed.Results Compared with control group,the levels of blood fat and C-reactive protein reduced significantly in treatment group (P < 0.01).Conclusions Early administration of atorvastatin can decrease the plasma concetration of hs-CRP,TC,TG and LDL-C significantly in patients with unstable angina,relieve the inflammatory reaction and stablize the atherosclerotic plaque.

  12. Sodium Tanshinone ⅡA Sulfonate Combined with Low Molecular Weight Heparin in Treating Unstable Angina: A Meta-analysis%丹参酮ⅡA磺酸钠联合低分子肝素治疗不稳定型心绞痛Meta分析

    Institute of Scientific and Technical Information of China (English)

    赵劲波; 李元红; 江洪

    2012-01-01

    目的 评价丹参酮ⅡA磺酸钠联合低分子肝素治疗不稳定型心绞痛的效果.方法 计算机检索中国学术期刊网络出版总库、CNKI( 1994-2011)、万方医学数据库(1999-2011)、维普中文科技期刊全文数据库(1989-2011年)中关于丹参酮ⅡA磺酸钠联合低分子肝素治疗不稳定型心绞痛的随机对照试验,对符合标准的随机对照试验进行Meta分析.结果 共命中7篇符合条件文献.Meta分析结果显示,治疗2周后试验组疗效优于对照组,总效应Z=6.12(P <0.00001),OR及其95%可信区间4.48(2.77,7.24),其中3项研究对心电图进行评价,治疗2周后心电图改善情况试验组亦显著优于对照组,总效应Z =3.80(P =0.0001),OR及其95%可信区间2.83(1.65,4.84).结论 不稳定型心绞痛患者在常规治疗基础上联合应用丹参酮ⅡA磺酸钠和低分子肝素可明显改善心绞痛症状,有效控制心绞痛发作.%Objective To evaluate the effectiveness of Sodium Tanshinone DA Sulfonate combined with Low Molecular Weight Heparin in treating unstable angina (UA). Methods We conducted Meta-analysis by the randomized controlled trails (RCT) for patients with Sodium Tanshinone DA Sulfonate combined with l>ow Molecular Weight Heparin in treating unstable angina ( UA) from CNKI database (1994—2012) , Wan Fang medicine database (1999—2012), VIP full-text data base (1989—2012) and Medline. Results There were 7 trials. After two weeks treatment Meta-analysis indicated that the rurative effect of combination therapy was better than that of regular group in treating angina pectoris. The total effect was Z =6. 12 (P <0.00001), and the total effect of therapy group was better than that of control group [OR =4.48, 95% CI (2.77, 7.24), P <0.00001 ]. Three items showed that the curative efficiency and significant efficiency in the improvement of electrocardiogram were dramatically better than that of control group, and the total effect was Z = 3.80 [OR = 2. 83

  13. IMA早期诊断结合介入治疗在UAP中的临床应用研究%Clinical application of IMA early diagnosis combined with interventional therapy in the treatment of unstable angina

    Institute of Scientific and Technical Information of China (English)

    宋代黎; 邱亦萍; 黄海峰; 李筱敏; 吴同果

    2013-01-01

    目的通过观察不稳定型心绞痛(UAP)患者在经皮冠状动脉介入治疗术(PCI)前后血清中的缺血性修饰白蛋白(IMA)、心肌肌钙蛋白(cTnI)及肌酸激酶同功酶(CK-MB)的浓度变化,探讨IMA在UAP早期诊断与治疗中的作用,为临床UAP的早期诊断与治疗提供客观依据。方法43例研究对象均选自诊断为UAP的住院且在住院期间再次出现胸痛发作患者,其中26例为行PCI治疗的冠心病患者(研究组),同时以17例仅行诊断性冠脉造影的患者为对照组,两组患者均于术前术后0.5、6、12 h采集血样测定IMA、cTnI及CK-MB的浓度,详细记录研究组患者术中的球囊扩张的压力、时间、次数,植入支架的部位和数目,术中、术后1d的心电图变化。结果研究组有24例患者的IMA在术后0.5 h较术前明显升高(P<0.05),术后6 h开始下降,术后12 h逐渐恢复至基线水平;而cTnI在术前、术后0.5、6 h的变化不明显,有17例患者于术后12 h升高,与其他时间段相比较差异有显著性(P<0.05),但其CK-MB于术前及术后各时间点的变化不明显(P>0.05),未见升高患者。而对照组患者术前、术后各时间点的IMA、cTnI及CK-MB的变化均不明显(P>0.05)。结论 PCI术会导致心肌发生缺血缺氧损伤,且IMA在PCI术后迅速升高,且比cTnl和CK-MB的出现要早;IMA的升高与术中球囊扩张的总压力、持续时间、扩张次数呈正相关。即IMA可作为早期及PCI术后诊断UAP的一个心肌标志物。%Objective By observing unstable angina pectoris (UAP) patients in the percutaneous coronary intervention therapy (PCI) of serum ischemia-modified albumin (IMA), cardiac troponin I (cTnI) and creatine kinase isoenzyme (concentration of CK-MB), and to explore the role of IMA in the UAP early diagnosis and treatment of, and provide an objective basis for the early diagnosis and treatment of

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

    Institute of Scientific and Technical Information of China (English)

    郝翠平

    2015-01-01

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

  15. Relationship Between Unstable Angina Pectoris CHD and MMP-1, MMP-2 and MMP-3%冠心病不稳定型心绞痛与MMP-1、MMP-2、MMP-3相关性研究

    Institute of Scientific and Technical Information of China (English)

    王莹威; 蒋宁; 高嵩山; 魏明慧

    2013-01-01

    目的:研究冠心病不稳定型心绞痛(UA)患者血清MMP-1、MMP-2、MMP-3的表达,并探讨其与冠状动脉狭窄程度和斑块不稳定性之间的关系.方法:分离出30例UA和30例CPS患者血清,采用酶联免疫吸附法(ELISA)检测其中的MMP-1、MMP-2、MMP-3表达水平,并进行相关性研究.结果:UA和CPS组患者血清中MMP-1、MMP-2、MMP-3有统计学意义(P<0.005).结论:冠心病不稳定型心绞痛患者血清中MMP-1、MMP-2、MMP-3表达水平增高,提示其可能是动脉粥样硬化不稳定斑块的发病机制之一.%Objective:To investigate patients with unstable angina(UA) serum expressions of MMP-1,MMP-2 and M MP-3,and explore the relationship between the coronary stenosis and plaque instability.Methods:The serum from 30 patients with UA and 30 patients with CPS was isolated in which MMP-1,MMP-2,MMP-3 expression levels were tested by enzyme-linked immunosorbent assay (ELISA),and related research was carried on.Results:UA and CPS groups' MMP-1,MMP-2,MMP-3 expressions had statistical significance(P < 0.005).Conclusion:The serum expression levels of MMP-1,MMP-2 and MMP -3 in coronary heart disease patients with unstable angina were increased,suggesting that it may be one of the unstable plaque pathogenesis of atherosclerosis.

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

    Institute of Scientific and Technical Information of China (English)

    苏泽飞; 晏廷亮

    2015-01-01

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

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

    DEFF Research Database (Denmark)

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

    2011-01-01

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

  18. Curative Effects of the Combination of Ginkgo Damo Injection and Yangxin Soup in the Treatment of Unstable Angina%银杏达莫注射液联合养心汤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)

    廖应平; 姚泉良; 付寒辉

    2011-01-01

    Objective To evaluate the efficacy of the combination of Ginkgo Damo Injection and Yangxin Soup in the treatment of Unstable Angina. Methods 46 patients with Unstable Angina are chosen and randomly divided into two groups, and the control group receive nitrate beta blockers and calcium antagonists low molecular heparin calcium treatment. Based on routine treatment, the treatment group is given 20 mLof Ginkgo's Injection in 5% of the glucose fluid and or physiological saline drip, 250 mLdaily, a total of 14 days, with oral Yangxin Soup 150 ml, 2 times daily. Results Compared with the control group,for the treatment group, the chest pain,chest tightness,shortness of breath, palpitations are effectively relieved (87% 65.2% P < 0.01), two groups have no obvious adverse reactions. Conclusion The combination of Ginkgo Damo injection and Yangxin soup treatment can obviously improve the symptoms of Unstable Angina of coronary heart disease, expand coronary artery blood vessels , improve myocardial ischemia, inhibit platelet aggregation and improve thromboembolism.%目的:观察银杏达莫注射液联合养心汤治疗不稳定型心绞痛的临床疗效.方法:选择不稳定型心绞痛患者46例,随机均分为2组,对照组常规给于硝酸盐制剂、β受体阻滞剂或钙拮抗剂、低分子肝素钙治疗.治疗组在常规治疗的基础上加用银杏达莫注射液20 mL于5%的葡萄糖液和或生理盐水250 mL中滴注,每日一次,共14天,并联合养心汤150 mL,日2次口服.结果:治疗组与对照组相比,可改善胸痛、胸闷、气促、心悸等症状,能有效缓解心绞痛的症状(87% 65.2%,P<0.01),心电图缺血性ST-T改善的有效率2组差异有统计学意义(69.7% 43.5%,P<0.05),两组均无明显不良反应.结论:银杏达莫注射液联合养心汤治疗可明显改善冠心病不稳定型心绞痛症状,具有扩张冠脉血管、改善心肌缺血、抑制血小板集聚、改善血栓栓塞性疾病的作用.

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

    Institute of Scientific and Technical Information of China (English)

    于薇; 孟存良; 容春莉; 曹东平; 吕军娥; 彭应心

    2011-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    周雷

    2014-01-01

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

  1. 复方丹参滴丸与单硝酸异山梨脂缓释片联用治疗不稳定性心绞痛56例效果观察%The Clinical Effect Observation on Compound Danshen Dropping Pill Combined With Single Nitrate Isosorbide Sustained-releaseTablets for the Treatment of 56 Cases of Unstable Angina

    Institute of Scientific and Technical Information of China (English)

    朱宏涛

    2015-01-01

    目的:观察复方丹参滴丸与单硝酸异山梨脂缓释片联用治疗不稳定性心绞痛的临床效果。方法选取2011年6月~2012年2月到本院治疗的120例不稳定性心绞痛的患者为研究对象,将120例患者随机分两组,一组56例为实验组;一组64例为对照组。实验组给予复方丹参滴丸与单硝酸异山梨脂缓释片联用,对照组单纯给予单硝酸异山梨脂缓释片治疗。治疗结束后,统计实验组及对照组患者的心电图好转情况。结果治疗结束后,实验组心电图改善率(64.3%)明显高于对照组43.8%,P<0.05,差异有统计学意义。结论复方丹参滴丸与单硝酸异山梨脂缓释片联用治疗不稳定性心绞痛的临床效果较单纯应用单硝酸异山梨脂缓释片好。%ObjectiveTo observe the clinical effect of compound danshen dropping pill combined with single nitrate isosorbide sustained-release tablets for the treatment of unstable angina.Methods From June 2011 to February 2012, 120 patients with unstable angina in our hospital were randomly divided into two groups, the experimental group (56 cases) and control group (64 cases). The compound danshen dropping pill combined with single nitrate isosorbide sustained-release tablets was given in experimental group, single nitrate isosorbide sustained-release tablets was given in control group. After the treatment, the electrocardiogram situations were analyzed between the two groups.Results After the treatment, in experimental group, the electrocardiogram improvement rate was (64.3%). It was significantly higher than the control group (43.8%), P<0.05, there was difference.Conclusions The clinical effect of compound danshen dropping pill combined with single nitrate isosorbide sustained-release tablets for the treatment of unstable angina was better than simple application of single nitrate isosorbide sustained-release tablets.

  2. [Panic disorder and angina pectoris].

    Science.gov (United States)

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

    2004-02-01

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

  3. Clinical analysis of 19 cases of unstable angina and gastrointestinal bleeding treated by triple antithrombotic therapy%三联抗栓治疗不稳定性心绞痛时合并消化道出血19例临床分析

    Institute of Scientific and Technical Information of China (English)

    左丽明

    2016-01-01

    Objective To explore the risk of aspirin,plavix,and low-molecular-weight heparin sodium in the treatment of unstable angina complicating by gastrointestinal bleeding,know more about unstable angina complicating by gastrointestinal bleeding,reduce the misdiagnosis and missed diagnosis,and guide the clinical medication.Methods We chose 19 patients diagnosed with unstable angina and gastrointestinal bleeding in our hospital from August 2014 to August 2015.All patients were given aspirin entetic-coated tablets 0.1 g/d,plavix tablets 75 mg/d,and low-molecular-weight hepatin sodium injection 5000 U per 12 h.Analyzed the clinical data of patients,observed the risk factors causing gastrointestinal bleeding,the situation of immediate diagnosis,treatment,and the prognosis.Results The age range of 19 patients in the study was from 62 to 75 years old,with the average of 68 years old,including 11 female (57.9%),and 8 male (42.1%);14 cases of low weight (73.7%),and 5 cases of over weight (26.3%);11 patients with the history of diabetes mellitus (57.9%),and 13 patients with the history of hypertension.17 patients (89.5%) had the symptoms of burning and blocking sensation in the abdomen,chest tightness,palpitation,dizziness,and sweating;2 patients (10.5%) received blood transfusion.18 patients (94.7%) were cured,1 patient (5.3%) died.Conclusions Gastrointestinal bleeding does not often occur in the process of triple antithrombotic therapy for unstable angina,but the state of the illness comes fast,which is easy to confused with angina pectoris.What to do is to stop using anti thrombotic drugs immediately,the treatment of rehydration,stopping bleeding,and protecting gastric mucosa.So gastric mucosa heals quickly and the prognosis is good.Anti thrombotic therapy should pay more attention to individualized treatment for the elderly,women,low weight,hypertension,diabetes and so on.%目的 探讨阿司匹林、波立维双重抗血小板及低分子肝素钠抗凝血

  4. 圣·约翰草提取物对老年不稳定型心绞痛患者伴发抑郁症的疗效%Effect of St. John's wort extracts on the treatment of depressive disorder in elderly patients with unstable angina

    Institute of Scientific and Technical Information of China (English)

    刘健; 孟召伟; 李立宇; 冯丽莎; 杨慧

    2010-01-01

    目的 探讨抗抑郁植物药圣·约翰草提取物辅助治疗伴发抑郁症的老年不稳定型心绞痛患者的临床疗效.方法 前瞻性研究天津医科大学第二医院2006年10月至2008年9月住院的老年不稳定型心绞痛并发抑郁症患者170例,年龄65-75岁.排除双相障碍和重性精神病患者、严重自杀倾向者,入选前3个月未应用抗精神药物.将入选170例患者随机分为4组:圣·约翰草提取物组(n:44)、黛力新组(n,=44)、心理治疗组(n,=42)和对照组(n=40),4组患者基线资料差异无统计学意义,均治疗12周.以汉密尔顿抑郁量表(HAMO)减分率评定疗效,以临床心绞痛发作及心电图改变判定临床疗效.统计学处理采用SPSS 11.5统计软件包分析,计量资料采用(χ±s)表示,治疗前、后两组间比较采用配对t检验,计数资料多组间比较采用χ~2检验,计量资料多组间比较采用F检验,P<0.05为差异具有统计学意义.结果 (1)治疗组HAMD减分率分别为79.5%,56.8%,57.1%,与对照组比较,差异具有统计学意义(χ~2=29.9,P<0.001),圣·约翰草组疗效优于黛力新组及心理组(P<0.05);(2)治疗组加拿大心血管学会(CCS)心绞痛分级比较,显效率分别为88.7%,65.9%,57.1%,与对照组比较,差异具有统计学意义(χ~2=15.4,P<0.001),圣·约翰草组优于黛力新组及心理组(P<0.05).(3)治疗组心绞痛发作次数、发作持续时间、发作时心电图缺血改善明显优于对照组,差异具有统计学意义(F分别为值6.05,4.58,5.12,P<0.01),圣·约翰草组优于黛力新组及心理组(P<0.05).结论 圣·约翰草提取物能显著改善老年不稳定型心绞痛患者伴发的抑郁症,且有利于临床心绞痛发作的控制.%Objective To explore the effect of St. John' s wort extracts (SWE) on depressive disorder in el-der patients with unstable angina. Method A total of 170 patients, who fulfil the criteria, were enrolled in this prospective study. Patients

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

    Institute of Scientific and Technical Information of China (English)

    朱洪斌

    2015-01-01

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

  6. 联合检测超敏C反应蛋白、肌钙蛋白I及和肽素对早期不稳定型心绞痛的临床意义研究%Clinical Significance of Combined Detection of hs-CRP,cTnI and Copeptin on Early Unstable Angina

    Institute of Scientific and Technical Information of China (English)

    梁建光; 方长庚; 李晚泉; 曾小茹

    2015-01-01

    目的:探讨联合检测超敏C反应蛋白( hs-CRP)、肌钙蛋白I( cTnI)及和肽素( copeptin)对早期不稳定型心绞痛( UAP)的临床意义。方法选取2012年5月—2014年3月广东医学院附属三水医院确诊的89例UAP患者作为UAP组,从胸痛发作到入院时间≤4 h,根据冠状动脉不同病变分为左主干病变( LMCA)组26例、单支病变( XV)组25例、双支病变( DV)组22例和三支病变( TV)组16例;另选取同期89例健康志愿者作为对照组。比较两组受检者及冠状动脉不同病变组患者血清hs-CRP、cTnI及copeptin水平。结果 UAP组hs-CRP、cTnI及copeptin分别为(7.76±3.93)mg/L、(19.54±3.65)μg/L、(25.78±6.21)pmol/L,分别高于对照组的(1.25±0.36)mg/L、(1.44±0.68)μg/L、(5.44±3.89)pmol/L(P﹤0.05)。LMCA组和TV组患者血清hs-CRP水平高于XV组(P﹤0.05);LMCA组和TV组患者血清cTnI和copeptin水平高于XV组、DV组(P﹤0.05)。结论 UAP患者血清cTnI、hs-CRP及copeptin水平明显升高,联合检测三者能提高早期UAP诊断准确性且能更好地判断冠状动脉病变严重程度。%Objective To investigate the clinical significance of combined detection of hs-CRP,cTnI and copeptin on early unstable angina. Methods A total of 89 early unstable angina patients were selected as UAP group in Xanshui Hospital Affiliated to Guangdong Medical College from May 2012 to March 2014,all of them admitted to hospital within 4 hours after onset of chest pain;a total of 89 healthy cases were selected as control group at the same time. Patients of UAP group was divided into 4 subgroups according to coronary artery lesions,including left main coronary artery lesions(A group,n=26),single vessel lesions(B group,n=25),double vessel lesions(C group,n=22),three vessel lesions(D group,n=16). Xerum levels of hs-CRP,cTnI and copeptin were detected and compared. Results Xerum hs -CRP,cTnI and copeptin

  7. Retraction of a paper containing plagiarized material: the prognostic value of serum troponin T in unstable angina. Gökhan Cin V, Gök H, Kaptanoğlu B. Int J Cardiol. 1996 Mar;53(3):237-44.

    Science.gov (United States)

    Coats, Andrew J S

    2010-12-01

    On the 6th December 2008, in my role as Editor-in-Chief of the International Journal of Cardiology, I received an email from Professor Harold Garner of UT Southwestern Medical Center, Dallas. Professor Garner told me that using a new search engine methodology (eTBLAST) he and colleagues had identified a paper in the International Journal of Cardiology published in 1996 which had remarkable text and data similarity to an earlier paper published in 1992 in the New England Journal of Medicine. They had detected this similarity after randomly selecting citations from Medline and submitting them to the tool to find other highly similar citations as part of their NIH/R01 funded research on the ethics of publication. We have been notified that all such cases are reported in a database, Déjà Vu (http://spore.swmed.edu/dejavu/). We investigated the text of the two papers and we agreed that there was such a similarity that the later paper must have plagiarized the earlier paper, and in doing so infringed the copyright. In accordance with our previously published standards on ethical publishing in the Journal we hereby retract the paper "The prognostic value of serum troponin T in unstable angina. Gökhan Cin V, Gök H, Kaptanoğlu B. Int J Cardiol. 1996 Mar;53(3):237-44.".

  8. Angina de Prinzmetal Angina de Prinzmetal Prinzmetal's angina

    OpenAIRE

    Eduardo Contreras Zuniga; Juan Esteban Gomez Mesa; Sandra Ximena Zuluaga Martinez; Vanesa Ocampo; Cristian Andres Urrea

    2009-01-01

    Essa síndrome é causada por um espasmo focal de uma artéria coronária epicárdica, levando a isquemia miocárdica grave. Embora freqüentemente acredite-se que o espasmo ocorra em artérias sem estenose, muitos pacientes com angina de Prinzmetal apresentam espasmo adjacente a placas ateromatosas. A causa exata do espasmo não está bem definida, mas pode estar relacionada à hipercontratilidade do músculo liso vascular devido a mitógenos vasoconstrictores, leucotrienos ou serotonina. Em alguns pacie...

  9. 缺血修饰清蛋白和心型脂肪酸结合蛋白检测在不稳定性心绞痛诊断及危险分层中的应用%Application of ischemia modified albumin and heart-type fatty acid-binding protein for the diagnosis and risk stratification of unstable angina

    Institute of Scientific and Technical Information of China (English)

    辛增莲; 杨丽; 郭宇璇; 彭辉; 徐菲莉

    2015-01-01

    Objective To determine the value of ischemia modified albumin,heart-type fatty acid-binding protein,B-type natri-uretic peptide and homocysteine in the risk stratification of patients with unstable angina pectoris;thus to provide an assessment for the condition of patients in clinic.Methods 135 patients with unstable angina were included in the disease group and subjected to risk stratification according to GRACE risk score software,70 cases of low-risk group,60 cases in the middle-risk group and 5 cases in the high-risk group.Another 145 healthy people were in the control group.The levels of ischemia modified albumin,heart-type fatty acid-binding protein,B-type natriuretic peptide and homocysteine were detected and compared.Results Between the control group and the disease group,significant difference of heart-type fatty acid-binding protein,B-type natriuretic peptide and homocys-teine was found (P 0.05).In the dis-ease group,the levels of ischemia modified albumin,heart-type fatty acid-binding protein and homocysteine in each risk stratification showed no significant difference(P >0.05).The level of B-type natriuretic peptide in high-risk group was higher than that in the low-risk group and in the middle-risk group and the difference was statistically significant (P 0.05 ).Conclusion The detection of heart-type fatty acid-binding protein,B-type natriuretic peptide and homocysteine possesses certain meaning in diagnosing unstable angi-na,and the level of B-type natriuretic peptide indicates the risk degree of the disease.%目的:探讨血清缺血修饰清蛋白(IMA)、心型脂肪酸结合蛋白(H-FABP)、B 型利钠肽(BNP)、同型半胱氨酸(Hcy)与不稳定性心绞痛(UA)危险分层的关联性,为临床提供评估患者病情的依据。方法选取135例不稳定性心绞痛(UA)患者作为病例组,根据全球急性冠状动脉事件注册(GRACE)危险评分软件,将病例组分为低危组70例、中危组60例及高危组5

  10. 丹参酮ⅡA磺酸钠注射液治疗不稳定型心绞痛疗效和安全性的Meta分析*%Meta-analysis on Effectiveness and Safety of TanshinoneⅡA Sulfonate Sodium Injection in Treatment of Unstable Angina Pectoris

    Institute of Scientific and Technical Information of China (English)

    马晓聪; 李建橡; 许明东; 邓学秋; 岳桂华; 郑景辉

    2015-01-01

    This paper was aimed to study the effectiveness and safety of TanshinoneⅡA Sulfonate Sodium Injection in the treatment of unstable angina pectoris (UAP). Keywords such as coronary atherosclerotic heart disease, coronary heart disease, unstable angina, chest impediment, cardialgia, TanshinoneⅡA Sulfonate Sodium Injection, tanshinone injection, tanshinoneⅡA sulfonate, unstable, angina, randomized controlled trial (RCT), and clinical trials were searched in CNKI, VIP, Wanfang and Pubmed from the construction of database until October 31st, 2014. The inclusion criteria were RCT with clinical data integrity, similar literature research methods, and good balance between groups. The Jadad score method was used to carry out quality assessment. Meta-analysis was conducted by RevMan5.2 software. Count data was processed by odds ratio (OR). Measurement data was processed with the weighted mean differences (WMD). The 95% confidence interval (CI) was also calculated. The heterogeneity test result of included literatures was P > 0.05. The fixed effects model was used in the meta-analysis. On the other hand, random effect model was used. For the analysis results of more than 10 papers, the funnel plot was used in the analysis of publication bias. The results showed that a total of 34 studies were included. The results of meta-analysis suggested that the total efficiency of conventional treatment plus TanshinoneⅡA Sulfonate Sodium Injection for UAP was [OR = 3.83, 95%CI (3.11, 4.71),P < 0.000 01]. The electrocardiogram improvement rate was [OR = 3.34, 95%CI (2.61,4.28),P < 0.000 01]; plasma viscosity improvement was [WMD = -0.20, 95%CI (-0.38, -0.03),P = 0.03]; high shear viscosity of whole blood improvement was [WMD = -0.67, 95%CI (-0.85, -0.50),P < 0.000 01]; C-reactive protein improvement was [WMD = -2.66, 95%CI (-3.31, -2.00),P < 0.000 01]. It was concluded that the conventional treatment plus TanshinoneⅡA Sulfonate Sodium Injection for UAP had certain clinical

  11. The optimal timing of early invasive therapy in patients with unstable angina and non-ST-elevation myocardial infarction:a Meta-analysis%非ST段抬高急性冠脉综合征不同介入时间窗的Meta分析

    Institute of Scientific and Technical Information of China (English)

    贾林·阿布扎力汗; 于子翔; 马依彤; 杨毅宁; 李晓梅; 谢翔; 刘芬; 陈铀

    2016-01-01

    ObjectiveThis meta-analysis aims to determine the optimal timing of invasive therapy in patients with unstable angina and non-ST-elevation myocardial infarction.Methods The following databases are searched,PubMed(1985 to October 2015),The Cochrane Library (January 1975 to October 2015),MEDLINE (January 1980 to September 2015),EMbase (January 1978 to September 2015),CBM (January 1994 to September 2015),CNKI (January 1990 to November 2015),and Wanfang (January 1993 to October 2015).The evaluation of the included studies and data extraction were done by two independent reviewers.Data analyses were performed by using the Cochrane Collaboration's RevMan 5.3 software.Results According to including criteria,seven trials were included finally,of which six were RCTs including 7568 patients,and one was observational study.Meta-analyses showed that the incidence of all-cause death,fatal or non-fatal myocardial infarction at 1 month or long-term follow-up and rehospitalisation related to angina between two groups(24 h group were not significant statistically(OR=0.99,P=0.96 andOR=0.87,P=0.27,respectively). There was no publication bias among the included studies in terms of all-cause mortality.The incidence of fatal or non-fatal myocardial infarction at 1 month was non-significant(OR=0.71,P=0.20);During the long-term follow-up,the 12~24 h group had a significantly lower incidence of fatal or non-fatal myocardial infarction compared to >24 h group.There was also a reduction in rehospitalization related to angina in the 12~24 h group(OR=0.76,P=0.01).Conclusion For patients with UA/NSTEMI,the potential timing of intervention would be 12~24 h.More studies will be needed to determine the optimal timing for patients with unstable angina or non-ST-elevation myocardial infarction.%目的:系统评价非ST段抬高急性冠脉综合征早期介入治疗的最适时间窗。方法计算机检索PubMed(1985.1~2015.10)、Cochrane图书馆(1975.1~2015.10)、MEDLINE(1980.1

  12. 丹红注射液联合西药常规治疗不稳定型心绞痛疗效和安全性系统评价%Efficacy and Safety of Danhong Injection Plus Conventional Western Medicine for Unstable Angina: A Systematic Review

    Institute of Scientific and Technical Information of China (English)

    崔然; 夏昆; 时萍; 聂小曼

    2012-01-01

    目的 系统评价丹红注射液联合西药常规治疗不稳定型心绞痛的有效性与安全性.方法 检索PubMed、Medline、中国期刊全文数据库、万方数据知识服务平台中丹红注射液联合西药常规治疗不稳定型心绞痛的临床随机对照试验文献,按照Cochrane协作网推荐的方法评价纳入研究文献的质量后,采用RevMan 4.2软件进行Meta分析.结果 经筛选纳入23篇文献,共2 675例,其中治疗组(丹红注射液联合西药常规治疗)1 382例,对照组(单纯西药治疗)1 293例.各研究基线情况具有可比性.Meta分析结果显示:丹红注射液加西药常规治疗在提高心电图疗效[RR=2.84,95% CI(2.28,3.55)]、心绞痛疗效[RR=4.13,95% CI(3.12,5.47)],升高高密度脂蛋白-胆固醇[high density lipoprotein-cholesterol,HDL-C)(WMD=0.29,95% CI(0.05,0.52)],降低低密度脂蛋白-胆固醇(low density lipoprotein-cholesterol,LDL-C)[WMD=-0.98,95% CI(-1.33,-0.63)]和高敏C反应蛋白(high sensitive C-reactive protein,hs-CRP)[WMD=-1.42,95% CI(-2.18,-0.65)]方面均优于西药常规治疗组.结论 丹红注射液联合西药常规治疗在改善不稳定型心绞痛患者的心电图疗效,升高HDL-C,降低LDL-C和hs-CRP水平方面优于对照组.受纳入文献质量的限制,本研究结论尚需更多高质量大样本的临床随机双盲对照研究加以验证.%Objective To systematically evaluate the efficacy and safety of Danhong Injection, a patent traditional Chinese Medicine (TCM) mainly composed of Salvia miltiorrhiza and safflower for activating blood stasis, combined with conventional western medicine in the treatment of unstable angina. Methods The literatures, which involve with randomized controlled trials (RCTs ) of Danhong Injection combined with conventional western medicine in the treatment of unstable angina, were retrieved in the databases such as PubMed, Medline, Chinese Journal Full-text Database, and Wanfang Data Knowledge Service Platform. The

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

    Institute of Scientific and Technical Information of China (English)

    卢旭升

    2016-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    陈波; 杨万勇; 周利龙; 郭乃芸; 程奎山; 曾庆贤

    2012-01-01

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

  15. Gene Polymorphism and Serum Lipid Levels Correlation of Unstable Angina Angiotensin Converting Enzyme%不稳定性心绞痛患者血管紧张素转换酶基因多态性与血脂水平的相关性研究

    Institute of Scientific and Technical Information of China (English)

    邵静; 贾景香; 陈璐

    2014-01-01

    Objective:Discussion the correlation of ACE gene polymorphism and serum lipid levels on the elderly unstable angina( UA), as the traditional Chinese medicine treatment of the disease to provide reference. Methods:Choose 60 cases of elderly patients with un-stable angina,with 30 cases of healthy people as a control. Through the restriction fragment length polymorphism by polymerase chain reaction( PCR-RFLP)to determine the insertions and deletions included 16 sub-polymorphism and serum lipid levels of ACE gene and compare the different genotypes. Results:The intron of ACE gene in UA group carrying DD genotype and D allele was higher than that of control group. The control group carrying II genotype and I allele was higher than that of old UA group(P<0. 05). The TG and LDL-C blood concentrations of Elderly UA group were higher than that of control group. The TG and LDL-C levels of disease group were sig-nificantly higher(P<0. 05),whereas HDL-C levels were significantly lower than that of control group(P<0. 05). Compared the ACE DD and ID genotype of disease groups with II genotype,the difference had statistical significance(P<0. 05). ACE gene polymorphism and TG,LDL-C had significantly positively correlated(P<0. 01)but negative correlation with HDL-C concentrations(P<0. 001). Con-clusion:ACE DD genotype and D allele have relation with abnormal lipid metabolism,but have nothing to do with I allele.%目的:探讨老年不稳定性心绞痛( UA)患者ACE基因多态性与血脂水平的相关性,为中医药治疗本病提供参考。方法:选取老年不稳定性心绞痛患者60例,同期选择老年健康人群30例作为对照,通过限制性片段长度多态性聚合酶链反应( PCR-RFLP)技术测定ACE基因内含子16的插入和缺失多态性,并比较不同基因型的血脂水平差异。结果:老年UA组ACE基因内含子16携带DD基因型和 D等位基因较对照组增高,对照组携带 II基因型及 I

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

    Institute of Scientific and Technical Information of China (English)

    胡亚力; 苏珍; 白洪雁; 苏晓燕; 刘怡

    2001-01-01

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

  17. D型人格不稳定心绞痛患者治疗前后抑郁情绪躯体疲劳状况及生活质量的变化%The healty status and quality of life of unstable angina patients with type D personality

    Institute of Scientific and Technical Information of China (English)

    欧薇; 孙月吉; 孙玉兰; 孙喜琢; 姜一农; 曲鹏

    2008-01-01

    目的 探讨D型人格不稳定心绞痛患者治疗前后抑郁情绪躯体疲劳状况及生活质量的变化.方法 依据D型人格量表(DS14)评分情况,将109名患者分为D型人格组(n=32)和非D型人格组(n=77).在治疗前和治疗后1个月,采用抑郁自评量表(SDS)、疲劳评定量表(FIA)和生活质量综合评定问卷(GQOL-74)进行评估.结果 1)D型人格在冠心病患者中约占29%.2)治疗前后D型人格组疲劳改善不明显;D型人格组较非D型人格组抑郁情绪改善的程度差,2组治疗前后SDS评分差值分别为(0.85±1.04)分,(-2.31±0.809)分,差异有显著性(P<0.05);生活质量方面D型人格组改善更差.3)治疗前后GQOL-74项分值差为因变量,进入回归方程的是D型人格和疲劳评定因子1得分差值.结论 影响冠心患者治疗结果和生活质量的因素主要是D型人格和FIA-1得分差值.%Objective To find out the relation of type D personality and unstable angina.Methods 109 patients with unstable angina(UA)were drawn out in the gome hospital in Dalian.All patients were divided into two groups according to DSl4 diagnostic criterion(Type D Personality Scale),one group had 32 patients with D type personality(type D group)and the other group had 77 patienm without D type personality(non-type D group).All of them were investigated with the General Health Questionnaire.the Zung' Self-Rating Depression scale(SDS),Fatigue Assessment Instrument(FIA)and General Quality of Life Inventory-74(GQOL-74)before receiving medication and after one month.SPSS11.0 software was used.Results 1)29%patients with UA were type D patients.After 1 month,when the patients have recovered from the stress.A significant difference were found in FIA-14,SDS(0.85±1.049,-2.31±0.809,t=2.311,P=0.027)and GQOL between the D type group and non-type D group.The GQOL-74 difference serve as a dependence value.and other psychologic factors as independent value.results enter the regression equation are D type

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

    Institute of Scientific and Technical Information of China (English)

    何文芳; 王喆; 蔡军; 池洪杰; 杨新春

    2015-01-01

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

  19. 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

  20. Unstable volatility

    DEFF Research Database (Denmark)

    Casas, Isabel; Gijbels, Irène

    2012-01-01

    The objective of this paper is to introduce the break-preserving local linear (BPLL) estimator for the estimation of unstable volatility functions for independent and asymptotically independent processes. Breaks in the structure of the conditional mean and/or the volatility functions are common i...

  1. The relevance between carotid atherosclerosis and serum pregnancy-associated protein A of unstable angina patients%不稳定型心绞痛患者血清妊娠相关蛋白A与颈动脉粥样硬化的相关性

    Institute of Scientific and Technical Information of China (English)

    刘克坚; 罗春生; 邱强; 刘诚; 唐斌

    2012-01-01

    目的 探讨颈动脉粥样硬化、血清妊娠相关性蛋白A与不稳定型心绞痛、稳定型心绞痛、非冠心病的相关性.方法 因胸痛入院的患者1 w内行冠脉造影,排除急性及亚急性心梗后,不稳定型心绞痛、稳定型心绞痛、非冠心病各40例被纳入研究中,进行冠状动脉Gensini评分;彩超检测颈动脉内中膜厚度、斑块形成情况,应用酶联免疫吸附法测定血清妊娠相关蛋白A水平,并进行统计学分析.结果 除吸烟史外,各组间其余基线资料匹配;不稳定型心绞痛、稳定型心绞痛的冠脉Gensini评分、颈动脉粥样硬化指标均较非冠心病高(P<0.001);不稳定型心绞痛组比稳定型心绞痛及非冠心病组血清妊娠相关蛋白A的浓度高(P<0.001),妊娠相关蛋白A在不稳定型心绞痛患者明显升高,其与颈动脉粥样硬化指标、冠脉Gensini积分正相关;Grouse积分预测心绞痛型冠心病,敏感度、特异度分别为0.79、0.92;颈动脉内中膜厚度平均值预测心绞痛型冠心病敏感度、特异度分别为0.97、0.85;妊娠相关蛋白A预测不稳定型心绞痛敏感度、特异度分别为0.825、0.937.结论 颈动脉粥样硬化指标与冠状动脉Gensini积分有较好的相关性,而妊娠相关蛋白A可作为预测不稳定型心绞痛的指标;二者联合检测可能是预测不稳定型心绞痛的重要临床依据.%Objective To investigate the relevance between carotid atherosclerosis, serum pregnancy-associated protein A ( PAPP-A) and the incidence of unstable angina (UAP) , stable angina pectoris(SAP) , Non-coronary heart disease ( NCHD) ,to further discuss joint significance of carotid atherosclerosis and PAPP-A concentration in the forecast of UAP. Methods Patients admitted to hospital because of chest pain,coronary angiography were completed within 1 w, which with acute and subacute myocardial infarction had been excluded, then, 40 case of UAP,40 cases of SAP,40 cases of

  2. Characteristics of Coronary Lesions in Patients Older than 80 Years with Unstable Angina and Efficacy & Safety of Percutaneous Coronary Intervention%80岁以上高龄心绞痛患者冠状动脉病变特点和经皮冠状动脉介入治疗的效果及安全性

    Institute of Scientific and Technical Information of China (English)

    刘同库; 万凤伟; 丁福祥; 顾明

    2012-01-01

    Objective To study the characteristics of coronary lesions in patients older than 80 years with unstable angina and to evaluate the efficacy and safety of percutaneous coronary intervention ( PCI ). Methods A total of 72 patients ( elderly group, over 80 years old ) and 187 patients ( middle - aged group, 40 to 60 years old ) with unstable angina admitted to the cardiovascular center of the affiliated hospital of Beihua university from October 2008 to October 2011 were recruited in this study. All patients received PCI. The risk factors, Syntax scores of coronary lesions, distribution of coronary lesions segments, number and length of stent, short - term effectiveness, and complications were compared between the two groups. Results The prevalence of high blood pressure, diabetes, hyperlidemia, and smoking showed significant differences between the elderly group and middle - aged group ( all P <0. 01 ). The coronary lesions of RCA and LCA took place in the 2nd - 3rd segments and the 5th, 11th, 12th - 13th segments respectively in the two groups. The differences in constituent ratio of coronary artery disease ( CAD ) counts, Syntax scores of coronary lesions, number and length of stent, hemorrhagic complications, incident rate of MACE were all significant ( all P <0. 05 ). The significant differences were also found in the blood stream of target vessel TIMI 3 level, acute or sub - acute thrombosis, the incident rate of broke and mortality. Conclusion The coronary lesions in elderly patients had such characteristics as more numbers, more complex and more severity. The short - term efficacy and safety of PCI in treating elderly patients who had angina and pectoris but without severe brain, lung, kidney, valvular lesions were the same as those in middle - aged patients.%目的 探讨80岁以上高龄冠心病心绞痛患者的冠状动脉病变特点和经皮冠状动脉介入(PCI)治疗的疗效和安全性.方法 选择2008年10月-2011年10月在北华大学附属

  3. Successfully treated unstable angina pectoris in a young Japanese female.

    Science.gov (United States)

    Umetani, K; Nakagawa, K; Oagawa, R; Iida, T; Kohno, I; Osada, M; Sawanobori, T; Ijiri, H; Komori, S; Tamura, K

    2001-05-01

    A 25-year-old Japanese female complaining chest oppression and palpitation was admitted to hospital under the presumptive diagnosis of ischemic heart disease (IHD), although no obvious underlying disease associated with IHD was detected. Coronary angiography showed stenosis at the proximal site of left anterior descending artery (LAD), with dilatation and tortuosity at the bifurcation of the first and the second septal branches. Intravascular ultrasound imaging of the LAD showed intimal thickness without calcification at the site of stenosis. The stenosis was successfully and smoothly dilated by percutaneous transluminal angioplasty. Even with precise evaluation, the cause of the coronary artery disease in this young female patient was not clarified. Further careful follow-up is needed.

  4. 降香舒心胶囊对气滞血瘀型不稳定型心绞痛患者血管内皮功能的影响%Effects of Jiangxiang Shuxin Capsules on Endothelial Function in Patients with Unstable Angina Pectoris of Qi Stagnation and Blood Stasis Type

    Institute of Scientific and Technical Information of China (English)

    常智玲; 何江; 李溥; 管慧; 周锦勇; 李世红; 廖沙; 阳淑芳

    2012-01-01

    目的:探讨降香舒心胶囊对气滞血瘀型不稳定型心绞痛的临床疗效及血管内皮功能的影响.方法:采用随机双盲安慰剂对照试验设计方法,选择158例气滞血瘀型不稳定型心绞痛患者随机分为治疗组81例和对照组77例,两组均采用最佳西医治疗方案,治疗组在西医治疗基础上口服降香舒心胶囊(4粒/次,3次/d),对照组口服安慰剂胶囊(4粒/次,3次/d).治疗疗程均为8周.并观察两组患者治疗前后心绞痛发作、中医证候以及检测血清一氧化氮(NO)、内皮素(ET)、血管性血友病因子(vWF)、超氧化物歧化酶(SOD)、丙二醛(MDA)水平及肱动脉血流介导的血管扩张变化率(FMD).结果:治疗组与对照组心绞痛缓解总有效率分别为93.82%,68.83%,中医症状疗效总有效率分别为98.76%,66.23%;两组患者胸痛、胸闷、气短、心悸等各单项评分及总分与治疗前比较均降低(P<0.01).治疗组与对照组比较,差异有统计学意义(P<0.05);与治疗前比较,治疗后两组患者血清ET,vWF降低,NO,FMD均升高(P<0.01)).治疗组血清SOD水平明显升高,MDA水平显著下降(P<0.01),而对照组SOD和MDA水平无变化.结论:降香舒心胶囊能改善气滞血瘀型不稳定型心绞痛患者临床症状和血管内皮功能,是安全有效的辅助治疗药物.其机制可能与抗脂质过氧化作用有关.%Objective: To investigate the effect of Jiangxiang Shuxin capsules on vascular endothelium in patients with unstable angina pectoris ( UAP) of Qi stagnation and blood stasis type. Method; A design of randomized, placebo-controlled, double-blind trial was adopted; 158 cases of UAP of Qi stagnation and blood stasis type were selected and randomly divided into treatment group and control group, with 81 cases in treatment group and 77 in control group. The best western medical therapy solution was applied to both groups, on which basis Jiangxiang Shuxin capsules and placebo capsules

  5. The relationship of carotid atherosclerosis,serum pregnancy-associated protein A and unstable angina%颈动脉粥样硬化、血清妊娠相关蛋白A与不稳定型心绞痛的相关性

    Institute of Scientific and Technical Information of China (English)

    罗春生; 邱强; 刘克坚; 严治涛; 罗丽萍; 周康; 刘诚

    2012-01-01

    Objective This study aimed to investigate the relationship of carotid atherosclerosis, serum pregnancy - associated protein A ( PAPP - A ), unstable angina ( LAP ), stable angina pectoris( SAP ), and non - coronary heart disease ( NCIID ), and discuss the joint significance of carotid atherosclerosis and PAPP - A concentration in the prediction of LAP. Methods Patients were admitted to hospital because of chest pain. Coronary angiography was completed within 1 week. After exclusion of the diagnosis of acute and subacute myocardial infarction, patients with LAP ( n - 40 ), SAP ( n = 40 ), and NCIID ( n - 40 ) were taken into the research. Gensini score, intima - media thickness( IMT )of carotid artery , plaque formation of carotid artery were determined by color doppler ultrasound, serum level of PAPP - A was determined by enzyme -linked immunosorbent assay ( EL1SA ). The results were analyzed statistically. Results Except smoking history, baseline information of the groups matched each other. Coronary Gensini score and indicators of carotid atherosclerosis of LAP and SAP were higher than NIICD ( P < 0. 001 ). Serum concentration of PAPP - A of LAP was higher than SAP and MIICD ( P < 0. 001 ). PAPP - A in patients with LAP was significantly higher, and its concentration was positively correlated with indicators of carotid atherosclerosis and coronary artery Gensini score. For the prediction of angina - type CUD, the sensitivity and specificity of Crouse score were respectively 0. 79 and 0. 92, these values of the average of carotid 1MT were respectively 0. 97 and 0. 85. For the prediction of LAP, the sensitivity and specificity of PAPP - A were respectively 0. 825 and 0. 937. Conclusion Indicators of carotid atherosclerosis and coronary artery Gensini score are well correlated, and PAPP - A can be served as a predictable indicator of LAP. The combined use of these parameters may provide important clinical basis for the prediction of LAP.%目的 探讨颈动脉粥

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

    Institute of Scientific and Technical Information of China (English)

    赵春杰; 曹明英; 姚朱华

    2014-01-01

    unstable angina pectoris has advantages in improving clinical symptoms,heart function and hemodynamics.%目的 观察益气复脉注射液联合前列地尔注射液治疗老年人慢性心功能不全伴发不稳定心绞痛的临床疗效. 方法 采用随机法将慢性心功能不全(NYHAⅡ~Ⅲ级)伴不稳定心绞痛患者150例分为对照组、益气复脉组、益气复脉联合前列地尔组,观察各组临床疗效、心电图、心功能、血流动力学各项指标. 结果 益气复脉联合前列地尔组临床疗效总有效率(94%),高于益气复脉组(78%)和对照组(54%)(P<0.05).心电图疗效:益气复脉联合前列地尔组总有效率(84%),高于益气复脉组(58%)和对照组(42%)(P<0.05).治疗前左心射血分数3组差异无统计学意义;治疗14 d后,益气复脉组较治疗前明显改善[(49±9)%比(40±10)%,P<0.05],益气复脉联合前列地尔组较治疗前同样明显改善[(59±9)%比(41±10)%,P<0.05],但两治疗组之间比较差异无统计学意义(P>0.05);对照组治疗前后左心射血分数未见明显改善(P>0.05).3组血流动力学各项指标心排量、心脏指数、左室工作指数于治疗前差异无统计学意义(P>0.05);治疗后益气复脉组较治疗前有明显改善(P<0.05),益气复脉联合前列地尔组较治疗前改善更为明显(P<0.05),对照组较治疗前无明显改善(P>0.05). 结论 益气复脉联合前列地尔可以改善心功能不全伴不稳定性心绞痛患者临床症状、心功能及血流动力学状况.

  7. 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

  8. Angina de Prinzmetal

    OpenAIRE

    Contreras Zuniga,Eduardo; Gomez Mesa,Juan Esteban; Zuluaga Martinez,Sandra Ximena; Ocampo,Vanesa; Andres Urrea,Cristian

    2009-01-01

    Essa síndrome é causada por um espasmo focal de uma artéria coronária epicárdica, levando a isquemia miocárdica grave. Embora freqüentemente acredite-se que o espasmo ocorra em artérias sem estenose, muitos pacientes com angina de Prinzmetal apresentam espasmo adjacente a placas ateromatosas. A causa exata do espasmo não está bem definida, mas pode estar relacionada à hipercontratilidade do músculo liso vascular devido a mitógenos vasoconstrictores, leucotrienos ou serotonina. Em alguns pacie...

  9. Effects of problem solving interventions on perceived health behavior in patients with unstable angina%解决问题技能干预对提高不稳定性心绞痛患者健康行为自我效能的影响

    Institute of Scientific and Technical Information of China (English)

    邵燕

    2014-01-01

    Objective:To determine the effects of problem solving intervention on perceived health behavior in patients with unstable angina. Methods: One hundred subjects underwent examination using the perceived health behavior scale, which was consisted of 28 items, including 4 subscales in 4 domains:the responsibility for health, psychological well being, nutrition, and exercise. The questionnaire was rated as 0 to 4 points, with the total score ranging from 0 to 112 points, with higher scores indicating a higher efficiency of implementation of perceived health behaviors. Problem solving skills were then offered as the intervention steps: determination of the problem, generation of alternative solutions, decision making, as well as implementation of plans and evaluate the results. The main contents included the misperceptions of patient ' s own disease, intervention on patients lacking knowledge, skills and confidence, the intervention of adverse behaviors as well as intervention against adverse psychological conditions. At month 3 after intervention, the self efficiency was reassessed using the perceived health behavior scale. Data were compared using the t tests. Results: The intervention with problem solving skills markedly improved the self efficiency and perceived health behaviors among all domains ( all P<0.01) . Conclusion:The intervention with problem solving skills effectively improves patient's perceived health behavior and self efficiency and promotes recovery in patients with unstable angina.%目的:观察解决问题技能干预对提高不稳定性心绞痛患者自觉健康行为自我效能的影响作用。方法:被试对象100例,采用自觉健康行为自我效能量表进行入组测评。该量表共28个条目,包含4个分量表(4个维度):即健康责任、心理安适、营养、运动。问卷采用予0~4级计分,总分为0~112分,得分愈高代表自觉执行健康行为的自我效能越高。然后给予问题解决技能

  10. Clinical effects and changes in CRP, BNP of patients with unstable angina in treatment with metoprolol and simvas-tatin%美托洛尔联合辛伐他汀治疗老年不稳定型心绞痛患者的效果及对 CRP、BNP 水平的影响

    Institute of Scientific and Technical Information of China (English)

    李军朋; 高爱红; 刘积伦; 何亚军

    2016-01-01

    Objective To discuss the clinical efficacy of metoprolol combined with simvastatin on CRP and BNP lev-els in the treatment of elderly patients with unstable angina pectoris (UAP).Methods From April 2014 to May 2015, 118 cases of UAP patients in Shanxi Nuclear Industry No.215 Hospital were selected as the research object, and according to the random number table method, they were divided into observation group with 59 cases and control group with 59 cases.Treat-ment of two groups of patients after admission were given conventional oxygen, ECG monitoring, aspirin, low molecular hepa-rin sodium gel, nitrate isosorbide ester;the control group based on the conventional treatment, also combined application of metoprolol, initial dose each 12.5 mg orally, twice daily, until 25 mg, 2 times daily; observation group besides the control group treatment, also received simvastatin tablets with 20 mg /time, 1 time /d, bedtime meal service.The course of treat-ment in 2 groups was 3 months.The clinical efficacy of the 2 groups, myocardial enzyme spectrum, blood lipids, CRP, BNP levels, adverse events and cardiovascular events were observed before and after the treatment.Results After treatment, the observation groups’ total effective rate was significantly higher than that of control group (98.3% vs.84.7%,χ2 =6.993, P 0.05).Conclusion Metoprolol combined with simvastatin in the treatment of elderly patients with unstable angi-na pectoris is effective and safe, it can significantly reduce the levels of CRP and BNP, it is worthy of clinical promotion.%目的:探讨美托洛尔联合辛伐他汀治疗老年不稳定型心绞痛( UAP)患者的临床疗效及对C反应蛋白( CRP)、脑钠肽( BNP)水平的影响。方法选取2014年4月—2015年5月于陕西省核工业二一五医院住院治疗的UAP患者118例为研究对象,按随机数字表法分为观察组59例和对照组59例。2组患者入院后均给予常规吸氧、心电监护,应用阿司匹

  11. Angina pectoris efter sumatriptan (Imigran)

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Christiansen, B D

    1992-01-01

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

  12. 肌钙蛋白Ⅰ对老年不稳定型心绞痛患者危险分层的判断价值%The value of cardiac troponin Ⅰ in risk stratification of elderly patients with unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    党彦平; 耿秀双

    2009-01-01

    Objective To study the value of serum troponin I(cTnI)in risk stratification of elderly patients with unstable angina pectoris(UAP).Methods Serum cTnI levels were measured in 22 healthy subjects(control group),27 stable angina peetoris(SAP)and 72 UAP elderly patients,respectively.Cardiac events(non fatal myocardial infarction,cardiac sudden death)were observed within 1 month of hospitalization.Serum cTnI≥1.5 μg/L was considered as the cutoff level for myocardial damage.Results Serum cTnI levels in the UAP group were higher than those in the SAP and control group [(1.96±0.61)μg/L,(0.68±0.19)μg/L and(0.46±0.10)μg/L,respectively](P<0.01).In the UAP group,serum cTnI levels increased with increase of Braunwald classification class[(1.25±0.38)μg/L,(2.12±0.34)μg/L and(3.06±0.72)μg/L,respectively](P<0.05).In Braunwald class Ⅲ patients,the rate of cardiac events in patients with serum cTnI≥1.5 μg/L was much higher than that in those with cTnI<1.5μg/L(16.7%vs 6.3%,P<0.05),risk ratio 2.05(95%confidence limit 1.02-9.78).The positive predictive value of serum cTnI≥1.5μg/L for cardiac events was 44.3%and the negative predictive value was 84.8%.Conclusions Detection of serum cTnI has clinical value in risk stratification of elderly atients with UAP.%目的 探讨心脏肌钙蛋白Ⅰ(cTnI)对老年不稳定型心绞痛(UAP)患者危险分层的价值.方法 对72例老年UAP患者、27例稳定型心绞痛(SAP)患者及22例健康对照者分别进行血清cTnI测定,并观察住院1个月内心脏事件发生情况.结果 UAP组血清cTnI值为(1.96±0.61)μg/L,明显高于SAP组的(0.68±0.19)μg/L及对照组的(0.46±0.10)μg/L(P均<0.01).UAP组内,随着Braunwald临床分级增高,Ⅰ~Ⅲ级血清cTnI值相应增高[分别为(1.25±0.38)μg/L、(2.12±0.34)μg/L及(3.06±0.72)μg/L](P<0.05).对照组、SAP组及Braunwald Ⅰ级UAP患者无一例发生心脏事件;18例Ⅱ级患者中,1例(其血清cTnI≥1.5μg/L)发

  13. 低分子肝素联合银杏达莫注射液治疗不稳定型心绞痛的临床观察%Clinical observation on therapeutic effect of low-molecule heparin integrated with Ginkgo-dipyidamolum injection on unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    罗炽权; 黄仕洲

    2011-01-01

    Objective To study the therapeutic effect of low-molecule heparin (LMWH) and Ginkgo-dipyidamolum injection for unstable angina (UA). Methods One hundred and seventy-five cases with UA were chosen from March 2006 to March 2010, completely randomly divided into treatment group (58 cases) and control group Ⅰ (52 cases) and control group Ⅱ (65 cases). On the basis of routine therapy, control and treatment groups for UA patients were established, and for experimental group, 58 patients were treated with both LMWH and Ginkgo-dipyidamolum injection. Results Statistically,compared with control group, the treatment of experimental group is more effective on aspects as follows: easing clinical symptoms, allaying myocardial ischemia diagnosed by electrocardiogram, and preventing composite of non-fatal stroke, myocardial infarction and cardiovascular death[82.76% (48/58 ) vs 65.38% (34/52) ,63.08% (41/65) ;77.59% (45/58) vs 55.77% (29/52) ,53.85% (35/65) ;18.97% (11/58)vs36.54%(19/52),35.38%(23/65),P<0. 05,P<0.01]. Conclusion LMWH and Ginkgo-dipyidamolum injection are more effective than that of either LMWH or Ginkgo-dipyidamolum injection on abirritating myocardial blooding and relieving clinical symptom.%目的 探讨低分子肝素( LMWH)联合银杏达莫注射液治疗不稳定型心绞痛的疗效。方法 选择2006年3月至2010年3月不稳定型心绞痛患者175例,完全随机分为治疗组(58例)、对照Ⅰ组(52例)和对照Ⅱ组(65例)。在常规治疗的基础上,治疗组应用LMWH联合银杏达莫注射液治疗,对照Ⅰ组应用LMWH治疗,对照Ⅱ组应用银杏达莫注射液治疗,疗程均为2周。比较3组临床症状改善、心电图缺血改善及复合终点事件发生情况。结果 治疗后治疗组临床症状改善总有效率、心电图缺血改善总有效率、复合终点事件发生率方面明显优于对照Ⅰ组和对照Ⅱ组[分别为82.76%( 48/58)比65.38% (34/52)、63.08

  14. Value of heart-type fatty acid binding protein to predicting senile unstable angina pectoris%心脏型脂肪酸结合蛋白预测老年不稳定型心绞痛患者预后的价值

    Institute of Scientific and Technical Information of China (English)

    钱海燕; 黄觊; 杨跃进; 杨艳敏; 张朝阳

    2013-01-01

    Objective To explore the value of heart fatty acid binding protein (H-FABP) to predicting the prognosis of senile unstable angina pectoris (UAP).Methods A total of 175 UAP patients aged 60 years or older were divided into positive H-FABP group and negative H-FABP group,and were recorded and analyzed the clinical data and 12-month follow-up survey results.Results The age was older,body mass index was larger,and the proportions of smoking history,family history of coronary heart disease,previous myocardial infarction and coronary artery bypass history,and diabetes mellitus were higher in positive group than those in negative group (P<0.05).The left ventricular ejection fraction was lower in positive group than that in negative group (P<0.05).Coronary angiography results showed that the rates of multi-vessel lesions,diffusive and occlusive lesions,and left main and left anterior descending lesions were higher in positive group than those in negative group (P<0.05).After the follow-up survey for 12 months,the incidence of major adverse cardiovascular events was significantly higher in positive group than that in negative group (P<0.01).Conclusion H FABP is valuable to identify the high risk population and to predict the prognosis of UAP patients aged 60 years or older.%目的 探讨心脏型脂肪酸结合蛋白(heart type fatty acid binding protein,H-FABP)预测老年不稳定型心绞痛患者预后的价值.方法 年龄≥60岁不稳定型心绞痛患者175例,分为H-FABP阳性组48例和阴性组127例,记录并分析2组资料及12个月随访结果.结果 阳性组年龄、体质量指数大于阴性组(P<0.05),吸烟、冠心病家族史、既往心肌梗死病史、冠状动脉介入和旁路移植手术史及合并糖尿病比例明显高于阴性组(P<0.05),左室射血分数低于阴性组(P<0.05);冠状动脉造影显示,阳性组多支、弥漫甚至闭塞病变、累及左主干和前降支比例高于阴性组(P<0.05);随访12个

  15. Effect of Compound Danshen Dripping Pill Combined with Clopidogrel on Platelet Function in Patients with Unstable Angina%复方丹参滴丸联合氯吡格雷片对不稳定型心绞痛患者血小板功能的影响

    Institute of Scientific and Technical Information of China (English)

    蔡洪滨; 姚朱华; 高仪

    2013-01-01

    Objective To observe the effect of Compound Danshen Dripping Pill (CDDP) combined with clopidogrel for unstable angina (UA). Methods Totally 102 UA patients were randomized into the CDDP group (33 cases) , clopidogrel group (35 cases) and CDDP+clopidogrel group (34 cases). The patients in the CDDP group were orally taken 270mg CDDP twice daily on the basis of routine treatment. The patients in the clopidogrel group were orally taken 75 mg clopidogrel once daily. The CDDP+clopidogrel group was given the combo therapy of the CDDP group and clopidogrel group. After the treatments were given to each of groups for 3 weeks, the improvement of clinical symptoms and electrocardiogram (ECG) ST segment changes were evaluated. The platelet aggregation function and thromboxane B2(TXB2) levels were measured before and after treatment. Results There was no significant difference between groups in the total effective rate and ECG effective rate (P> 0. 05). The platelet aggregation rates and TXB2 levels were significantly decreased in all groups after treatment (P<0. 01) , especially in the CDDP+clopidogrel group (P<0. 05). Conclusion The combo therapy of clopidogrel and CDDP is more effective in inhibiting platelet aggregation than single treatment. It provides the basis for clinical integrative antithrombotic therapy.%目的 观察复方丹参滴丸联合氯吡格雷片对不稳定型心绞痛患者的作用.方法 将102例不稳定型心绞痛患者随机分为3组,在常规治疗的基础上,复方丹参滴丸组(33例)给予复方丹参滴丸每次270 mg,每日2次,口服.氯吡格雷片组(35例)给予氯吡格雷片每次75 mg,每日1次,口服.联合治疗组(34例)给予前两种治疗方案联合治疗.各组均治疗3周后观察患者的症状疗效及心电图疗效,测定血小板聚集率及血栓素B2(TXB2).结果 复方丹参滴丸组、氯吡格雷片组、联合治疗组症状疗效总有效率分别为90.9%、91.4%、94.1%,心电图

  16. 缺血性ST段或T波变化及病灶特征与 血小板功能的相关性%Relationship among ischemic ST segment or T wave shifts, angiographic morphology and platelet function in patients with unstable angina

    Institute of Scientific and Technical Information of China (English)

    刘志忠; 段宝祥; 陈绍良; 王自正; 王书奎; 刘玲玲; 常芸

    2001-01-01

    Objective:To determine the relations among specific clinical pictures ,including electrocardiogram (ECG) abnormalities associated with ischemia,angiographic morphology and plate let function. Method:Thirtyeight consecutive patients were divided into two groups according to ST segment or T waves changes associated with ischemia or angiographic morphology. Venous blood samples were measured for ratios of platelet glycoprotein (GP) Ⅱ b/Ⅲ a by flow cytometry. Result:Twenty-two of the 38 patients exhibited reversible ST segment depression (n= 20) or elevation (n= 2) during ischemic episodes, whereas the other 16 exhibited reversible T wave changes. Positive ratios of platelet GP Ⅱ b/Ⅲ a were different significantly between ST segment shift group and T wave change group (4.4±2.1)% vs (2.7± 1.6)%, P <0.01. Angiographic examinationamong the 38 patients showed complex lesions in 13 patients and no significant stenosis (<50%) in 2 patients. The positive ratios of platelet GP Ⅱ b/Ⅲ a in complex lesion group were markedly elevated compared with noncomplex lesion group(4. 6±2.5)% vs (2.2±1.1)%, P <0. 01. Conclusion:The results suggest that the occurrence of reversible ST segment shifts associated with ischemia or complex lesions noted in angiographic examination identifies the increase of platelet activation in patients with unstable angina and who may be beneficial from antiplatelet therapy.%目的:确立不稳定型心绞痛(UAP)患者缺血性ST段或T波变化及冠状动脉(冠脉)造影所示病灶特征与血小板功能的相关性。方法:38例拟诊UAP患者分别依据胸痛发作时心电图(ECG)短暂性的ST段或T波改变及冠脉造影下病灶特征分组,流式细胞仪检测每例患者外周血糖蛋白(GP)Ⅱb/Ⅲ a受体阳性表达的血小板比率,比较组间GPⅡb/Ⅲ a受体表达差异。9例健康成人作对照组。结果:胸痛发作时22例患者ECG有短暂性ST段变化,另16例表现为短暂性T波

  17. Correlation between lipoprotein-associated phospholipase A2 and main risk factors in unstable angina pectoris patients%血清脂蛋白相关磷脂酶A2与不稳定心绞痛患者主要危险因素的相关性

    Institute of Scientific and Technical Information of China (English)

    张卫萍; 马云龙; 马琼; 陈涛; 郜珊珊

    2016-01-01

    目的:探讨血清脂蛋白相关磷脂酶A2(Lp-PLA2)与不稳定心绞痛患者主要危险因素的相关性。方法选择本院心脏内科2015-03~2015-06不稳定心绞痛住院就诊的52例患者为研究组,同期58例因胸痛行冠状动脉造影术( CAG)冠状动脉狭窄<30%且排除冠心病的患者为对照组。不稳定心绞痛患者入院后24 h内采用TIMI评分进行危险分层以及Gensi-ni积分,并检测血压,心率,肝、肾功能,血脂,凝血功能,心肌酶,N端脑利钠肽前体( NT-proBNP),高敏性C反应蛋白等指标。ELISIA法测定血清Lp-PLA2水平,并评价Lp-PLA2与不稳定心绞痛主要危险因素的相关性。结果不稳定心绞痛组脂蛋白( a)、低密度脂蛋白、肌钙蛋白I、肌酸激酶、NT-proBNP、纤维蛋白降解产物( FDP)、hs-CRP和Lp-PLA2水平明显高于对照组(P<0.05或P<0.01),Apo-A1则明显降低(P<0.05);TIMI评分高危组和中危组Lp-PLA2水平与Gensini积分高于低危组(P<0.01);不稳定心绞痛组血清Lp-PLA2水平与TIMI评分、Gensini积分、LDL、脂蛋白a、APTT以及D-二聚体呈现明显的正相关(P<0.05);Lp-PLA2水平与TIMI评分、Gensini积分、LDL和脂蛋白a呈线性回归。结论 Lp-PLA2水平是不稳定心绞痛高危人群危险程度和冠脉病变严重程度的有力预测因素,并且Lp-PLA2水平的升高也直接反映了LDL和脂蛋白( a)与动脉粥样硬化不稳定斑块发展的相关性。%Objective To investigate the correlation between lipoprotein-associated phospholipase A2(Lp-PLA2) and main risk factors of unstable angina pectoris( UA) . Methods Totally 52 patients with UA in Department of Cardiovascular Medicine from March 2015 to June 2015 were chosen as study group, and 58 chest pain patients with coronary stenosis<30% detected by coronary angiography and non-coronary heart disease were chosen as control group. All UA patients were subjected to risk assessment and stratification with TIMI risk score and Gensini score

  18. Living with heart disease and angina

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000576.htm Living with heart disease and angina To use the sharing features on ... pain and reduce your risks from heart disease. Heart Disease and Angina CHD is a narrowing of the ...

  19. 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.

  20. Menstruation angina: a case report

    Directory of Open Access Journals (Sweden)

    Choo Wai Kah

    2009-03-01

    Full Text Available Abstract Introduction Menstruation is commonly associated with migraine and irritable bowel but is rarely correlated with angina or myocardial ischaemia. Only a small number of cases have been reported suggesting a link between menstruation and myocardial ischaemic events. Case presentation A case of menstruation angina is reported in order to raise awareness of this association. A 47-year-old South Asian woman presented with recurrent chest pains in a monthly fashion coinciding with her menstruations. Each presentation was associated with troponin elevation. Angioplasty failed to resolve her symptoms but she eventually responded to hormonal therapy. Conclusions The possibility of menstruation angina should always be taken into account in any female patients from puberty to menopause presenting with recurrent chest pains. This can allow an earlier introduction of hormonal therapy to arrest further myocardial damage.

  1. Statine bei instabiler Angina pectoris

    Directory of Open Access Journals (Sweden)

    Marschang G

    1999-01-01

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

  2. 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.

  3. Statins decreases expression of five inflammation-associated microRNAs in the plasma of patients with unstable angina%他汀类药物可降低不稳定性心绞痛患者血浆中炎症相关 microRNAs 的表达水平

    Institute of Scientific and Technical Information of China (English)

    张静; 任景怡; 陈红; 韩冠平

    2015-01-01

    目的:评估服用他汀类药物对不稳定性心绞痛患者血浆中microRNAs( miRNAs)表达谱的影响。方法:采用miRNAs TLDA(Taqman low-density array)芯片对长期规律服用他汀类药物的不稳定性心绞痛患者(他汀治疗组, n=6)及未曾服用过他汀类药物的不稳定性心绞痛患者(非他汀治疗组,n=6)血浆中差异表达的miRNAs表达谱进行筛查,并选择部分差异表达的炎症相关的miRNAs在非心源性胸痛患者(对照组,n=20)、未曾服用过他汀类药物的不稳定性心绞痛患者(非他汀治疗组,n=26)、长期规律服用他汀类药物的不稳定性心绞痛患者(他汀治疗组,n=19)中采用real-time PCR的方法进行验证。结果:他汀治疗组患者血浆中miRNAs的表达谱与非他汀治疗组患者相比差异有统计学意义,包括miR-106b、miR-21、miR-25、miR-451以及 miR-92a等炎症相关miRNAs在内的21种血浆miRNAs水平显著降低(组间差异倍数>3,错误发现率<0.0001%),选取miR-106b、miR-21、miR-25、miR-451以及miR-92a进行real-time PCR验证的结果与芯片筛查结果一致,与未曾服用过他汀类药物的患者相比,长期规律服用他汀类药物可降低上述5种炎症相关miRNAs的表达水平(P<0.05),而非他汀治疗组患者血浆中上述5种炎症相关miRNAs的表达水平高于对照组(P<0.001)。结论:服用他汀类药物可显著降低不稳定性心绞痛患者血浆中一组炎症相关的miRNAs的表达水平。%Objective:To explore the influence of treatment with HMG-CoA reductase inhibitors ( sta-tins) on the expression profile of microRNAs ( miRNAs) in the plasma of patients with unstable angina ( UA) .Methods:The Taqman low-density miRNA array ( TLDA) and significance analysis of microar-rays ( SAM) were used to identify distinct miRNA expression profiles in the plasma of UA patients treated with long-term and regular

  4. Influences of pioglitazone on quantity of endothelial progenitor cells and adiponectin level in patients with unstable angina pectoris complicating diabetes%吡格列酮对不稳定型心绞痛合并糖尿病患者内皮祖细胞数量及脂联素水平的影响

    Institute of Scientific and Technical Information of China (English)

    陈立东; 肖敏; 张绪国; 朱艳霞; 梁鹏飞; 邹兆坤

    2015-01-01

    目的:探讨吡格列酮对不稳定型心绞痛(UAP)合并2型糖尿病患者内皮祖细胞(EPCs)数量及脂联素水平的影响。方法入选自2010年6月至2011年5月在湖北医药学院附属太和医院住院的有UAP合并2型糖尿病患者57例,随机分为吡格列酮组(n=28)和对照组(n=29),吡格列酮组应用吡格列酮(30 mg/d)治疗,对照组患者不使用噻唑烷二酮类药物。治疗前及治疗12周时通过流式细胞技术双色分析法检测所有患者外周血中EPCs占有核细胞的百分比,其中EPCs用CD34+/KDR+双标记定位,比较两组患者在干预前后内皮祖细胞数量的变化及血清脂联素水平的变化。结果两组患者在治疗前EPCs的数量无统计学差异(P>0.05)。治疗12周时,吡格列酮组患者EPCs数量较治疗前明显增加(0.023±0.010 vs.0.051±0.012,P<0.01);对照组患者EPCs数量在治疗前后无统计学差异(P>0.05);12周时,吡格列酮组患者EPCs数量高于对照组患者(P<0.028)。吡格列酮组血清脂联素水平在治疗前、后有统计学差异(P<0.05);对照组患者血脂联素水平在治疗前、后无统计学差异(P>0.05);12周时,吡格列酮组患者血清脂联素水平高于对照组患者(P<0.05)。结论吡格列酮能够促进冠心病合并糖尿病患者EPCs的动员,提高患者血清脂联素水平。%Objective To investigate the influences of pioglitazone on quantity of endothelial progenitor cells (EPCs) and adiponectin level in patients with unstable angina pectoris (UAP) complicating type 2 diabetes mellitus (T2DM). Methods The patients (n=57) were randomly divided into pioglitazone group (n=28) and control group (n=29), and pioglitazone group was treated with pioglitazone (30 mg/d) and control group was not given TZD drugs. The percentage of peripheral EPCs in karyocytes was detected by using flow cytometry and double color analysis before

  5. Effects of Ginkgo Mihuan Oral Liquid on CRP,E SOD,P LPO,E LPO and Other Indexes in Patients with Unstable Angina Pecto-ris%银杏蜜环口服液对不稳定型心绞痛病人CRP、E SOD、P LPO、E LPO的影响

    Institute of Scientific and Technical Information of China (English)

    范国颖; 谢岩; 刘文忠

    2016-01-01

    目的:观察银杏蜜环口服液对不稳定型心绞痛病人 C反应蛋白(CRP)、血浆过氧化脂质(P LPO)、红细胞超氧化物歧化酶(E LPO)等指标水平的变化。方法选取辽宁中医药大学附属医院、辽宁电力中心医院、大连市中医医院三所医院前来就诊住院的160例不稳定型心绞痛病人,根据病情、病程、年龄及性别等因素采用分层随机法分为对照组和观察组,每组80例。两组均给予西医常规对症治疗,观察组在常规对症治疗的基础上给予银杏蜜环口服液(每次10 mL,一日3次)口服。治疗疗程为4周。分别于治疗前后观察心电图及临床症状改变,检测血清蛋白CRP,E SOD平均活性P LPO、红细胞过氧化脂质(E LPO)、肱动脉内皮依赖性舒张功能(FMD)、内皮素(ET 1)、一氧化氮(NO)、血栓素 B2(TXB2)以及6酮前列腺素 Fla(6 keto PGF 1α)水平变化,并进行临床疗效评价。结果治疗后,两组各指标均有所改善,观察组CRP、P LPO、E LPO、ET 1、TXB2水平明显下降(P<0.05或P<0.01),E SOD、FMD、NO、6 Keto PGF lα水平明显升高(P<0.05或P<0.01),与对照组比较具有统计学意义(P<0.05或P<0.01)。观察组组总有效率为88.75%,明显高于对照组67.50%(P<0.05)。结论银杏蜜环口服液联合西医常规对症治疗能有效改善不稳定型心绞痛临床症状,改善血液流变学指标水平、改善血管内皮功能的作用,提高临床综合疗效。%Objective To observe the effects of Ginkgo Mihuan oral liquid (GMOL)on serum C reactive protein (CRP),plasma lipid peroxide (P LPO),erythrocyte lipid peroxide (E LPO)and other indexes in patients with unstable angina pectoris (UAP). Meth-ods One hundred and sixty patients with UAP in the Third Affiliated Hospital of Liaoning University of traditional Chinese medicine, Liaoning Electric Power Center Hospital,Dalian Hospital of Traditional Chinese Medicine,according to the il ness,disease,age, and sex factors using a

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2001-09-01

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

  7. Selection of drug therapy in stable angina pectoris.

    Science.gov (United States)

    Savonitto, S; Ardissino, D

    1998-05-01

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

  8. How Can Angina Be Prevented?

    Science.gov (United States)

    ... can help prevent or delay angina and heart disease. To adopt a healthy lifestyle, you can: Quit smoking and avoid secondhand smoke ... a healthy diet Be physically active Maintain a healthy ... and controlling heart disease risk factors, visit the Diseases and Conditions Index ...

  9. Performing stable angina pectoris: an ethnographic study.

    Science.gov (United States)

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

    2008-04-01

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

  10. Avaliação das pressões sistólica, diastólica e pressão de pulso como fator de risco para doença aterosclerótica coronariana grave em mulheres com angina instável ou infarto agudo do miocárdio sem supradesnivelamento do segmento ST Evaluation of systolic, diastolic, and pulse pressure as risk factors for severe coronary arteriosclerotic disease in women with unstable angina non-ST-elevation acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    José Marconi Almeida de Sousa

    2004-05-01

    Full Text Available OBJETIVO: Avaliar se as pressões, medidas na raiz da aorta, são fatores de risco para doença aterosclerótica coronariana grave em mulheres com angina instável ou infarto agudo do miocárdio sem supradesnivelamento do segmento ST (AI/IAMSS. MÉTODO:As pressões, assim como os fatores de risco para doença arterial coronariana (DAC foram prospectivamente coletados de março/1993 a agosto/2001 em 593 mulheres com diagnóstico de AI/IAMSS submetidas à cinecoronariografia. Lesões coronarianas definidas como graves estenoses > 70%. RESULTADOS: Idade média de 59,2±11,2 anos, significantemente mais alta nas pacientes com DAC: 61,9 ± 10,8 anos vs 56.4 ± 10,8 anos; tabagismo, diabetes e climatério foram mais freqüentes nas pacientes com DAC. As médias das pressões sistólica e arterial média foram iguais nos dois grupos, entretanto as médias das pressões diastólicas do ventrículo esquerdo (17.6 ± 8.7 x 15.1 ± 8.1, p=0.001 e da pressão de pulso aórtica foram significantemente maiores nas pacientes com DAC (75.5 ± 22 x 70 ± 19, p=0.002, enquanto a média da pressão diastólica aórtica foi significantemente mais alta nas pacientes sem DAC (75.3 ± 17.5 x 79.8 ± 16, p=0.003. Na análise multivariada a pressão de pulso > 80 mmHg e pressão sistólica > 165 foram independentemente associadas a DAC com razão de chance de 2.12 e 2.09, p 80 mmHg e pressão sistólica > 165 mmHg determinaram risco duas vezes maior de lesão coronariana grave.OBJECTIVE: To evaluate pressures assessed at the aortic root as risk factors for severe atherosclerotic coronary heart disease in women with unstable angina/compatible clinical history associated with increase in cardiac enzymes (total CPK and CK-MB 2 times greater than the standard value used in the hospital, with the absence of new Q waves on the electrocardiogram (UA/NSTEMI. METHODS: Five hundred and ninety-three female patients with clinical diagnosis of UA/NSTEMI underwent cinecoronariography

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-06-01

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

  12. Angina

    Science.gov (United States)

    ... Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine . 10th ... Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of ...

  13. 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

  14. Relationship between N-terminal pro brain natriuretic peptide and insulin sensitivity index in pa-tients with unstable angina pectoris%血浆NT-proBNP水平及胰岛素敏感性指标与不稳定型心绞痛危险分层相关研究

    Institute of Scientific and Technical Information of China (English)

    王培; 郑晓晖; 胡丰朝; 杨睿

    2014-01-01

    Objective To study the correlation of N-terminal pro brain natriuretic peptide( NT-proBNP)with insulin sensitivity index( FBG,FINS,FINS/FBG,ISI)in UAP patients,and its clinical significance. Methods One hundred patients with UAP were enrolled as the observation group,30 pa-tients with stable angina pectoris( SAP)as SAP group,and 30 healthy people as the normal control (COM)group. According to the Braunwald UAP,patients in UAP group were graded into 3 sup-groups( grade 1 ,grade 2 and grade 3 ). The plasma NT-proBNP and insulin sensitivity indexes were detected in each group,and then the results were analyzed and the linear correlation analysis was made. Results The concentration of plasma NT-proBNP,FINS,FINS/FBG in patients with UAP and SAP group were significantly higher than those in COM group( P﹤0. 05 ),but ISI was lower than that in COM group( P ﹤0. 05 ). The concentration of plasma NT-proBNP,FINS,FINS/FBG in patients with UAP were significantly higher than those in patients with SAP( P﹤0. 05 ),but ISI was lower than that in patients with SAP(P﹤0. 05),and there was no significant difference in FBG between the two groups. The concentration of plasma NT-proBNP,FINS,FINS/FBG in patients with grade 2 and grade 3 were significantly higher than those in patients with grade 1( P﹤0. 05 ),but ISI was lower in the grade 2( P﹤0. 05). No significant diference was found between grade 2 and grade 3. In UAP patients,the plasma NT-proBNP concentration was positively correlated with FINS,FINS/FBG( r =0. 38,P =0. 046,r =0. 56 ,P=0. 039 ),and negative correlated with ISI( r = -0. 62 ,P =0. 028 ),and with no correlation with FBG. Conclusions The concentration of plasma NT-proBNP was elevated and insulin sensitivity decreased in UAP, especially in Braunwald UAP grade 2 and grade 3( rest angina ),the concentration of NT-proBNP was negatively cor-related with insulin sensitivity. The combined determination is significant in risk grading reference of UAP.%目的:

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

    Science.gov (United States)

    Mazel, J A

    2004-11-06

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

  16. Microvascular angina in postmenopausal women.

    Directory of Open Access Journals (Sweden)

    Alexander Valdés Martín

    2011-10-01

    Full Text Available Fundamento: la angina microvascular es frecuente en mujeres posmenopáusicas. La isquemia miocárdica ha sido inducida mediante pruebas de estrés, en las que se ha comprobado una relación entre la disfunción endotelial y los defectos de perfusión miocárdica. Objetivo: determinar si la isquemia miocárdica puede evidenciarse por anormalidades de la perfusión y de la función detectadas por gammagrafía miocárdica en mujeres con angina típica, angiografía coronaria normal y disfunción endotelial. Métodos: estudio descriptivo realizado en el Instituto de Cardiología y Cirugía Cardiovascular de La Habana que incluyó 59 mujeres. Se les realizó lipidograma, se les midió función endotelial de la arteria braquial mediante ultrasonido, y estudio electrocardiográfico de 24 horas (Holter. Se aplicó un protocolo de estrés-reposo durante la gammagrafía. Las pacientes fueron divididas en dos grupos, acorde a la presencia (grupo I o ausencia (grupo II de defectos de perfusión miocárdica. Resultados: mostraron defectos de la perfusión 21 pacientes. El 57 % de las pacientes del grupo I exhibió más disfunción endotelial. Sólo doce pacientes mostraron defectos reversibles de la perfusión y en el 75 % de los casos se asoció a una reducción de la fracción de eyección ventricular izquierda postestrés mayor de un 5 % y a anormalidades regionales de la motilidad de la pared. Tres pacientes en el grupo I mostraron evidencia de isquemia comparado con cuatro en el grupo II. Conclusiones: la isquemia inducida por estrés se asocia a una reducción de la fracción de eyección ventricular izquierda postestrés y a una vasodilatación anormal dependiente del endotelio.

  17. Control of Unstable Flows

    Institute of Scientific and Technical Information of China (English)

    刘曾荣; 茅坚民

    2003-01-01

    Without introducing a discrete model, unstable continuous flows in a neighbourhood of an unstable stationary point can be stabilized. The linear part of the vector field of disturbing the flow can be managed to become the state variable multiplied by a negative constant. The nonlinear part of the vector field keeps to be unchanged,therefore flows far away from the stationary point are almost unaffected by the disturbance. The control method is easy to be used, even for practical problems for which a priori analytical knowledge of system dynamics is unavailable.

  18. Instabile Angina pectoris: nichtinvasive und invasive Diagnostik

    Directory of Open Access Journals (Sweden)

    Benzer W

    1999-01-01

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

  19. 中青年高血压合并不稳定心绞痛患者动态脉压、脉压指数与 MMP-9、Hs-CRP 的相关性%Relationship between ambulatory pulse pressure and pulse pressure index with MMP-9 and Hs-CRP in middle-aged patients with hypertension and unstable angina pectoris

    Institute of Scientific and Technical Information of China (English)

    刘冬梅; 谢艳凤; 马丽; 苗昌荣; 王晓蕊; 赵紫英

    2016-01-01

    目的:观察中青年高血压合并不稳定心绞痛患者动态脉压、脉压指数水平的变化,并探讨其与血清基质金属蛋白酶-9(MMP-9)、超敏 C 反应蛋白(Hs-CRP)水平的关系。方法选择中青年高血压合并不稳定心绞痛患者102例作为观察组,采用酶联免疫吸附法(ELISA)测定 MMP-9与 Hs-CRP 水平,选择同期健康体检者94例为对照组。将观察组按动态脉压进行分层,分为41~60 mmHg、61~80 mmHg、≥81 mmHg 3个水平;脉压指数进行分层,分为 APPI≤0.400、0.401~0.500、≥0.5013个水平;比较不同动态脉压和脉压指数水平时MMP-9、Hs-CRP 水平的变化,并进行 MMP-9与 Hs-CRP 之间的直线相关和回归分析。结果观察组 MMP-9、Hs-CRP 水平明显高于对照组;动态脉压与脉压指数水平越大,观察组血清 MMP-9、Hs-CRP 水平越高;直线相关和回归分析表明,MMP-9与 Hs-CRP 呈显著正相关。结论血清 MMP-9、Hs-CRP 水平升高与中青年高血压合并不稳定心绞痛密切相关;动态脉压、脉压指数与 MMP-9、Hs-CRP 密切相关。%Objective To observe the ambulatory pulse pressure(APP)and pulse pressure index(APPI)in the middle-aged patients with hypertension and unstable angina pectoris(UAP),and to probe into relationship between ambulatory pulse pressure(APP)and pulse pressure index(APPI)with matrix metalloproteinase-9(MMP-9)and High-sensitive C-reactive protein(Hs-CRP). Methods The 102 middle-aged patients with hypertension and UAP were the observation group,in which levels of MMP-9 and Hs-CRP were examined by eyzyme-linked immuno sorbent assay(ELISA). In the same period,94 healthy physical examinees were included in the control group. The observation group were divided into 3 layers according to the level of APP(41-60 mmHg,61-80 mmHg,≥81mmHg respective-ly);According to the level of APPI,there were also three layers(≤0. 400,0. 401-0. 500,≥0. 501 respectively)in the

  20. A case of reninoma with variant angina

    Directory of Open Access Journals (Sweden)

    Hyung Ah Jo

    2014-06-01

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

  1. Controls for unstable structures

    Science.gov (United States)

    Guenther, Oliver; Hogg, Tad; Huberman, Bernardo A.

    1997-06-01

    We study the behavior of several organizations for a market based distributed control of unstable physical systems and show how a hierarchical organization is a reasonable compromise between rapid local responses with simple communication and the use of global knowledge. We also introduce a new control organization, the multihierarchy, and show that is uses less power than a hierarchy in achieving stability. The multihierarchy also has a position invariant response that can control disturbances at the appropriate scale and location.

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

    DEFF Research Database (Denmark)

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

    1997-01-01

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

  3. Safety and efficacy of angioplasty with intracoronary stenting in patients with unstable coronary syndromes. Comparison with stable coronary syndromes

    Directory of Open Access Journals (Sweden)

    Luís C. L. Correia

    2000-06-01

    Full Text Available OBJECTIVE: To assess safety and efficacy of coronary angioplasty with stent implantation in unstable coronary syndromes. METHODS: Retrospective analysis of in-hospital and late evolution of 74 patients with unstable coronary syndromes (unstable angina or infarction without elevation of the ST segment undergoing coronary angioplasty with stent placement. These 74 patients were compared with 31 patients with stable coronary syndromes (stable angina or stable silent ischemia undergoing the same procedure. RESULTS: No death and no need for revascularization of the culprit artery occurred in the in-hospital phase. The incidences of acute non-Q-wave myocardial infarction were 1.4% and 3.2% (p=0.6 in the unstable and stable coronary syndrome groups, respectively. In the late follow-up (11.2±7.5 months, the incidences of these events combined were 5.7% in the unstable coronary syndrome group and 6.9% (p=0.8 in the stable coronary syndrome group. In the multivariate analysis, the only variable with a tendency to significance as an event predictor was diabetes mellitus (p=0.07; OR=5.2; 95% CI=0.9-29.9. CONCLUSION: The in-hospital and late evolutions of patients with unstable coronary syndrome undergoing angioplasty with intracoronary stent implantation are similar to those of the stable coronary syndrome group, suggesting that this procedure is safe and efficacious when performed in unstable coronary syndrome patients.

  4. Clinical And Paraclinical Characteristics Of Patients With Unstable Anyina Hospitalized At Ccu

    Directory of Open Access Journals (Sweden)

    Sadr Bafghi S M

    2003-09-01

    Full Text Available Unstable angina (UA is situated in a spectrum with myocardial infarction (MI at one end of it and stable angina at the other end. To determine the clinical and paraclinical characteristics of unstable angina this study was designed."nMaterials and Methods: Two hundred patients with definite UA who were hospitalized at cardiac care units (CCU in Yazd were enrolled in this cross- sectional study. Clinical and para-clinical characteristics including class of severity of angina, clinical circumstances, drugs, risk factors, changes in ECG, and patient's condition at the time of leaving hospital were evaluated."nResults& Conclusions: The average of age of patients was 61.85 years and 57% of them were female and 43% were male. The most prevalent risk factor among men was smoking (48.8% and among women was hypertension (62.8%. According to Braunwald suggestion, patients were divided into 3 classes based on the severity of their diseases. Frequency distribution of patients in classes I,H and III were 24.5%, 4% and 71.5%, respectively. Normal ECG, was observed in 24.5% of subjects at the time of hospitalization and in 67% of patients when leaving hospitals. Frequency distribution based on the risk stratification was 22.5%, 58.5% and 19% in the low, medium and high risk groups, respectively. During hospitalization, acute myocardial infarction (AMI was seen in 3.5% of individuals that majority of them belonged to class III of angina.

  5. Cumulative risk assessment in unstable angina: clinical, electrocardiographic, autonomic, and biochemical markers

    OpenAIRE

    Kennon, S; Price, C P; Mills, P G; MacCallum, P K; Cooper, J; Hooper, J; Clarke, H.; Timmis, A D

    2003-01-01

    Objectives: To determine the incremental value of clinical data, troponin T, ST segment monitoring, and heart rate variability for predicting outcome in patients with non-ST elevation acute coronary syndromes.

  6. Mycotic aortocoronary saphenous vein graft aneurysm presenting with unstable angina pectoris.

    Science.gov (United States)

    Hirsch, Glenn A; Johnston, Peter V; Conte, John V; Achuff, Stephen C

    2004-10-01

    We report the case of a 60-year-old man with a history of coronary bypass surgery 20 years prior who had a fever, chest pain, and a mediastinal mass develop after a complicated postoperative course of abdominal aortic aneurysm resection. A mycotic aneurysm of the saphenous vein graft to his left anterior descending coronary artery was diagnosed based on blood culture results and visualization of the aneurysm before resection. A summary of the saphenous vein graft aneurysm and pseudoaneurysm cause, diagnosis, and management is detailed.

  7. [Bilateral coronary artery-pulmonary artery fistulas in a case with unstable angina pectoris].

    Science.gov (United States)

    Kepez, Alper; Kaya, Ergün Bariş; Aytemir, Kudret; Oto, Ali

    2008-03-01

    Bilateral coronary artery fistulas originating from both right and left coronary arteries are rare congenital abnormalities. A 58-year-old man presented with chest pain unrelated to exertion. Coronary angiography showed a fistula originating from the level of the first diagonal branch of the left anterior descending (LAD) coronary artery and a 95% stenosis just distal to the fistula. Right coronary angiography showed another fistula originating from the ostium of the right coronary artery. Both fistulas drained into the pulmonary artery. Coronary bypass surgery was performed for the LAD lesion using the left internal mammary artery graft, during which both fistulas were ligated. No complications were encountered postoperatively.

  8. Usefulness of diabetes mellitus to predict long-term outcomes in patients with unstable angina pectoris.

    Science.gov (United States)

    Farkouh, Michael E; Aneja, Ashish; Reeder, Guy S; Smars, Peter A; Lennon, Ryan J; Wiste, Heather J; Traverse, Kay; Razzouk, Louai; Basu, Ananda; Holmes, David R; Mathew, Verghese

    2009-08-15

    The objective of this study was to determine short- and long-term cardiovascular outcomes in unselected patients with diabetes mellitus (DM) with acute ischemic chest pain (AICP). In patients with DM presenting to the emergency department with AICP, short-term cardiovascular outcomes remain discordant between trials and registries, whereas long-term outcomes are not well-described. A consecutive cohort of all residents of Olmsted County, Minnesota, presenting with AICP from January 1, 1985, to December 31, 1992, was followed for a median duration of 16.6 years. The primary outcome was long-term all-cause mortality. Other outcomes included a composite of death, myocardial infarction, stroke, and revascularization (major adverse cardiovascular and cerebrovascular events [MACCEs]) as well as heart failure (HF) events at 30 days and at a median of 7.3 years, respectively. Of the 2,271 eligible patients, 336 (14.8%) were classified with DM. The crude 30-day MACCE rate was 10.1% in patients with DM and 6.1% in those without DM (p = 0.007). HF events were more common in patients with DM at 30 days (9.8% vs 3.1%, p <0.001). At 7.3 years, patients with DM were more likely to experience MACCEs and HF events than those without DM (71.2% vs 45.1%, unadjusted hazard ratio 2.15%, 95% confidence interval 1.87 to 2.48, p <0.001, and 45.1% vs 18.2%, p <0.001, respectively). Over the follow-up period, 272 patients with DM (81.9%) died, compared with 936 (49.2%) without DM (p <0.001). In conclusion, DM is associated with a higher short-term risk for MACCEs and HF and a higher long-term risk for mortality in unselected patients with AICP. DM should be included as a high-risk variable in national acute coronary syndrome guidelines.

  9. First Diagonal Coronary Artery: Left Ventricular Fistula Presenting as Unstable Angina

    Directory of Open Access Journals (Sweden)

    Murat Sener

    2013-01-01

    Full Text Available Coronary artery fistulae are characterized by communications between a coronary artery and a cardiac chamber or another vascular structure. They are usually congenital, but acquired forms may occur. Most patients are usually asymptomatic. However, some studies have emphasized that the incidence of symptoms and complications increases with age, particularly after the age of 20 (Liberthson et al. 1979, Hong et al. 2004. We aimed to present a very rare form of fistula originating from the first diagonal artery and connecting into the left ventricle.

  10. First diagonal coronary artery: left ventricular fistula presenting as unstable angina.

    Science.gov (United States)

    Sener, Murat; Akkaya, Mehmet; Bilici, Muammer

    2013-01-01

    Coronary artery fistulae are characterized by communications between a coronary artery and a cardiac chamber or another vascular structure. They are usually congenital, but acquired forms may occur. Most patients are usually asymptomatic. However, some studies have emphasized that the incidence of symptoms and complications increases with age, particularly after the age of 20 (Liberthson et al. 1979, Hong et al. 2004). We aimed to present a very rare form of fistula originating from the first diagonal artery and connecting into the left ventricle.

  11. Renal artery stenosis presenting as crescendo angina pectoris.

    Science.gov (United States)

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

    1995-07-01

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

  12. Ectasia coronaria, angina inestable e insuficiencia aórtica

    Directory of Open Access Journals (Sweden)

    Róger A Lanzas Rodríguez

    2009-12-01

    Full Text Available Se presenta el caso de una paciente femenina de 79 años, conocida portadora de cardiopatía hipertensiva, insuficiencia aórtica y dislipidemia, que se hospitalizó con un síndrome coronario agudo. Durante su evolución presentó cambios electrocardiográficos de isquemia subepicardica anterior extensa e inferior, por lo que se le realizó una coronariografia selectiva bilateral, detectándose ectasia de la arteria coronaria derecha, con flujo lento y retención del medio de contraste. Se refirió el caso para cirugía de reemplazo valvular.Coronary artery ectasia, unstable angina and aortic insufficiency The case of a 79 year old female patient, who was hospitalized with acute coronary syndrome (ACS, is presented. She had known hypertensive heart disease, aortic insufficiency and dyslipidemia. During the evolution of her ACS, she presented electrocardiographic changes of ischemia. Selective coronary angiography detected ectasia of the right coronary artery with slow flow and retention of contrast medium. The patient was referred for aortic valve replacement surgery.

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

    Science.gov (United States)

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

    2011-10-01

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

  14. The Black Ring is Unstable

    CERN Document Server

    Santos, Jorge E

    2015-01-01

    We study non-axisymmetric linearised gravitational perturbations of the Emparan-Reall black ring using numerical methods. We find an unstable mode whose onset lies within the "fat" branch of the black ring and continues into the "thin" branch. Together with previous results using Penrose inequalities that fat black rings are unstable, this provides numerical evidence that the entire black ring family is unstable.

  15. Treating angina pectoris by acupuncture therapy.

    Science.gov (United States)

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

    2013-01-01

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

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

    Science.gov (United States)

    Parikh, Raj; Kadowitz, Philip J

    2014-02-01

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

  17. A rare cause of Ludwig's angina by Morganella morganii.

    Science.gov (United States)

    Ho, Min-Po; Tsai, Kuang-Chau; Yen, Szu-Lin; Lu, Cheng-Lin; Chen, Chia-Hung

    2006-10-01

    Ludwig's angina is a rapidly spreading and potentially lethal infection involving the floor of the mouth and neck. We present a rare case of Ludwig's angina caused by an unusual microorganism, Morganella morganii, and the group D alpha-hemolytic streptococcus. To our knowledge, this is the first case of Ludwig's angina and deep neck infection caused by Morganella morganii. Adequate airway maintenance, appropriate use of antibiotics and surgical drainage resulted in survival of the patient without complications.

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

    Science.gov (United States)

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

    2014-01-01

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

  19. Effectiveness of Ivabradine in Treating Stable Angina Pectoris.

    Science.gov (United States)

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

    2016-04-01

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

  20. Balancing for unstable nonlinear systems

    NARCIS (Netherlands)

    Scherpen, J.M.A.

    1993-01-01

    A previously obtained method of balancing for stable nonlinear systems is extended to unstable nonlinear systems. The similarity invariants obtained by the concept of LQG balancing for an unstable linear system can also be obtained by considering a past and future energy function of the system. By c

  1. 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.

  2. Necrotizing fasciitis in association with Ludwig's angina - A case report.

    Science.gov (United States)

    Kavarodi, A M

    2011-07-01

    A 28 year old male diabetic patient developed Ludwig's angina which subsequently evolved into cervicofacial necrotizing fasciitis. The differential characteristic of Ludwig's angina and cervicofacial necrotizing fasciitis, as it relates to this rare presentation is discussed. The clinical and radiological features, pathophysiology, diagnosis and the management that resulted in a successful outcome are presented.

  3. Treatment of Unstable Ankle Fractures

    Directory of Open Access Journals (Sweden)

    Yaniel Truffín Rodríguez

    2015-11-01

    Full Text Available Patients with unstable ankle fractures frequently attend the emergency rooms. It is estimated that there are 122 ankle fractures per 100 000 people a year. Surgical treatment of those that are unstable is inevitable since they can not be corrected in a conservative way. Several surgical procedures for repair of such lesions have been described and all of them constitute important tools for the orthopedic surgeon. Therefore, we conducted a literature review to discuss the current management of unstable ankle fractures based on the analysis of the published literature and the experiences in the Dr. Gustavo Aldereguía Lima University General Hospital of Cienfuegos.

  4. Angina de Ludwig. Reporte de 2 casos

    OpenAIRE

    Antonio Fabbio Gagliardi Lugo; María Gabriela Contreras Ravago; Ronar Alejandro Gudiño Martinez; Rafael José Zeballos Peltrini

    2014-01-01

    La angina de Ludwig (AL) es una entidad patológica, odontogénica e infecciosa que representa una situación de emergencia en la Cirugía Bucal y Maxilofacial por comprometer la vida del paciente debido a una progresiva oclusión de la vía aérea, producto del avance de la infección hacia los espacios submandibulares, sublinguales y submental, lo que trae como consecuencia el colapso de la misma. En el presente trabajo se hace una revisión de la literatura actualizada acerca de dicha entidad, orig...

  5. 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.

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

    DEFF Research Database (Denmark)

    Andréll, P; Yu, W; Gersbach, P;

    2010-01-01

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

  7. Proton scattering from unstable nuclei

    Indian Academy of Sciences (India)

    Y Blumenfeld; E Khan; F Maréchal; T Suomijärvi

    2001-08-01

    Recent improvements in the intensities and optical qualities of radioactive beams have made possible the study of elastic and inelastic proton scattering on unstable nuclei. The design and performances of an innovative silicon strip detector array devoted to such experiments are described. The quality of the data obtained are illustrated with recent results obtained at the GANIL facility for unstable oxygen, sulfur and argon isotopes. Methods to analyse the data using phenomenological and microscopic optical model potentials are discussed.

  8. Two dimensional unstable scar statistics.

    Energy Technology Data Exchange (ETDEWEB)

    Warne, Larry Kevin; Jorgenson, Roy Eberhardt; Kotulski, Joseph Daniel; Lee, Kelvin S. H. (ITT Industries/AES Los Angeles, CA)

    2006-12-01

    This report examines the localization of time harmonic high frequency modal fields in two dimensional cavities along periodic paths between opposing sides of the cavity. The cases where these orbits lead to unstable localized modes are known as scars. This paper examines the enhancements for these unstable orbits when the opposing mirrors are both convex and concave. In the latter case the construction includes the treatment of interior foci.

  9. [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)

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

    Science.gov (United States)

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

    2016-02-15

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

  11. Selection of medical treatment in stable angina pectoris

    DEFF Research Database (Denmark)

    Ardissino, D; Savonitto, S; Egstrup, K

    1995-01-01

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

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

    DEFF Research Database (Denmark)

    Ahlehoff, Ole; Hansen, Peter Riis

    2009-01-01

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

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

    DEFF Research Database (Denmark)

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

    1993-01-01

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

  14. 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.

  15. Unstable oscillators based hyperchaotic circuit

    DEFF Research Database (Denmark)

    Murali, K.; Tamasevicius, A.; G. Mykolaitis, A.;

    1999-01-01

    A simple 4th order hyperchaotic circuit with unstable oscillators is described. The circuit contains two negative impedance converters, two inductors, two capacitors, a linear resistor and a diode. The Lyapunov exponents are presented to confirm hyperchaotic nature of the oscillations in the circ......A simple 4th order hyperchaotic circuit with unstable oscillators is described. The circuit contains two negative impedance converters, two inductors, two capacitors, a linear resistor and a diode. The Lyapunov exponents are presented to confirm hyperchaotic nature of the oscillations...

  16. 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...

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

    Science.gov (United States)

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

    2016-06-01

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

  18. 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.

  19. Hyperchaotic system with unstable oscillators

    DEFF Research Database (Denmark)

    Murali, K.; Tamasevicius, A.; Mykolaitis, G.;

    2000-01-01

    A simple electronic system exhibiting hyperchaotic behaviour is described. The system includes two nonlinearly coupled 2nd order unstable oscillators, each composed of an LC resonance loop and an amplifier. The system is investigated by means of numerical integration of appropriate differential e...... equations, PSPICE simulations and hardware experiments. The Lyapunov exponents are presented to confirm hyperchaotic mode of the oscillations....

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

    Science.gov (United States)

    Giavarini, Alessandra; de Silva, Ranil

    2016-08-01

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

  1. Inherently Unstable Internal Gravity Waves

    CERN Document Server

    Liang, Y

    2016-01-01

    Here we show that there exist internal gravity waves that are inherently unstable, that is, they cannot exist in nature for a long time. The instability mechanism is a one-way (irreversible) harmonic-generation resonance that permanently transfers the energy of an internal wave to its higher harmonics. We show that, in fact, there are countably infinite number of such unstable waves. For the harmonic-generation resonance to take place, nonlinear terms in the free surface boundary condition play a pivotal role, and the instability does not obtain if a simplified boundary condition such as rigid lid or linear form is employed. Harmonic-generation resonance presented here also provides a mechanism for the transfer of the energy of the internal waves to the higher-frequency part of the spectrum where internal waves are more prone to breaking, hence losing energy to turbulence and heat and contributing to oceanic mixing.

  2. Angina de Ludwig. Reporte de 2 casos

    Directory of Open Access Journals (Sweden)

    Antonio Fabbio Gagliardi Lugo

    2014-10-01

    Full Text Available La angina de Ludwig (AL es una entidad patológica, odontogénica e infecciosa que representa una situación de emergencia en la Cirugía Bucal y Maxilofacial por comprometer la vida del paciente debido a una progresiva oclusión de la vía aérea, producto del avance de la infección hacia los espacios submandibulares, sublinguales y submental, lo que trae como consecuencia el colapso de la misma. En el presente trabajo se hace una revisión de la literatura actualizada acerca de dicha entidad, origen, vías de diseminación, manejo terapéutico y posibles complicaciones. Se reportan 2 casos que acuden a Emergencias del Hospital General del Oeste «Dr. José Gregorio Hernández» (HGO en Los Magallanes de Catia (Caracas, Venezuela con diagnóstico de AL. Se presenta el manejo clínico y la relevancia del rol que adquiere el cirujano maxilofacial en el diagnóstico en aras de la preservación de la vida del paciente.

  3. Pharmacological Management of Chronic Stable Angina: Focus on Ranolazine.

    Science.gov (United States)

    Rosano, Giuseppe M C; Vitale, Cristiana; Volterrani, Maurizio

    2016-08-01

    Percutaneous coronary intervention and anti-anginal medications have similar prognostic effectiveness in patients with chronic stable angina. The choice of optimal medical therapy for the management of chronic angina is of pivotal importance in patients with stable ischemic heart disease. The most commonly used anti-anginal agents have demonstrated equivalent efficacy in improving patient reported ischemic symptoms and quantitative exercise parameters. With regards to mortality, beta-blockers are beneficial only in the setting of depressed left ventricular systolic function after a recent myocardial infarction. Recent evidence suggests the lack of any benefit of beta-blockers in patients with preserved systolic function, even in the setting of prior myocardial infarction.Ranolazine is a non-haemodynamic anti-anginal agent. It is effective as adjunctive therapy in patients with chronic stable angina whose symptoms are un-adequately controlled by conventional treatment. The clinical development program of ranolazine has shown that the drug improves exercise performance, decreases angina and use of sublingual nitrates, compared to placebo. Ranolazine is well tolerated with neutral effect on haemodynamics. Besides its role in chronic stable angina, ranolazine has the potential for development in a number of other cardiovascular and non-cardiovascular conditions in the future.

  4. Insights into the pathophysiology of unstable coronary artery disease.

    Science.gov (United States)

    Kristensen, S D; Ravn, H B; Falk, E

    1997-09-01

    Coronary atherosclerosis without thrombosis is, in general, a benign disease. However, plaque disruption, or fissuring, with superimposed thrombosis, frequently complicates the course of coronary atherosclerosis. Small ruptures often remain clinically silent, whereas more extensive plaque rupture may cause the development of unstable angina, myocardial infarction, and sudden death. The risk of plaque disruption depends more on plaque type (composition) than on plaque size and stenosis severity. Major determinants of a plaque's vulnerability to rupture are: the size and consistency of the lipid-rich atheromatous core; the thickness of the fibrous cap covering the core; and ongoing inflammation and repair within the cap. Both plaque vulnerability (intrinsic disease) and rupture triggers (extrinsic forces) are important for plaque disruption. The former predisposes the plaque to rupture whereas the latter may precipitate it. The resultant thrombotic response, which is important for the clinical presentation and outcome, is portly determined by the reactivity of the circulating platelets and the balance between the fibrinolytic and coagulation systems. New ways of identification and treatment of the dangerous vulnerable plaques responsible for infarction and death, and optimization of antithrombotic treatment, are highly warranted in order to prevent and treat life-threatening coronary thrombosis.

  5. ["Persistent" angina: rationale for a metabolic approach].

    Science.gov (United States)

    Marzilli, Mario

    2004-03-01

    Despite increasing pharmacological and mechanical treatment options, ischemic heart disease continues to be associated with considerable patient mortality and morbidity. The estimates of the direct and indirect costs associated with chronic stable angina amount to billions of dollars. Given the epidemiological and economic magnitude of the problem, the need for more effective therapies is self-evident. Based on current guidelines, the management of ischemic heart disease has progressively broadened to include risk factor modification, patient education, and pharmacological therapy. The latter includes i) classic antianginal agents such as beta-blockers, calcium antagonists, and nitrates, and ii) drugs for secondary prevention, such as aspirin, clopidogrel, statins, and angiotensin-converting enzyme inhibitors. Tailoring therapy to individual needs has become even more challenging because of the marked changes in the clinical profile of patients with chronic ischemic heart disease. Compared with the past, today's patients tend to be older, to have undergone revascularization procedures, and to frequently have associated illnesses, including heart failure and diabetes. Significant progress has been made in recent years in understanding the role of cardiac energy metabolism in the pathogenesis of myocardial ischemia. A better understanding of metabolic derangements associated with ischemia and reperfusion is translating into innovative therapeutic approaches. Optimization of cardiac energy metabolism is based on promoting cardiac glucose oxidation. This has been proved to enhance cardiac function and protect myocardial tissue against ischemia-reperfusion injury. A new class of metabolic agents, known as the 3-ketoacyl coenzyme A thiolase inhibitors (trimetazidine), is able to elicit an increase in glucose and lactate combustion secondary to partial inhibition of fatty acid oxidation, producing clinical benefits in patients with ischemic heart disease.

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

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    尹瑞兴; 冯建章; 陈旦红; 乌汉东

    2000-01-01

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

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

    Institute of Scientific and Technical Information of China (English)

    尹瑞兴; 冯建章; 陈旦红; 乌汉东

    2000-01-01

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

  9. Unstable Fields in Kerr Spacetimes

    CERN Document Server

    Dotti, Gustavo; Ranea-Sandoval, Ignacio F

    2011-01-01

    We present a generalization of previous results regarding the stability under gravitational perturbations of nakedly singular super extreme Kerr spacetime and Kerr black hole interior beyond the Cauchy horizon. To do so we study solutions to the radial and angular Teukolsky's equations with different spin weights, particulary $s=\\pm 1$ representing electromagnetic perturbations, $s=\\pm 1/2$ representing a perturbation by a Dirac field and $s=0$ representing perturbations by a scalar field. By analizing the properties of radial and angular eigenvalues we prove the existence of an infinite family of unstable modes.

  10. Is Quantum Spacetime Foam Unstable?

    CERN Document Server

    Redmount, I H; Redmount, Ian H.; Suen, Wai-Mo

    1993-01-01

    A very simple wormhole geometry is considered as a model of a mode of topological fluctutation in Planck-scale spacetime foam. Quantum dynamics of the hole reduces to quantum mechanics of one variable, throat radius, and admits a WKB analysis. The hole is quantum-mechanically unstable: It has no bound states. Wormhole wave functions must eventually leak to large radii. This suggests that stability considerations along these lines may place strong constraints on the nature and even the existence of spacetime foam.

  11. High probability of disease in angina pectoris patients

    DEFF Research Database (Denmark)

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

    2007-01-01

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

  12. Inherently Unstable Internal Gravity Waves

    Science.gov (United States)

    Alam, Reza

    2016-11-01

    Here we show that there exist internal gravity waves that are inherently unstable, that is, they cannot exist in nature for a long time. The instability mechanism is a one-way (irreversible) harmonic-generation resonance that permanently transfers the energy of an internal wave to its higher harmonics. We show that, in fact, there are countably infinite number of such unstable waves. For the harmonic-generation resonance to take place, nonlinear terms in the free surface boundary condition play a pivotal role, and the instability does not obtain for a linearly-stratified fluid if a simplified boundary condition such as rigid lid or linear form is employed. Harmonic-generation resonance discussed here also provides a mechanism for the transfer of the energy of the internal waves to the higher-frequency part of the spectrum where internal waves are more prone to breaking, hence losing energy to turbulence and heat and contributing to oceanic mixing. Yong Liang (yong.liang@berkeley.edu).

  13. 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

  14. Blood blisters of the oral mucosa (angina bullosa haemorrhagica).

    Science.gov (United States)

    Deblauwe, B M; van der Waal, I

    1994-08-01

    Angina bullosa haemorrhagica is a benign phenomenon that is characterized by the sudden appearance of a blood blister on the oral mucosa in the absence of an identifiable cause or systemic disorder; local trauma has been suggested to be the most likely contributory factor. No treatment is required. Angina bullosa haemorrhagica affects mainly middle-aged and elderly people. There is no strong predilection for either men or women. In this article nine patients with such blisters are described. Blood blisters apparently are more common than has been suggested in the literature.

  15. LUDWIG’S ANGINA AND ANAESTHETIC DIFFICULTIES: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Sarda Devi

    2015-04-01

    Full Text Available Patients with deep neck infections present challenging airways for an anesthesiologist . Ludwig’s angina is potentially lethal, rapidly spreading cellulitis involving the floor of the mouth and neck. Without aggressive management it often results in life th reatening upper airway obstruction. Securing the airway remains the top priority in treatment of Ludwig’s angina. Although awake fibreoptic intubation remains the ideal method for securing the airway, but it is not available in every set up, so all feasibl e options of securing the airway should be prepared. We present a case successfully managed at our hospital with a brief review of airway management options.

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

    DEFF Research Database (Denmark)

    Egstrup, K

    1987-01-01

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

  17. The prevalence and management of angina among patients with chronic coronary artery disease across US outpatient cardiology practices: insights from the Angina Prevalence and Provider Evaluation of Angina Relief (APPEAR) study.

    Science.gov (United States)

    Kureshi, Faraz; Shafiq, Ali; Arnold, Suzanne V; Gosch, Kensey; Breeding, Tracie; Kumar, Ashwath S; Jones, Philip G; Spertus, John A

    2017-01-01

    Although eliminating angina is a primary goal in treating patients with chronic coronary artery disease (CAD), few contemporary data quantify prevalence and severity of angina across US cardiology practices. The authors hypothesized that angina among outpatients with CAD managed by US cardiologists is low and its prevalence varies by site. Among 25 US outpatient cardiology clinics enrolled in the American College of Cardiology Practice Innovation and Clinical Excellence (PINNACLE) registry, we prospectively recruited a consecutive sample of patients with chronic CAD over a 1- to 2-week period at each site between April 2013 and July 2015, irrespective of the reason for their appointment. Eligible patients had documented history of CAD (prior acute coronary syndrome, prior coronary revascularization procedure, or diagnosis of stable angina) and ≥1 prior office visit at the practice site. Angina was assessed directly from patients using the Seattle Angina Questionnaire Angina Frequency score. Among 1257 patients from 25 sites, 7.6% (n = 96) reported daily/weekly, 25.1% (n = 315) monthly, and 67.3% (n = 846) no angina. The proportion of patients with daily/weekly angina at each site ranged from 2.0% to 24.0%, but just over half (56.3%) were on ≥2 antianginal medications, with wide variability across sites (0%-100%). One-third of outpatients with chronic CAD managed by cardiologists report having angina in the prior month, and 7.6% have frequent symptoms. Among those with frequent angina, just over half were on ≥2 antianginal medications, with wide variability across sites. These findings suggest an opportunity to improve symptom control.

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

    Science.gov (United States)

    Zuchi, Cinzia; Tritto, Isabella; Ambrosio, Giuseppe

    2013-02-20

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

  19. 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.

  20. [Microvascular angina in women: a diagnostic and therapeutic challenge

    NARCIS (Netherlands)

    Elias-Smale, S.E.; Boer, M.J. de; Maas, A.H.E.M.

    2014-01-01

    Gender differences play an important role in coronary heart disease (CHD). Not only in the presentation of symptoms, but also in their underlying pathophysiology. Women with persistent angina without obstructive coronary artery disease (CAD) pose a diagnostic and therapeutic challenge. Half of these

  1. Multiple front propagation into unstable states

    CERN Document Server

    Montagne, R; Hernández-García, E; Miguel, M S

    1993-01-01

    The dynamics of transient patterns formed by front propagation in extended nonequilibrium systems is considered. Under certain circumstances, the state left behind a front propagating into an unstable homogeneous state can be an unstable periodic pattern. It is found by a numerical solution of a model of the Fr\\'eedericksz transition in nematic liquid crystals that the mechanism of decay of such periodic unstable states is the propagation of a second front which replaces the unstable pattern by a another unstable periodic state with larger wavelength. The speed of this second front and the periodicity of the new state are analytically calculated with a generalization of the marginal stability formalism suited to the study of front propagation into periodic unstable states. PACS: 47.20.Ky, 03.40.Kf, 47.54.+r

  2. [Anesthetic management of coronary artery bypass grafting for unstable angina pectoris in a patient undergoing home oxygen therapy].

    Science.gov (United States)

    Arai, Takero; Enomoto, Yoshiro; Kuno, Yuichiro; Inoue, Hisashi; Okuda, Yasuhisa

    2008-04-01

    A 70-year-old man with pneumoconiosis receiving home oxygen therapy presented with chest pain. Coronary angiogram showed severe stenosis of his left main trunks and required emergency off-pump coronary artery bypass grafting. Anesthesia was induced and maintained with propofol, fentanyl and vecuronium. The trachea was intubated and the lungs were ventilated with oxygen and air maintaining the PaO2 between 80-100 mmHg and the PaCO2 between 55-65 mmHg. The operation was performed uneventfully. In the intensive care unit, the trachea was extubated after ensuring adequate respiratory function. The postoperative course was satisfactory.

  3. Prasugrel versus clopidogrel for patients with unstable angina or non-ST-segment elevation myocardial infarction with or without angiography

    DEFF Research Database (Denmark)

    Wiviott, Stephen D; White, Harvey D; Ohman, E Magnus

    2013-01-01

    Treatment with prasugrel and aspirin improves outcomes compared with clopidogrel and aspirin for patients with acute coronary syndrome who have had angiography and percutaneous coronary intervention; however, no clear benefit has been shown for patients managed first with drugs only. We assessed...

  4. Prediction of clinical outcome by myocardial CT perfusion in patients with low-risk unstable angina pectoris

    DEFF Research Database (Denmark)

    Linde, Jesper J; Sørgaard, Mathias; Kühl, Jørgen T

    2017-01-01

    The prognostic implications of myocardial computed tomography perfusion (CTP) analyses are unknown. In this sub-study to the CATCH-trial we evaluate the ability of adenosine stress CTP findings to predict mid-term major adverse cardiac events (MACE). In 240 patients with acute-onset chest pain, y...

  5. Influence of Lipid Transport System Gene Polymorphism on the Dyslipidemia and Coronary Lesions in Patients with Unstable Angina

    Directory of Open Access Journals (Sweden)

    Aziz S. Eshpulatov

    2015-12-01

    Full Text Available The purpose of this study was to identify the features of lipid metabolism and coronary lesions in view of the combined carrier of the ε4 allele of APOE ε2/ε3/ε4 polymorphism and the S2 allele of APOC3SstI polymorphism in UA patients. Materials and Methods: The study included 141 Uzbek patients with UA class IIB (Braunwald E. et al., 1989 who had coronary atherosclerosis of varying degrees, according to coronary angiography. The control group consisted of 50 healthy, age-matched, randomly selected Uzbek persons without clinical and instrumental signs of CHD according to the exercise test. Coronary angiography was performed using Allura CV-20 (Philips, Netherlands. Genotyping of the APOE (ε2/ε3/ε4 gene polymorphism and the APOC3 (SstI gene polymorphism was performed by the PCR-RFLP method. Results: Our analysis revealed a significant prevalence of carriers of the S2 allele of APOC3SstI polymorphism and carriers of the ε4 allele of APOE ε2/ε3/ε4 polymorphism among UA patients compared to healthy ethnic Uzbeks. A combination of these two “damaging” alleles was observed in 26.2% of UA patients, which was accompanied by significantly higher blood levels of TC and LDL-C (P<0.05, a higher APOB/APOAI ratio (P<0.05, and a lower level of HDL-C (P<0.05. According to coronary angiography, a three-vessel lesion and more significantly predominated among these UA patients (OR: 2.25, 95% CI: 1.05-4.84, χ2=3.66, p<0.05.

  6. Frequent sampling by clear venipuncture in unstable angina is a reliable method to assess haemostatic system activity

    NARCIS (Netherlands)

    Biasucci, L.M.; Liuzzo, G.; Caligiuri, G.; Monaco, C.; Quaranta, G.; Sperti, G.; Greef, W. van de; Maseri, A.; Kluft, C.

    1994-01-01

    Sudden limitations in coronary flow account for the majority of cases of UA. Measurement of TAT in peripheral blood represent a reliable marker of an ongoing thrombotic process. The aim of the study was to assess the reliability of frequent blood sampling (Phase A) and to correlate TAT fluctuation t

  7. 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

  8. 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

    primary goal of this study is to determine HRV relationship with other prognostic markers in unstable angina patients. Materials and methods: We studied prospectively patients with diagnosis of unstable angina. We considered predictors of cardiovascular risk (unresponsive rest angina, hipotension, heart failure, dynamic ST changes, ejection fraction less than 40% and angiographic features (2 or more vessels, conforming two groups, high risk and low risk. In every patient was made a 5 minute electrocardiographic recording and we analysed HRV variables in time domain and frequency domain. All this variables were compared between both groups Results: We included 63 patients (44 males, 70% with mean age 63 + 10.4 years old (35-90; 46 were considered of high risk because dynamic ST changes and depressed ejection fraction and the remaining 17 were considered at low risk. In the first group, total spectral power was statistically different (p=0.04 compared with low-risk group. Low frequency band (LF was also different but without statistic significance (p=0.07 and other variables like SDNN, NN5 0 and low frequency showed only a trend to be less in the high-risk group. Conclusion: Clinical high-risk patients with unstable angina have low HRV variables. This feature could be predictive of poor survival in follow-up prospective studies.

  9. Predicting prognosis in stable angina--results from the Euro heart survey of stable angina: prospective observational study.

    NARCIS (Netherlands)

    Daly, C.A.; Stavola, B. De; Lopez Sendon, J.L.; Tavazzi, L.; Boersma, E.; Clemens, F.; Danchin, N.; Delahaye, F.; Gitt, A.; Julian, D.; Mulcahy, D.; Ruzyllo, W.; Thygesen, K.; Verheugt, F.W.A.; Fox, K.M.

    2006-01-01

    OBJECTIVES: To investigate the prognosis associated with stable angina in a contemporary population as seen in clinical practice, to identify the key prognostic features, and from this to construct a simple score to assist risk prediction. DESIGN: Prospective observational cohort study. SETTING: Pan

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

    Science.gov (United States)

    1996-12-01

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

  11. Osteoporosis in unstable adult scoliosis

    Energy Technology Data Exchange (ETDEWEB)

    Velis, K.P.; Healey, J.H.; Schneider, R.

    1988-12-01

    New noninvasive techniques as well as conventional methods were used to evaluate skeletal mass in the following three populations of adult white women as follows: (1) 79 subjects with preexisting idiopathic scoliosis designated as unstable (US) because of the associated presence in the lumbar spine of lateral spondylolisthesis with segmental instability; (2) 67 subjects with preexisting idiopathic scoliosis without lateral spondylolisthesis designated as stable (SS); and (3) 248 age-matched nonscoliotic controls. Ages in all three groups were categorized into premenopausal (25-44 years), perimenopausal (45-54 years), and postmenopausal (55-84 years). The results showed higher scoliosis morbidity in the US compared to the SS populations. The prevalence and severity of osteoporosis were markedly increased in US versus SS populations. Femoral neck density determined by dual-photon absorptiometry techniques averaged 26% to 48% lower in all age categories of US patients compared to controls. These changes were found in the youngest age groups, indicating reductions in bone mineral content earlier in the adult life of white women with a specific type of high-morbidity US characterized by the marker of lateral spondylolisthesis.

  12. The clinical characteristics and investigations planned in patients with stable angina presenting to cardiologists in Europe: from the Euro Heart Survey of Stable Angina.

    NARCIS (Netherlands)

    Daly, C.A.; Clemens, F.; Lopez-Sendon, J.; Tavazzi, L.; Boersma, E.; Danchin, N.; Delahaye, F.; Gitt, A.; Julian, D.; Mulcahy, D.; Ruzyllo, W.; Thygesen, K.; Verheugt, F.W.A.; Fox, K.M.

    2005-01-01

    AIMS: The Euro Heart Survey of Stable Angina set out to prospectively study the presentation and management of patients with stable angina as first seen by a cardiologist in Europe, with particular reference to adherence to existing guidelines and regional variability in patient presentation and ini

  13. 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 ...

  14. Electromagnetic Radiation Originating from Unstable Electron Oscillations

    DEFF Research Database (Denmark)

    Juul Rasmussen, Jens; Pécseli, Hans

    1975-01-01

    Electromagnetic oscillations in the range 300 – 700 MHz were observed from an unmagnetized argon discharge with an unstable electron velocity distribution function.......Electromagnetic oscillations in the range 300 – 700 MHz were observed from an unmagnetized argon discharge with an unstable electron velocity distribution function....

  15. Rheology of unstable mineral emulsions

    Directory of Open Access Journals (Sweden)

    Sokolović Dunja S.

    2013-01-01

    Full Text Available In this paper, the rheology of mineral oils and their unstable water emulsion were investigated. The oil samples were domestic crude oil UA, its fractions UA1, UA4 and blend semi-product UP1, while the concentration of oil in water emulsions was in the range from 1 up to 30%. The results were analyzed based on shear stress. The oil samples UA, UA1 and UP1 are Newtonian fluids, while UA4 is pseudoplastic fluid. The samples UA and UA4 show higher value of shear stress (83.75 Pa, 297 Pa, then other two samples UA1 and UP1 (18.41 Pa, 17.52 Pa. Rheology of investigated oils due to its complex chemical composition should be analyzed as a simultaneous effect of all their components. Therefore, structural composition of the oils was determined, namely content of paraffins, naphthenes, aromatics and asphaltenes. All samples contain paraffins, naphthenes and aromatics but only oils UA and UA4 contain asphaltenes as well. All investigated emulsions except 30% EUA4 are Newtonian fluids. The EUA4 30% emulsion shows pseudoplastic behaviour, and it is the only 30% emulsion among investigated ones that achieves lower shear stress then its oil. The characteristics of oil samples that could have an influence on their properties and their emulsion rheology, were determined. These characteristics are: neutralization number, interfacial tension, dielectric constant, and emulsivity. Oil samples UA and UA4 have significantly higher values of neutralization number, dielectric constants, and emulsivity. The sample UA has the lowest value of interface tension and the greatest emulsivity, indicating that this oil, among all investigated, has the highest preference for building emulsion. This could be the reason why 20% and 30% emulsions of the oil UA achieve the highest shear stress among all investigated emulsions.

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

    CERN Document Server

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

    2001-01-01

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

  17. Intravenous nitroglycerin for rest angina. Potential pathophysiologic mechanisms of action.

    Science.gov (United States)

    DePace, N L; Herling, I M; Kotler, M N; Hakki, A H; Spielman, S R; Segal, B L

    1982-10-01

    Twenty patients with refractory rest angina pectoris were treated with intravenously (IV) administered nitroglycerin (mean dosage, 72.4 micrograms/min; range, 15 to 226 micrograms/min). There was a considerable reduction or abolition in the number of ischemic episodes in 85% of patients without overall substantial changes in heart rate, mean arterial BP, pulmonary capillary wedge pressure (PCWP), and pulmonary arterial mean pressure. However, those patients with an initial PCWP of more than 12 mm Hg or a systolic pressure of more than 130 mm Hg had a substantial reduction in PCWP and systolic BP following IV nitroglycerin. We conclude that IV nitroglycerin may relieve rest angina by different pathophysiologic mechanisms. In some patients, IV nitroglycerin favorably altered the hemodynamic determinants of myocardial oxygen consumption. In others, however, no change in these determinants occurred, suggesting a direct effect on the coronary circulation.

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

    Science.gov (United States)

    Ong, Peter; Athanasiadis, Anastasios; Sechtem, Udo

    2016-08-01

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

  19. 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

  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 sym...

  1. Ivabradine: the evidence of its therapeutic impact in angina

    Directory of Open Access Journals (Sweden)

    Guillaume Marquis-Gravel

    2008-12-01

    Full Text Available Guillaume Marquis-Gravel, Jean-Claude TardifMontreal Heart Institute, Université de Montréal, Montreal, Quebec, CanadaIntroduction: Stable angina pectoris (SAP is a widely prevalent disease affecting 30 000 to 40 000 per million people in Europe and the US. SAP is associated with reductions in quality of life and ability to work, and increased use of healthcare resources. Ivabradine is a drug with a unique therapeutic target, the If current of the sinus node, developed for the treatment of cardiovascular diseases including SAP. It has an exclusive heart rate reducing effect, without any negative effect on left ventricular function or coronary vasodilatation.Aims: The aim of this paper is to review the evidence concerning the use of ivabradine in the treatment of SAP.Evidence review: Ivabradine is an effective antianginal and antiischemic drug, not inferior to the beta blocker atenolol and the calcium channel antagonist (CCA amlodipine. It decreases the frequency of angina attacks and increases the time to anginal symptoms during exercise. Because of its exclusive chronotropic effect, ivabradine is not associated with the typical adverse reactions associated with beta blockers or other antianginal drugs.Clinical value: Clinical evidence shows that ivabradine is a very good antiischemic and antianginal agent, being as effective as beta blockade and CCA therapy in controlling myocardial ischemia and symptoms of stable angina. Ongoing studies will determine the potential of ivabradine to improve morbidity and mortality in coronary artery disease and heart failure.Key words: evidence, If current, ivabradine, outcomes, stable angina pectoris, treatment

  2. Angina treatments and prevention of cardiac events: an appraisal of the evidence.

    Science.gov (United States)

    Winchester, David E; Pepine, Carl J

    2015-12-01

    Angina pectoris is the symptomatic manifestation of transient myocardial ischaemia. At the most fundamental level, angina arises when myocardial oxygen demand exceeds the ability of the coronary circulation to provide adequate oxygen delivery to maintain normal myocardial metabolic function. In vivo, the balance of oxygen demand and delivery is a complex physiological process that can be altered by a variety of interventions. Lifestyle modification is a cornerstone of cardiovascular disease management, with or without angina. Additional pharmaceutical and physical interventions are usually applied to patients with angina. Mechanisms of action for these interventions include heart rate modulation, vascular smooth muscle relaxation, metabolic manipulation, revascularization, and others. A number of these interventions have overlapping mechanisms that target angina. Additionally, some interventions may directly or indirectly prevent or delay adverse outcomes such as myocardial infarction or death. This review summarizes current evidence for many applied ischaemia treatments documented to modify angina and comments on available evidence relating to improvement in cardiovascular outcomes.

  3. Diurnal variation in exercise responses in angina pectoris.

    Science.gov (United States)

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

    1982-01-01

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

  4. Update on ranolazine in the management of angina

    Science.gov (United States)

    Codolosa, J Nicolás; Acharjee, Subroto; Figueredo, Vincent M

    2014-01-01

    Mortality rates attributable to coronary heart disease have declined in recent years, possibly related to changes in clinical presentation patterns and use of proven secondary prevention strategies. Chronic stable angina (CSA) remains prevalent, and the goal of treatment is control of symptoms and reduction in cardiovascular events. Ranolazine is a selective inhibitor of the late sodium current in myocytes with anti-ischemic and metabolic properties. It was approved by the US Food and Drug Administration in 2006 for use in patients with CSA. Multiple, randomized, placebo-controlled trials have shown that ranolazine improves functional capacity and decreases anginal episodes in CSA patients, despite a lack of a significant hemodynamic effect. Ranolazine did not improve cardiovascular mortality or affect incidence of myocardial infarction in the MERLIN (Metabolic Efficiency with Ranolazine for Less Ischemia in Non-ST-Elevation Acute Coronary Syndrome)-TIMI (Thrombolysis In Myocardial Infarction) 36 trial, but significantly decreased the incidence of recurrent angina. More recently, ranolazine has been shown to have beneficial and potent antiarrhythmic effects, both on supraventricular and ventricular tachyarrhythmias, largely due to its inhibition of the late sodium current. Randomized controlled trials testing these effects are underway. Lastly, ranolazine appears to be cost-effective due to its ability to decrease angina-related hospitalizations and improve quality of life. PMID:25028555

  5. Sexual function in patients with chronic angina pectoris.

    Science.gov (United States)

    Kloner, Robert A; Henderson, Luana

    2013-06-01

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

  6. Cost-utility of enoxaparin compared with unfractionated heparin in unstable coronary artery disease

    Directory of Open Access Journals (Sweden)

    Milne Ruairidh

    2001-10-01

    Full Text Available Abstract Background Low molecular weight heparins hold several advantages over unfractionated heparin including convenience of administration. Enoxaparin is one such heparin licensed in the UK for use in unstable coronary artery disease (unstable stable angina and non-Q wave myocardial infarction. In these patients, two large randomised controlled trials and their meta-analysis showed small benefits for enoxaparin over unfractionated heparin at 30–43 days and potentially at one year. We found no relevant published full economic evaluations, only cost studies, one of which was conducted in the UK. The other studies, from the US, Canada and France, are difficult to interpret since their resource use and costs may not reflect UK practice. Methods We aimed to compare the benefits and costs of short-term treatment (two to eight days with enoxaparin and unfractionated heparin in unstable coronary artery disease. We used published data sources to estimate the incremental cost per quality adjusted life year (QALY, adopting a NHS perspective and using 1998 prices. Results The base case was a 0.013 QALY gain and net cost saving of £317 per person treated with enoxaparin instead of unfractionated heparin. All but one sensitivity analysis showed net savings and QALY gains, the exception (the worst case being a cost per QALY of £3,305. Best cases were a £495 saving and 0.013 QALY gain, or a £317 saving and 0.014 QALY gain per person. Conclusions Enoxaparin appears cost saving compared with unfractionated heparin in patients with unstable coronary artery disease. However, cost implications depend on local revascularisation practice.

  7. Predicting prognosis in stable angina - results from the Euro heart survey of stable angina: prospective observational study

    DEFF Research Database (Denmark)

    Daly, Caroline A.; De Stavola, Bianca; Sendon, Jose L. Lopez

    2006-01-01

    -European survey in 156 outpatient cardiology clinics. Participants 3031 patients were included on the basis of a new clinical diagnosis by a cardiologist of stable angina with follow-up at one year. Main outcome measure Death or non-fatal myocardial infarction. Results The rate of death and non-fatal myocardial...... of outcome to estimate the probability of death or myocardial infarction within one year of presentation with stable angina. Conclusions A score based on the presence of simple, objective clinical and investigative variables makes it possible to discriminate effectively between very low risk and very high...... risk patients and to estimate the probability of death or non-fatal myocardial infarction over one year....

  8. Magnetic Black Holes Are Also Unstable

    CERN Document Server

    Kim, Sang Pyo

    2004-01-01

    Most black holes are known to be unstable to emitting Hawking radiation (in asymptotically flat spacetime). If the black holes are non-extreme, they have positive temperature and emit thermally. If they are extremal rotating black holes, they still spontaneously emit particles like gravitons and photons. If they are extremal electrically charged black holes, they are unstable to emitting electrons or positrons. The only exception would be extreme magnetically charged black holes if there do not exist any magnetic monopoles for them to emit. However, here we show that even in this case, vacuum polarization causes all magnetic black holes to be unstable to emitting smaller magnetic black holes.

  9. Bisphosphonate-related osteonecrosis of the jaw complicated by Ludwig's angina.

    Science.gov (United States)

    Yang, Rong-Hsin; Shen, Shu-Huei; Li, Wing-Yin; Chu, Yum-Kung

    2015-01-01

    Ludwig's angina is a life-threatening cellulitis that involves the submandibular and sublingual spaces. It often occurs after an infection of the roots of the teeth. However, modern dental care and use of antibiotics for oral infections have made Ludwig's angina rare. We present here a cancer patient exhibiting the sequential features of bisphosphonate related osteonecrosis of the jaw on bone scan complicating with Ludwig's angina. This report highlights the need for medical practitioners to be alert to these rare combinations in the compromised patient after bisphosphonate therapy. To the best of our knowledge, no case of Ludwig's angina secondary to osteonecrosis of the jaw has been reported.

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

    Science.gov (United States)

    Xu, Mingzhu; Yang, Xiangjun

    2015-01-01

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

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

    Science.gov (United States)

    Droste, C

    1988-01-01

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

  12. Unstable attractors induce perpetual synchronization and desynchronization.

    Science.gov (United States)

    Timme, Marc; Wolf, Fred; Geisel, Theo

    2003-03-01

    Common experience suggests that attracting invariant sets in nonlinear dynamical systems are generally stable. Contrary to this intuition, we present a dynamical system, a network of pulse-coupled oscillators, in which unstable attractors arise naturally. From random initial conditions, groups of synchronized oscillators (clusters) are formed that send pulses alternately, resulting in a periodic dynamics of the network. Under the influence of arbitrarily weak noise, this synchronization is followed by a desynchronization of clusters, a phenomenon induced by attractors that are unstable. Perpetual synchronization and desynchronization lead to a switching among attractors. This is explained by the geometrical fact, that these unstable attractors are surrounded by basins of attraction of other attractors, whereas the full measure of their own basin is located remote from the attractor. Unstable attractors do not only exist in these systems, but moreover dominate the dynamics for large networks and a wide range of parameters.

  13. Wavefunction Intensity Statistics from Unstable Periodic Orbits

    CERN Document Server

    Kaplan, L

    1998-01-01

    We examine the effect of short unstable periodic orbits on wavefunction statistics in a classically chaotic system, and find that the tail of the wavefunction intensity distribution in phase space is dominated by scarring associated with the least unstable periodic orbits. In an ensemble average over systems with classical orbits of different instabilities, a power law tail is found, in sharp contrast to the exponential prediction of random matrix theory. The calculations are compared with numerical data and quantitative agreement is obtained

  14. 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.

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

    NARCIS (Netherlands)

    Daly, C.A.; Clemens, F.; Lopez Sendon, J.L.; Tavazzi, L.; Boersma, E.; Danchin, N.; Delahaye, F.; Gitt, A.; Julian, D.; Mulcahy, D.; Ruzyllo, W.; Thygesen, K.; Verheugt, F.W.A.; Fox, K.M.

    2006-01-01

    BACKGROUND: We sought to examine the impact of gender on the investigation and subsequent management of stable angina and to assess gender differences in clinical outcome at 1 year. METHODS AND RESULTS: The Euro Heart Survey of Stable Angina enrolled patients with a clinical diagnosis of stable angi

  16. 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

  17. Muscle Fibre Types, Ubiquinone Content and Exercise Capacity in Hypertension and Effort Angina

    DEFF Research Database (Denmark)

    Karlsson, Jan; Diamant, Bertil; Folkers, Karl;

    1991-01-01

    Farmakologi, hypertension, IHD, skeletal muscle fibre composition, muscle coenzyme Q10, ischaemic heart disease, effort angina, muscle fibre lesion, muscle ubiquinone......Farmakologi, hypertension, IHD, skeletal muscle fibre composition, muscle coenzyme Q10, ischaemic heart disease, effort angina, muscle fibre lesion, muscle ubiquinone...

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  19. Necrotizing fasciitis in association with Ludwig’s angina – A case report

    OpenAIRE

    Kavarodi, A.M.

    2011-01-01

    A 28 year old male diabetic patient developed Ludwig’s angina which subsequently evolved into cervicofacial necrotizing fasciitis. The differential characteristic of Ludwig’s angina and cervicofacial necrotizing fasciitis, as it relates to this rare presentation is discussed. The clinical and radiological features, pathophysiology, diagnosis and the management that resulted in a successful outcome are presented.

  20. Necrotizing fasciitis in association with Ludwig’s angina – A case report

    Science.gov (United States)

    Kavarodi, A.M.

    2011-01-01

    A 28 year old male diabetic patient developed Ludwig’s angina which subsequently evolved into cervicofacial necrotizing fasciitis. The differential characteristic of Ludwig’s angina and cervicofacial necrotizing fasciitis, as it relates to this rare presentation is discussed. The clinical and radiological features, pathophysiology, diagnosis and the management that resulted in a successful outcome are presented. PMID:24151421

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

    Science.gov (United States)

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

    1983-05-01

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

  2. Changes in multifractal properties for stable angina pectoris

    Science.gov (United States)

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

    2005-12-01

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

  3. Ivabradine: the evidence of its therapeutic impact in angina

    OpenAIRE

    Guillaume Marquis-Gravel; Jean-Claude Tardif

    2008-01-01

    Guillaume Marquis-Gravel, Jean-Claude TardifMontreal Heart Institute, Université de Montréal, Montreal, Quebec, CanadaIntroduction: Stable angina pectoris (SAP) is a widely prevalent disease affecting 30 000 to 40 000 per million people in Europe and the US. SAP is associated with reductions in quality of life and ability to work, and increased use of healthcare resources. Ivabradine is a drug with a unique therapeutic target, the If current of the sinus node, developed ...

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

    Science.gov (United States)

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

    2008-10-31

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

  5. False vacuum as an unstable state

    Science.gov (United States)

    Urbanowski, K.

    2016-11-01

    Calculations performed within the Standard Model suggest that the electroweak vacuum is unstable if MH Higgs particle). LHC discovery of the Higgs boson indicates that MH ≃ 125 GeV. So the vacuum in our Universe may be unstable. We analyze properties of unstable vacuum states from the point of view of the quantum theory. At asymptotically late times the survival probability as a function of time t has an inverse power-like form. We show that at this time region the energy of the false vacuum states tends to the energy of the true vacuum state as 1/t2 for t → ∞. This means that the energy density in the unstable vacuum state should have analogous properties and hence the cosmological constant Λ = Λ(t) too. So Λ in the Universe with the unstable vacuum should have a form of the sum of the "bare" cosmological constant and of the term of a type 1/t^2:Λ (t) ≡ Λbare + d/t^2, (where Λbare is the cosmological constant for the Universe with the true vacuum).

  6. Unstable solar lentigo: A defined separate entity.

    Science.gov (United States)

    Byrom, Lisa; Barksdale, Sarah; Weedon, David; Muir, Jim

    2016-08-01

    An unstable solar lentigo is a solar lentigo with areas of melanocytic hyperplasia not extending past the margin of the lesion. They are discrete, macular, pigmented lesions arising on sun-damaged skin and a subset of typical solar lentigos. Clinically they differ from usual solar lentigines in often being solitary or larger and darker than adjacent solar lentigines. These lesions are of clinical importance as they can arise in close proximity to lentigo maligna and in a single lesion there can be demonstrated changes of solar lentigo, unstable solar lentigo and lentigo maligna. These observations led us to conjecture that unstable solar lentigos could be a precursor lesion to lentigo maligna. In this article we examine the possibility that lentigo maligna can arise within a solar lentigo through an intermediate lesion, the unstable solar lentigo. We propose that the histopathological recognition of this entity will allow for future research into its behaviour and thus management. We review difficulties in the diagnosis of single cell predominant melanocytic proliferations and the concept of unstable lentigo in view of the literature and clinical experience supporting the proposal of its recognition as a separate entity.

  7. Chaos, Order Statistics and Unstable Periodic Orbits

    CERN Document Server

    Valsakumar, M C; Kanmani, S

    1999-01-01

    We present a new method for locating unstable periodic points of one dimensional chaotic maps. This method is based on order statistics. The densities of various maxima of the iterates are discontinuous exactly at unstable periodic points of the map. This is illustrated using logistic map where densities corresponding to a small number of iterates have been obtained in closed form. This technique can be applied to the class of continuous time systems where the successive maxima of the time series behave as if they were generated from a unimodal map. This is demonstrated using Lorenz model.

  8. 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.

  9. 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.

  10. [Significance of the fusospirillum complex (Plaut-Vincent angina)].

    Science.gov (United States)

    Van Cauwenberge, P

    1976-01-01

    The results are discussed of a retrospective study of 126 patients by whom an excess of the fusospirochaetal complex was found by direct microscopic examination of tonsillar material. These bacteria are not only found in unilateral ulcero-necrotic tonsillitis, but also in different other tonsillar and general diseases. Vincent's angina appears almost exclusively in young persons, aged from 16 to 25 years; in the adolescence (16-20 years) it forms about 40% of all cases of acute tonsillitis. The fusospirochaetal complex is also often found in chronic tonsillitis and even in morfologically normal tonsils, especially in patients with general diseases like rheumatic arthritis. In one third of the patients with infectious mononucleosis, the complex is present in the tonsillar lesions. The occurrence of Vincent's angina is double as high in women than in men. From our assessments we can conclude that the fusospirochaetal complex has a very low pathogenity, and that it only can grow in patients with a reduced local or general resistance, even without causing local lesions.

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

    Science.gov (United States)

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

    1986-09-01

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

  12. Angina crónica estable. Consideraciones actuales

    Directory of Open Access Journals (Sweden)

    Yanier Coll Muñoz

    2011-03-01

    Full Text Available La angina de pecho crónica estable es un síndrome clínico caracterizado por dolor o malestar precordial secundario a isquemia miocárdica y sin características clínicas de inestabilidad. El debate actual sobre esta entidad clínica incluye tres aspectos fundamentales: diagnóstico, prevalencia e impacto socioeconómico, y tratamiento médico frente a revascularización miocárdica. En los últimos cuatro años se han dado a conocer los resultados de varios estudios multicéntricos de gran importancia que compararon tratamiento médico con revascularización miocárdica y cirugía de revascularización frente a intervención coronaria percutánea; además, han mejorado las técnicas de revascularización y existe abundante información sobre la eficacia de nuevos fármacos antiisquémicos. El presente trabajo tiene como objetivo hacer una revisión de los aspectos actuales más importantes relacionados con la angina de pecho estable y su tratamiento, publicados en la literatura especializada.

  13. 40 CFR 258.15 - Unstable areas.

    Science.gov (United States)

    2010-07-01

    ... determining whether an area is unstable: (1) On-site or local soil conditions that may result in significant... movements, and Karst terranes. (2) Structural components means liners, leachate collection systems, final... MSWLF unit, because of natural or man-induced events, results in the downslope transport of soil...

  14. Supersymmetric integrable scattering theories with unstable particles

    CERN Document Server

    Fring, A

    2005-01-01

    We propose scattering matrices for N=1 supersymmetric integrable quantum field theories in 1+1 dimensions which involve unstable particles in their spectra. By means of the thermodynamic Bethe ansatz we analyze the ultraviolet behaviour of some of these theories and identify the effective Virasoro central charge of the underlying conformal field theories.

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

    Science.gov (United States)

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

    2015-01-01

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

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

    DEFF Research Database (Denmark)

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

    1994-01-01

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

  17. Management of Stable Angina with Ivabradine as Safe Alternative to Patients with Myasthenia Gravis

    Directory of Open Access Journals (Sweden)

    Giuliano Ohde Dalledone

    2016-01-01

    Full Text Available Management of cardiac symptoms in myasthenia gravis (MG patients can be challenging. The aim of this report is to describe the safe use of ivabradine for stable angina in MG patients. A 48 y.o. woman, with MG diagnosis, presented stable angina. Therapies choices were reduced considering concomitant disease as well as previous and unsuccessful cardiologic managements. Ivabradine showed unexpected results. The patient presented an improvement of neurological and cardiac symptoms, bringing ivabradine as one more therapeutic option to similar patients. In this report we recommend ivabradine as an effective and safe drug for treatment of stable angina in MG patients.

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

    Science.gov (United States)

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

    2008-07-01

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

  19. Effects of acupuncture in moderate, stable angina pectoris

    DEFF Research Database (Denmark)

    Ballegaard, Søren; Pedersen, F; Pietersen, A

    1990-01-01

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

  20. 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.

  1. "Explosively growing" vortices of unstably stratified atmosphere

    Science.gov (United States)

    Onishchenko, O. G.; Horton, W.; Pokhotelov, O. A.; Fedun, V.

    2016-10-01

    A new type of "explosively growing" vortex structure is investigated theoretically in the framework of ideal fluid hydrodynamics. It is shown that vortex structures may arise in convectively unstable atmospheric layers containing background vorticity. From an exact analytical vortex solution the vertical vorticity structure and toroidal speed are derived and analyzed. The assumption that vorticity is constant with height leads to a solution that grows explosively when the flow is inviscid. The results shown are in agreement with observations and laboratory experiments

  2. Expanded complexity of unstable repeat diseases

    OpenAIRE

    Polak, Urszula; McIvor, Elizabeth; Dent, Sharon Y.R.; Wells, Robert D.; Napierala, Marek.

    2012-01-01

    Unstable Repeat Diseases (URDs) share a common mutational phenomenon of changes in the copy number of short, tandemly repeated DNA sequences. More than 20 human neurological diseases are caused by instability, predominantly expansion, of microsatellite sequences. Changes in the repeat size initiate a cascade of pathological processes, frequently characteristic of a unique disease or a small subgroup of the URDs. Understanding of both the mechanism of repeat instability and molecular consequen...

  3. The Fate of Unstable Gauge Flux Compactifications

    CERN Document Server

    Burgess, C P; Zavala, I

    2009-01-01

    Fluxes are widely used to stabilise extra dimensions, but if they arise within a non-abelian gauge sector they are often unstable. We seek the fate of this instability, focussing on the simplest examples: sphere-monopole compactifications in six dimensions. Without gravity most non-abelian monopoles are unstable, decaying into the unique stable monopole in the same topological class. We show that the same is true in Einstein-YM systems, with the geometry adjusting accordingly: a Mink(d)xS2 geometry supported by an unstable monopole relaxes to an AdS(d)xS2. For 6D supergravity, the dilaton obstructs this simple evolution, acquiring a gradient and thus breaking some of the spacetime symmetries. We argue that it is the 4D symmetries that break, and examine several endpoint candidates. Oxidising the supergravity system into a higher-dimensional Einstein-YM monopole, we use the latter to guide us to the corresponding endpoint. The result is a singular Kasner-like geometry conformal to Mink(4)xS2. The solution has ...

  4. Impact of pre-infarction angina on angiographic and echocardiographic outcomes in patients with acute ante

    Directory of Open Access Journals (Sweden)

    Ahmed El Missiri

    2016-09-01

    Conclusions: For patients suffering from a first attack of acute anterior wall STEMI, pre-infarction angina is associated with a better Killip class at presentation, better TIMI flow grade after PPCI, less incidence of TMP 0 flow grade.

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

    Science.gov (United States)

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

    1975-01-01

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

  6. 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

    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...... angina on initial assessment by a cardiologist. Baseline clinical details and cardiac investigations planned or performed within a 4-week period of the assessment were recorded, and follow-up data were collected at 1 year. A total of 3779 patients were included in the survey; 42% were female. Women were......, 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...

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

    DEFF Research Database (Denmark)

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

    2015-01-01

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

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

    NARCIS (Netherlands)

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

    1997-01-01

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

  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

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Nesto, R.W.; Phillips, R.T.; Kett, K.G.; Hill, T.; Perper, E.; Young, E.; Leland, O.S. Jr.

    1988-02-01

    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.

  11. 脑钠肽检测预测心绞痛复发的临床价值%Clinical value of BNP testing to predict recurrence of angina

    Institute of Scientific and Technical Information of China (English)

    刘建修; 杨粟毅; 邹园枚

    2015-01-01

    目的:探讨脑钠肽(BNP)检测预测心绞痛复发的临床价值。方法选取我科2011年1月至2013年1月收治的82例稳定性心绞痛患者,所有患者均随访至2014年8月,以心绞痛再发为随访终点,按照是否再发分为未再发组72例和再发组10例。比较两组患者治疗前后的BNP水平、成功治疗后的基本特点,采用受试者工作特征(ROC)曲线计算BNP成功治疗后预测心绞痛的截断值,同时预测心绞痛再发的敏感性和特异性。结果未再发组成功治疗后的BNP水平显著低于治疗前与再发组治疗后,再发组成功治疗后的BNP水平显著高于治疗前(P<0.01)。未再发组的收缩压(SBP)、舒张压(DBP)、总甘油三酯(TG)和总胆固醇(TC)水平水平明显低于再发组(P<0.05)。BNP在成功治疗后缓解期的截断值为58.20 pg/ml,其ROC曲线的敏感性为71.09%,特异性为96.97%。结论稳定性心绞痛患者在其治疗前后测定其BNP水平,对于预测心绞痛再发有一定临床价值。%Objective To analyze the clinical value of brain natriuretic peptide (BNP) detection in predicting recurrence of angina. Methods Eighty-two patients of unstable angina in our department from January 2011 to Janu-ary 2013 were enrolled in the study. The patients were followed up to August 2014, with angina recurrence as the end of follow-up. According to the recurrence status, the patients were divided into non-recurrence group (n=72) and recur-rence group (n=10). BNP levels before and after treatment and the basic characteristics of successful treatment were compared in two groups of patients. Receiver operating characteristic (ROC) curve was used to calculate BNP cutoff value to predict angina pectoris after successful treatment and predict the sensitivity and specificity. Results BNP levels in non-recurrence group after treatment were significantly lower than those before treatment, and the levels was also significantly lower than those in

  12. Angina-like chest pain: a joint medical and psychiatric investigation.

    OpenAIRE

    Colgan, S M; Schofield, P.M.; Whorwell, P. J.; Bennett, D.H.; Brooks, N H; Jones, P. E.

    1988-01-01

    Sixty three patients with chest pain typical of angina and who had normal coronary angiograms were investigated for left ventricular, oesophageal and psychiatric abnormalities. An additional 21 patients, age and sex matched, who had angina and significant coronary artery disease were also studied. Eighty six per cent of the 63 patients without evidence of coronary artery disease could be demonstrated to have a physical abnormality (left ventricular dysfunction in 35%, oesophageal disorder 51%...

  13. [Crescendo angina - an indication for surgery: A short literature survey and a discussion of three cases].

    Science.gov (United States)

    Meyer, J M; Kleynhans, P H; Hugo, J M; Verwoerd, C A; Steyn, J G

    1980-08-01

    A definition of crescendo angina is given, followed by a short discussion of the literature on this disease. A case of a patient treated surgically for crescendo angina is reported, and the angiograms of 2 other patients are reviewed to further illustrate the problem. The favourable postoperative course of the patients who underwent an operation for this life-threatening disease is a strong indication for this mode of treatment.

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

    Science.gov (United States)

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

    2011-01-01

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

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

    DEFF Research Database (Denmark)

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

    1994-01-01

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

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

    Directory of Open Access Journals (Sweden)

    I. M. Sokolov

    2011-01-01

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

  17. Antianginal Efficacy of Ivabradine/Metoprolol Combination in Patients With Stable Angina.

    Science.gov (United States)

    Zarifis, John; Kallistratos, Manolis; Katsivas, Apostolos

    2016-12-01

    Medical treatment is the main clinical strategy for controlling patients with chronic stable angina and improving their quality of life (QoL). Ivabradine treatment on top of metoprolol decreases angina symptoms and improves QoL in patients with stable angina and coronary artery disease (CAD). This is a post hoc analysis (636 CAD patients given ivabradine/metoprolol free combination) of a prospective, noninterventional study that included 2403 patients with CAD and stable angina. Data were recorded at baseline at 1 and 4 months after inclusion. Patient QoL was assessed using the EQ-5D questionnaire. From baseline to study completion; ivabradine administration on top of metoprolol decreased heart rate (HR) from 80.8 ± 9.6 to 64.2 ± 6.2 bpm (P Ivabradine combined with metoprolol significantly decreased angina symptoms and use of nitroglycerin in patients with stable angina and CAD, leading to improved QoL. The benefits observed with this combination explain the high rate of adherence to treatment.

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

    DEFF Research Database (Denmark)

    Savonitto, S; Ardissiono, D; Egstrup, K

    1996-01-01

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

  19. Crisis-induced unstable dimension variability in a dynamical system

    Energy Technology Data Exchange (ETDEWEB)

    Kubo, Geraldo T. [Departamento de Fisica, Universidade Federal do Parana, 81531-990, Curitiba, Parana (Brazil); Viana, Ricardo L. [Departamento de Fisica, Universidade Federal do Parana, 81531-990, Curitiba, Parana (Brazil)], E-mail: viana@fisica.ufpr.br; Lopes, Sergio R. [Departamento de Fisica, Universidade Federal do Parana, 81531-990, Curitiba, Parana (Brazil); Grebogi, Celso [Department of Physics, King' s College, University of Aberdeen, Aberdeen AB24 3UE (United Kingdom)

    2008-08-18

    Unstable dimension variability is an extreme form of non-hyperbolic behavior in chaotic systems whose attractors have periodic orbits with a different number of unstable directions. We propose a new mechanism for the onset of unstable dimension variability based on an interior crisis, or a collision between a chaotic attractor and an unstable periodic orbit. We give a physical example by considering a high-dimensional dissipative physical system driven by impulsive periodic forcing.

  20. Acute coronary syndrome

    Science.gov (United States)

    ... infarction - ACS; Unstable angina - ACS; Accelerating angina - ACS; Angina - unstable-ACS; Progressive angina ... a blood clot, treat high blood pressure or angina, relieve chest pain, and stabilize your heart. Angioplasty . This procedure ...

  1. The fate of unstable gauge flux compactifications

    Energy Technology Data Exchange (ETDEWEB)

    Burgess, C.P. [McMaster Univ., Hamilton, ON (Canada). Dept. of Physics and Astronomy]|[Perimeter Institute for Theoretical Physics, Waterloo, ON (Canada); Parameswaran, S.L. [Hamburg Univ. (Germany). 2. Inst. fuer Theoretische Physik; Zavala, I. [Bonn Univ. (Germany). Bethe Center for Theoretical Physics and Physikalisches Inst.

    2008-12-15

    Fluxes are widely used to stabilise extra dimensions, but the supporting monopolelike configurations are often unstable, particularly if they arise as gauge flux within a non-abelian gauge sector. We here seek the endpoint geometries to which this instability leads, focussing on the simplest concrete examples: sphere-monopole compactifications in six dimensions. Without gravity most monopoles in non-abelian gauge groups are unstable, decaying into the unique stable monopole in the same topological class. We show that the same is true in Einstein-YM systems, with the new twist that the decay leads to a shrinkage in the size of the extra dimensions and curves the non-compact directions: in D dimensions a Mink{sub D-2} x S{sub 2} geometry supported by an unstable monopole relaxes to AdS{sub D-2} x S{sub 2}, with the endpoint sphere smaller than the initial one. For supergravity the situation is more complicated because the dilaton obstructs such a simple evolution. The endpoint instead acquires a dilaton gradient, thereby breaking some of the spacetime symmetries. For 6D supergravity we argue that it is the 4D symmetries that break, and examine several candidates for the endpoint geometry. By using the trick of dimensional oxidation it is possible to recast the supergravity system as a higher-dimensional Einstein-YM monopole, allowing understanding of this system to guide us to the corresponding endpoint. The result is a Kasner-like geometry conformal to Mink{sub 4} times S{sub 2}, with nontrivial conformal factor and dilaton breaking the maximal 4D symmetry and generating a singularity. Yet the resulting configuration has a lower potential energy than did the initial one, and is perturbatively stable, making it a sensible candidate endpoint for the evolution. (orig.)

  2. Unstable Jefferson fractures: Results of transoral osteosynthesis

    Directory of Open Access Journals (Sweden)

    Yong Hu

    2014-01-01

    Full Text Available Background: Majority of C 1 fractures can be effectively treated conservatively by immobilization or traction unless there is an injury to the transverse ligament. Conservative treatment usually involves a long period of immobilization in a halo-vest. Surgical intervention generally involves fusion, eliminating the motion of the upper cervical spine. We describe the treatment of unstable Jefferson fractures designed to avoid these problems of both conservative and invasive methods. Materials and Methods: A retrospective review of 12 patients with unstable Jefferson fractures treated with transoral osteosynthesis of C 1 between July 2008 and December 2011 was performed. A steel plate and C 1 lateral mass screw fixation were used to repair the unstable Jefferson fractures. Our study group included eight males and four females with an average age of 33 years (range 23-62 years. Results: Patients were followed up for an average of 16 months after surgery. Range of motion of the cervical spine was by and large physiologic: Average flexion 35° (range 28-40°, average extension 42° (range 30-48°. Lateral bending to the right and left averaged 30° and 28° respectively (range 12-36° and 14-32° respectively. The average postoperative rotation of the atlantoaxial joint, evaluated by functional computed tomography scan was 60° (range 35-72°. Total average lateral displacement of the lateral masses was 7.0 mm before surgery (range 5-12 mm, which improved to 3.5 mm after surgery (range 1-6.5 mm. The total average difference of the atlanto-dens interval in flexion and extension after surgery was 1.0 mm (range 1-3 mm. Conclusions: Transoral osteosynthesis of the anterior ring using C 1 lateral mass screws is a viable option for treating unstable Jefferson fractures, which allows maintenance of rotation at the C 1-C 2 joint and restoration of congruency of the atlanto-occipital and atlantoaxial joints.

  3. String Fluid from Unstable D-branes

    CERN Document Server

    Gibbons, G W; Yi, P; Gibbons, Gary; Hori, Kentaro; Yi, Piljin

    2001-01-01

    We consider Sen's effective action for unstable D-branes, and study its classical dynamics exactly. In the true vacuum, the Hamiltonian dynamics remains well-defined despite a vanishing action, and is that of massive relativistic string fluid of freely moving electric flux lines. The energy(tension) density equals the flux density in the local co-moving frame. Furthermore, a finite dual Lagrangian exists and is related to the Nielsen-Olesen field theory of ``dual'' strings, supplemented by a crucial constraint. We conclude with discussion on the endpoint of tachyon condensation.

  4. Cosmological constraints on unstable heavy neutrinos

    Energy Technology Data Exchange (ETDEWEB)

    Binetruy, P.; Girardi, G.; Salati, P. (Grenoble-1 Univ., 74 - Annecy (France). Lab. de Physique des Particules)

    1984-01-12

    We reconsider the evolution of the population of unstable heavy neutrinos in the early universe and we study numerically the kinetic equation describing this evolution in a wide range of masses and lifetimes. It appears that the scattering upon light matter whose contribution is usually overlooked, plays an important role. Such neutrinos can be frozen at a sizeable density and we use astrophysical information such as the present energy density of the universe and the measured solar neutrino flux to obtain upper limits on the lifetime of these particles.

  5. Emergency management of hemodynamically unstable pelvic fractures

    Institute of Scientific and Technical Information of China (English)

    ZHAO Xiao-gang

    2011-01-01

    Pelvic fractures are serious injuries.Death within 24 hours is most often a result of acute blood loss.The emergency management of these patients is challenging and controversial.The key issues in its management are identifying the site(s) of hemorrhage and then controlling the bleeding.Management of hemodynamically unstable patients with pelvic fracture requires a multidisciplinary team.The issues addressed in this management algorithm are diagnostic evaluation,damage control resuscitation,indications for noninvasive pelvic stabilization,preperitoneal pelvic packing and the critical decisions concerning surgical options and angiography.This review article focuses on the recent body of knowledge on those determinations.

  6. Starting up unstable multivariable controllers safety

    DEFF Research Database (Denmark)

    Stoustrup, J.; Niemann, Hans Henrik

    The problem of superimposing a multivariable controller on a running plant is considered. A simple but effective controller architecture is suggested which allows the transition from a conventional controller to a full multivariable controller to take place in a continuous way. This architecture...... allows for unstable controllers to be handled in a reliable way. Moreover, bandwidth properties can be tuned separately. It is shown how this architecture can be extended to provide a useful tool to implement gain scheduled controllers in the same fashion....

  7. Boundary between stable and unstable regimes of accretion. Ordered and chaotic unstable regimes

    Science.gov (United States)

    Blinova, A. A.; Romanova, M. M.; Lovelace, R. V. E.

    2016-07-01

    We present a new study of the Rayleigh-Taylor unstable regime of accretion on to rotating magnetized stars in a set of high grid resolution three-dimensional magnetohydrodynamic simulations performed in low-viscosity discs. We find that the boundary between the stable and unstable regimes is determined almost entirely by the fastness parameter ωs = Ω⋆/ΩK(rm), where Ω⋆ is the angular velocity of the star and ΩK(rm) is the angular velocity of the Keplerian disc at the disc-magnetosphere boundary r = rm. We found that accretion is unstable if ωs ≲ 0.6. Accretion through instabilities is present in stars with different magnetospheric sizes. However, only in stars with relatively small magnetospheres, rm/R⋆ ≲ 7, do the unstable tongues produce chaotic hotspots on the stellar surface and irregular light curves. At even smaller values of the fastness parameter, ωs ≲ 0.45, multiple irregular tongues merge, forming one or two ordered unstable tongues that rotate with the angular frequency of the inner disc. This transition occurs in stars with even smaller magnetospheres, rm/R⋆ ≲ 4.2. Most of our simulations were performed at a small tilt of the dipole magnetosphere, Θ = 5°, and a small viscosity parameter α = 0.02. Test simulations at higher α values show that many more cases become unstable, and the light curves become even more irregular. Test simulations at larger tilts of the dipole Θ show that instability is present, however, accretion in two funnel streams dominates if Θ ≳ 15°. The results of these simulations can be applied to accreting magnetized stars with relatively small magnetospheres: Classical T Tauri stars, accreting millisecond X-ray pulsars, and cataclysmic variables.

  8. 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.

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

    NARCIS (Netherlands)

    Daly, C.A.; Clemens, F.; Lopez-Sendon, J.L.; Tavazzi, L.; Boersma, E.; Danchin, N.; Delahaye, F.; Gitt, A.; Julian, D.; Mulcahy, D.; Ruzyllo, W.; Thygesen, K.; Verheugt, F.W.A.; Fox, K.M.

    2006-01-01

    AIMS: The European Society of Cardiology published guidelines for the management of stable angina in 1997, with the objective of promoting an evidence-based approach to the condition. This study focuses on the impact of guideline compliant medical treatment on clinical outcome in patients with stabl

  10. Existence of the fifth unstable nuclide series

    Institute of Scientific and Technical Information of China (English)

    张家骅

    1996-01-01

    The production of derived nuclides by the reaction of 238U with constant nuclear reactor neutron flux for long time is theoretically described.The concentration of each derived nuclide is zero at the beginning.then increases gradually and approaches a saturated value at a certain irradiation time.The whole system(including the parent nuclide 238U and all its derived nuclides)will be in a state of equilibrium.Upon the reaction with neutron flux,the whole system decreases its concentration at the same rate as 238U.It constitutes actually a new type of unstable nuclide series which is in owrk only in the presence of reactor neutron flux.It has been found that the amount of materials consumed by neutron flux reaction is almost converted entrely to fission product.This peculiar property is quite different from the well known four radioactive series,so that it is named the fifth unstable nuclide series.

  11. Viscosity prescription for gravitationally unstable accretion disks

    CERN Document Server

    Rafikov, Roman R

    2015-01-01

    Gravitationally unstable accretion disks emerge in a variety of astrophysical contexts - giant planet formation, FU Orioni outbursts, feeding of AGNs, and the origin of Pop III stars. When a gravitationally unstable disk is unable to cool rapidly it settles into a quasi-stationary, fluctuating gravitoturbulent state, in which its Toomre Q remains close to a constant value Q_0~1. Here we develop an analytical formalism describing the evolution of such a disk, which is based on the assumptions of Q=Q_0 and local thermal equilibrium. Our approach works in the presence of additional sources of angular momentum transport (e.g. MRI), as well as external irradiation. Thermal balance dictates a unique value of the gravitoturbulent stress \\alpha_{gt} driving disk evolution, which is a function of the local surface density and angular frequency. We compare this approach with other commonly used gravitoturbulent viscosity prescriptions, which specify the explicit dependence of stress \\alpha_{gt} on Toomre Q in an ad hoc...

  12. Multiverse as an ensemble of stable and unstable Universes

    CERN Document Server

    Urbanowski, K

    2015-01-01

    Calculations performed within the Standard Model suggest that the electroweak vacuum is unstable if the mass of the Higgs particle is around 125 --- 126 GeV. Recent LHC results concerning the mass of the Higgs boson indicate that its mass is around 125.7 GeV. So it is possible that the vacuum in our Universe may be unstable. This means that it is reasonable to analyze properties of Universes with unstable vacua. We analyze properties of an ensemble of Universes with unstable vacua considered as an ensemble of unstable systems from the point of view of the quantum theory of unstable states and we try to explain why the universes with the unstable vacuum needs not decay.

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

    Institute of Scientific and Technical Information of China (English)

    徐向明; 黄运林; 钟巧媚; 黄瑞香; 何坚

    2012-01-01

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

  14. 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

  15. Value of iodine-123 metaiodobenzylguanidine scintigraphy in patients with vasospastic angina

    Energy Technology Data Exchange (ETDEWEB)

    Taki, Junichi; Nakajima, Kenichi; Matsunari, Ichiro; Takayama, Teruhiko; Tonami, Norihisa [Kanazawa Univ. School of Medicine (Japan). Dept. of Nuclear Medicine; Yasuhara, Shuichiro; Takamatsu, Tsuyoshi; Tatami, Ryozo; Ishise, Syozo [Maizuru Kyosai Hospital (Japan). Dept. of Internal Medicine

    1998-03-01

    To assess the presence and location of presynaptic myocardial sympathetic abnormality in patients with vasospastic angina, iodine-123 labelled metaiodobenzylguanidine (MIBG) single-photon emission tomography (SPET) was performed. Fifty patients suspected of having vasospastic angina pectoris were enrolled in the study. All patients underwent a provocative test with intracoronary ergonovine infusion during coronary angiography, in which 99%-100% obstructive spasm was defined as a positive result. Twenty-five patients were diagnosed as having vasospastic angina based on a positive provocative test. MIGB SPET was performed at 20 min and 3 h after administration of 111 MBq of MIBG. On early images, only 5 of 25 patients with vasospastic angina showed a mild reduction in MIBG uptake, whereas 3-h delayed images demonstrated MIBG abnormality in 20 patients (80%). The location of the MIBG abnormality was completely or partially consistent with the spastic coronary territory in 18 patients. On the other hand, only 4 of 25 patients (16%) with a negative provocative test demonstrated reduced MIBG uptake. Accordingly, positive and negative predictive values of MIBG SPET for the provocative test were 83% (20/24) and 81% (21/26) respectively. In conclusion, MIBG scintigraphy with SPET can permit the non-invasive detection and evaluation of suspected vasospastic angina. (orig.)

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

    Science.gov (United States)

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

    2014-12-20

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

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

    Science.gov (United States)

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

    2016-01-01

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

  18. Unstable Leidenfrost Drops on Roughened Surfaces

    CERN Document Server

    Boreyko, Jonathan B

    2010-01-01

    Drops placed on a surface with a temperature above the Leidenfrost point float atop an evaporative vapor layer. In this fluid dynamics video, it is shown that for roughened surfaces the Leidenfrost point depends on the drop size, which runs contrary to previous claims of size independence. The thickness of the vapor layer is known to increase with drop radius, suggesting that the surface roughness will not be able to penetrate the vapor layer for drops above a critical size. This size dependence was experimentally verified: at a given roughness and temperature, drops beneath a critical size exhibited transition boiling while drops above the critical size were in the Leidenfrost regime. These Leidenfrost drops were unstable; upon evaporation down to the critical size the vapor film suddenly collapsed.

  19. Coulomb dissociation of light unstable nuclei

    Energy Technology Data Exchange (ETDEWEB)

    Kido, Toshihiko [Japan Atomic Energy Research Inst., Tokai, Ibaraki (Japan). Tokai Research Establishment; Yabana, Kazuhiro; Suzuki, Yoshiyuki

    1997-05-01

    The aim of this study is that a simulation method applicable to the atomic nucleus with neutron halo structure developed till now is applied to a wider range unstable nucleus containing proton excess nucleus to also attribute understanding of nuclear reaction with interest in astronomical nuclear reaction. The proton dissociation energy in {sup 8}B nucleus is small value of 138 eV, which is thought to have a structure of proton at the most outer shell bound much weakly by core nucleus and spread in thinner thickness. For the coulomb excitation of such weak bound system, quantum theoretical and non-perturbational treatment is important. Therefore, 3-dimensional time-dependent Schroedinger equation on relative wave function of the core nucleus {sup 7}Be and halo proton p will be dissolved in time space and will execute a time developmental simulation. (G.K.)

  20. Effective Hamiltonians for Complexes of Unstable Particles

    CERN Document Server

    Urbanowski, K

    2014-01-01

    Effective Hamiltonians governing the time evolution in a subspace of unstable states can be found using more or less accurate approximations. A convenient tool for deriving them is the evolution equation for a subspace of state space sometime called the Krolikowski-Rzewuski (KR) equation. KR equation results from the Schr\\"{o}dinger equation for the total system under considerations. We will discuss properties of approximate effective Hamiltonians derived using KR equation for $n$--particle, two particle and for one particle subspaces. In a general case these affective Hamiltonians depend on time $t$. We show that at times much longer than times at which the exponential decay take place the real part of the exact effective Hamiltonian for the one particle subsystem (that is the instantaneous energy) tends to the minimal energy of the total system when $t \\rightarrow \\infty$ whereas the imaginary part of this effective Hamiltonian tends to the zero as $t\\rightarrow \\infty$.

  1. Pipeline modeling and assessment in unstable slopes

    Energy Technology Data Exchange (ETDEWEB)

    Caceres, Carlos Nieves [Oleoducto Central S.A., Bogota, Cundinamarca (Colombia); Ordonez, Mauricio Pereira [SOLSIN S.A.S, Bogota, Cundinamarca (Colombia)

    2010-07-01

    The OCENSA pipeline system is vulnerable to geotechnical problems such as faults, landslides or creeping slopes, which are well-known in the Andes Mountains and tropical countries like Colombia. This paper proposes a methodology to evaluate the pipe behaviour during the soil displacements of slow landslides. Three different cases of analysis are examined, according to site characteristics. The process starts with a simplified analytical model and develops into 3D finite element numerical simulations applied to the on-site geometry of soil and pipe. Case 1 should be used when the unstable site is subject to landslides impacting significant lengths of pipeline, pipeline is straight, and landslide is simple from the geotechnical perspective. Case 2 should be used when pipeline is straight and landslide is complex (creeping slopes and non-conventional stabilization solutions). Case 3 should be used if the pipeline presents vertical or horizontal bends.

  2. 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

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

    Science.gov (United States)

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

    1983-08-01

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

  4. Ludwig's angina and ketoacidosis as a first manifestation of diabetes mellitus.

    Science.gov (United States)

    Infante-Cossío, Pedro; Fernández-Hinojosa, Esteban; Mangas-Cruz, Miguel-Angel; González-Pérez, Luis-Miguel

    2010-07-01

    Ludwig's angina is a serious and rapidly progressive infectious process that spreads through the floor of the mouth and neck. In this paper we present an infrequent case of a patient who suffered an odontogenic infection with poor response to the previous treatment, which evolved towards a Ludwig's angina combined with ketoacidosis in the context of a diabetes mellitus not known before. According to the literature reviewed, this case report represents the first contribution of a Ludwig's angina and ketoacidosis as an initial manifestation of a diabetes mellitus. The airway management, the antibiotic prescription and the surgical drainage allowed the healing of the patient without medical complications. Factors of co-morbidity like the diabetes mellitus together with focus tooth of infection may eventually turn into serious medical complications as the diabetic ketoacidosis and develop potentially lethal cervical infections.

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

    DEFF Research Database (Denmark)

    Søgaard, Rikke; Sanchez, Ricardo

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

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

    Science.gov (United States)

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

    2016-04-01

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

  7. On the velocity of moving relativistic unstable quantum systems

    CERN Document Server

    Urbanowski, K

    2015-01-01

    We study properties of moving relativistic quantum unstable systems. We show that in contrast to the properties of classical particles and quantum stable objects the velocity of moving freely relativistic quantum unstable systems can not be constant in time. We show that this effect results from the fundamental principles of the quantum theory and physics: It is a consequence of the principle of conservation of energy and of the fact that the mass of the quantum unstable system is not definite.

  8. Unstable optical resonator loss calculations using the prony method.

    Science.gov (United States)

    Siegman, A E; Miller, H Y

    1970-12-01

    The eigenvalues for all the significant low-order resonant modes of an unstable optical resonator with circular mirrors are computed using an eigenvalue method called the Prony method. A general equivalence relation is also given, by means of which one can obtain the design parameters for a single-ended unstable resonator of the type usually employed in practical lasers, from the calculated or tabulated values for an equivalent symmetric or double-ended unstable resonator.

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

    Directory of Open Access Journals (Sweden)

    Schauenstein K

    1999-01-01

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

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

    DEFF Research Database (Denmark)

    Egstrup, K

    1988-01-01

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

  11. On the Velocity of Moving Relativistic Unstable Quantum Systems

    Directory of Open Access Journals (Sweden)

    K. Urbanowski

    2015-01-01

    Full Text Available We study properties of moving relativistic quantum unstable systems. We show that in contrast to the properties of classical particles and quantum stable objects the velocity of freely moving relativistic quantum unstable systems cannot be constant in time. We show that this new quantum effect results from the fundamental principles of the quantum theory and physics: it is a consequence of the principle of conservation of energy and of the fact that the mass of the quantum unstable system is not defined. This effect can affect the form of the decay law of moving relativistic quantum unstable systems.

  12. Usefulness of positive troponin-T and negative creatine kinase levels in identifying high-risk patients with unstable angina pectoris.

    Science.gov (United States)

    Pettijohn, T L; Doyle, T; Spiekerman, A M; Watson, L E; Riggs, M W; Lawrence, M E

    1997-08-15

    Troponin-T was measured in patients with chest pain and negative creatine phosphokinase-MB isoenzymes. Patients with elevated troponin-T had a significantly greater risk of cardiac events over the next 6 months than patients with normal troponin-T.

  13. The low molecule heparin treats unstable angina pectoris clinical research%低分子肝素治疗不稳定心绞痛临床研究

    Institute of Scientific and Technical Information of China (English)

    卢海崧; 曾紫英; 梁中华; 张伟华

    2005-01-01

    目的:探讨低分子肝素(速避凝)治疗不稳定型心绞痛(UAP)的疗效及安全性.方法:将116例UAP患者随机单盲分为对照组(常规治疗)和治疗组(常规治疗+低分子肝素)分别为58例.结果:4周后总有效率:治疗组为91.38%,对照组为68.97%(P<0.05);观察4周治疗组无1例发生心肌梗死,无1例死亡;对照组发生心肌梗死5例(占8.62%),死亡4例.治疗组未发生明显不良反应.结论:在常规抗凝治疗基础上加用低分子肝素能更有效的控制并预防心绞痛发作频率,并能减低心肌梗死的发生率.

  14. Management of a patient with unstable angina, left main coronary artery disease, and respiratory insufficiency due to eventration of the diaphragm.

    Science.gov (United States)

    Khanna, Surendra Nath; Paul, Mathews; Bal, Sabyasachi; Karlekar, Anil

    2013-09-01

    The incidence of eventration of diaphragm before cardiac surgery is rare. We describe the management of a patient with eventration of the diaphragm who underwent a coronary artery bypass grafting (CABG) for left main coronary artery disease followed by left diaphragm plication with video-assisted thoracic surgery (VATS) for the postoperative respiratory insufficiency.

  15. 不稳定心绞痛评估及预后的性别差异%Sex Differences in Evaluation and Outcome of Unstable Angina

    Institute of Scientific and Technical Information of China (English)

    Véronique L. Roger; Michael E. Farkouh; Susan A. Weston; Guy S. Reeder; Steven J. Jacobsen; Alan R. Zinsmeister; Barbara P. Yawn; Stephen L. Kopecky; Sherine E. Gabriel

    2001-01-01

    背景:关于心脏救治实施是否存在性别偏差目前仍有争议,对性别与心脏 救治实施,以及性别与预后的关系(在诊断程序的早期阶段,如患者因胸痛就诊时)亦知之甚 少。   目的:检验这一假设,即女性性别与发生不稳定性心绞痛时所受心 脏救治及其预后呈负相关。   设计:以人群为基础的队列研究,平均随访时间为6年。   地点:明尼苏达州Olmsted县的急诊科(Emergency departments,ED s)。   患者:1985~1992年,首次因不稳定性心绞痛而于急诊科就诊的Olm sted县居民共2 271例,其中男性1 306例,女性965例。   主要观察指标:在急诊90天内心脏操作(procedures)的使用、 总死亡率以及心脏事件( 心源性死亡、非致死性心肌梗死、非致死性心脏骤停和充血性心力衰竭)。根据性别以及卫 生保健政策研究署心血管危险水平(低、中或高)对上述指标进行分析比较。   结果:与男性相比,女性患者较为年长(P<0.001),有高血 压病史的可能性较大(P=0.001), 发生典型心绞痛的可能性较小。男性比女性更有可能接受无创性心脏检查(相对危险[RR] , 1.27;95%CI,1.14~1.40)以及创伤性心脏操作(RR,1.72;95%CI,1.51~1.97)。校 正后, 男性接受心脏操作的比率增加24%。心血管危险性处于高、中水平的男性和女性,其存活率 显著低于预期的普通人群(P<0.001)。女性患者比男性预后差。但是,经过多变量 校正 后 ,男性患者死亡危险性增加(RR,1.23;95%CI,0.99~1.54),并且心脏事件的危险也显 著增加(RR,1.21;95%CI,1.03~1.42)。   结论:这项以人群为基础的研究表明,在因不稳定心绞痛症状而于 急诊科就诊后,女性患者心脏操作的使用较少,但是校正基线特征后,男性患者的预后 较差。

  16. Intravenous injection of nicardipine changed the distribution of coronary artery endothelial shear stress and fluid dynamics in patients with unstable angina

    Institute of Scientific and Technical Information of China (English)

    CHEN Shao-liang; HU Zuo-ying; ZHANG Jun-jie; KAN Jing; XU Tian; LIU Zhi-zhong; XU Hai-mei

    2012-01-01

    Background Coronary endothelial shear stress (ESS) triggered the development of atherosclerosis.However,the effect of calcium channel antagonist on the distribution of ESS remained unclear.Methods Twenty consecutive patients with acute coronary syndrome (ACS) 48 hours after maximal medication with single left anterior descending artery stenosis <50% were studied.Nicardipine was intravenously injected at 1 μg/kg after a bolus of 10 mg in order to achieve mean blood pressure (MBP) reduced by 10% or more,or the heart rate increased by 10- 15 beats/min.Hemodynamic variables and angiogram at baseline and during injection of nicardipine were recorded,respectively.Coronary artery 3-D reconstruction was used for the analysis of ESS.Results Distal reference-vessel-diameter and minimal lumen diameter decreased significantly from (2.42±0.41) mm and (1.47±0.49) mm at baseline to (2.22±0.35) mm and (1.35±0.49) mm at maximal drug-dosage (P=0.018 and 0.020,respectively).Nicardipine did not change blood velocity.Lowest mean shear stress at segments 2-mm distal to plaque increased significantly from (0.034±0.519) Pa at baseline to (0.603±0.728) Pa (P=0.013) at peak effect of drug.Conclusions Nicardipine was associated with the constriction of diseased vessel segment that adapted to the reduction of blood pressure,without dynamic change of blood velocity at each stage of whole cardiac cycle.Increased ESS value at segments distal to plaque reflected the cardioprotection by nicardipine (ChiCTR-TRC-10000964).

  17. Long-term outcomes for women versus men with unstable angina/non-ST-segment elevation myocardial infarction managed medically without revascularization

    DEFF Research Database (Denmark)

    Clemmensen, Peter; Roe, Matthew T.; Hochman, Judith S.;

    2015-01-01

    BACKGROUND: Women with acute coronary syndromes (ACS) are less likely to undergo invasive revascularization than men, but sex-specific differences in long-term outcomes and platelet reactivity among medically managed ACS patients remain uncertain. We examined sex-specific differences in long-term...

  18. Investigation of Correlation Between Metabolism Syndrome and Unstable Angina%代谢综合征与不稳定型心绞痛相关性研究

    Institute of Scientific and Technical Information of China (English)

    王华

    2010-01-01

    目的 分析代谢综合征(MS)对不稳定型心绞痛(UA)的影响.方法 我院2005~2007年同不稳定型心绞痛患者112例,其中伴有代谢综合征者(MS组)56例.不伴有代谢综合征者(非Ms组)56例,比较2组患者临床疗效及2年内发生心肌栓死及死亡情况.结果 非MS组心绞痛发作与心绞痛持续时间较MS组明显减少(P<0.05);治疗后2组BraunWald分级的比较差异有统计学意义(P<0.05);随诊2年其发生心肌梗死及死亡例数2组间比较差异有统计学意义(P<0.05).结论 MS与UA关系密切,是UA的重要危险因素.

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

    Institute of Scientific and Technical Information of China (English)

    崔年芳; 郭杰

    2011-01-01

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

  20. Inadequate control of heart rate in patients with stable angina: results from the European heart survey.

    NARCIS (Netherlands)

    Daly, C.A.; Clemens, F.; Sendon, J.L.; Tavazzi, L.; Boersma, E.; Danchin, N.; Delahaye, F.; Gitt, A.; Julian, D.; Mulcahy, D.; Ruzyllo, W.; Thygesen, K.; Verheugt, F.W.A.; Fox, K.M.

    2010-01-01

    AIMS: To examine resting heart rate (HR) in a population presenting with stable angina in relation to prior and subsequent pharmacological treatment, comorbid conditions and clinical outcome. METHODS AND RESULTS: The European Heart Survey was a prospective, observational, cohort study of 3779 patien

  1. 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

  2. Spinal cord stimulation for refractory angina in a patient implanted with a cardioverter defibrillator.

    Science.gov (United States)

    Ferrero, Paolo; Grimaldi, Roberto; Massa, Riccardo; Chiribiri, Amedeo; De Luca, Anna; Castellano, Maddalena; Cardano, Paola; Trevi, Gian Paolo

    2007-01-01

    Spinal cord stimulation is currently used to treat refractory angina. Some concerns may arise about the possible interaction concerning the spinal cord stimulator in patients already implanted with a pacemaker or a cardioverter defibrillator. We are going to describe the successful implantation of a spinal cord stimulator in a patient previously implanted with a cardioverter defibrillator.

  3. Invasive Evaluation of Patients with Angina in the Absence of Obstructive Coronary Artery Disease

    Science.gov (United States)

    Lee, Bong-Ki; Lim, Hong-Seok; Fearon, William F.; Yong, Andy; Yamada, Ryotaro; Tanaka, Shigemitsu; Lee, David P.; Yeung, Alan C.; Tremmel, Jennifer A.

    2017-01-01

    Background More than 20% of patients presenting to the cardiac catheterization laboratory with angina have no angiographic evidence of coronary artery disease (CAD). Despite a “normal” angiogram, these patients often have persistent symptoms, recurrent hospitalizations, a poor functional status, and adverse cardiovascular outcomes, without a clear diagnosis. Methods and Results In 139 patients with angina in the absence of obstructive CAD (no diameter stenosis >50%), endothelial function was assessed, the index of microcirculatory resistance (IMR), coronary flow reserve (CFR), and fractional flow reserve (FFR) were measured, and intravascular ultrasound (IVUS) was performed. There were no complications. The average age was 54.0±11.4 years and 107 (77%) were women. All patients had at least some evidence of atherosclerosis based on IVUS examination of the LAD. Endothelial dysfunction (a decrease in luminal diameter of >20% after intracoronary acetylcholine) was present in 61 patients (44%). Microvascular impairment (an IMR ≥25) was present in 29 patients (21%). Seven patients (5%) had an FFR ≤0.80. A myocardial bridge was present in 70 patients (58%). Overall, only 32 patients (23%) had no coronary explanation for their angina, with normal endothelial function, normal coronary physiologic assessment, and no myocardial bridging. Conclusions The majority of patients with angina in the absence of obstructive CAD have occult coronary abnormalities. A comprehensive invasive assessment of these patients at the time of coronary angiography can be performed safely and provides important diagnostic information which may affect treatment and outcomes. PMID:25712205

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

    NARCIS (Netherlands)

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

    1997-01-01

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

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

    Science.gov (United States)

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

    2014-01-01

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

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

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

    Science.gov (United States)

    Fanta, S M

    2015-12-01

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

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

    NARCIS (Netherlands)

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

    1995-01-01

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

  9. 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.

  10. 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.

  11. Histopathological examination of specimens removed during directional coronary atherectomy in patients presenting with crescendo angina show mural thrombus.

    Science.gov (United States)

    Bellamy, C M; Grech, E D; Ashworth, M T; Ramsdale, D R

    1993-02-01

    Thrombus formation over a fissured coronary atheromatous plaque has been shown by post mortem histological examination to be the pathophysiological mechanism responsible for myocardial ischaemia in those patients who died following a crescendo pattern of angina. Histological examination of plaques responsible for a crescendo pattern of angina in patients who do not die has not been available until recently. We describe two patients who presented with a crescendo pattern of angina. A new technique of coronary revascularization, directional coronary atherectomy, produced symptomatic relief and resolution of myocardial ischaemia. Histological examination of material from the stenosis responsible for their myocardial ischaemia, obtained using this technique, confirmed thrombus formation overlying a fissured atheromatous plaque.

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

    DEFF Research Database (Denmark)

    Ardissino, D; Savonitto, S; Egstrup, K

    1991-01-01

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

  13. Boundary between Stable and Unstable Regimes of Accretion. Ordered and Chaotic Unstable Regimes

    CERN Document Server

    Blinova, A A; Lovelace, R V E

    2015-01-01

    We search for the boundary between stable and Rayleigh-Taylor unstable regimes of accretion to magnetized stars in a new set of high grid resolution simulations. We found that the boundary between stable and unstable regimes is mainly determined by the ratio of the corotation radius r_cor (where the Keplerian angular velocity in the disc matches the angular velocity of the star) to the magnetospheric radius r_m (where the magnetic stress in the magnetosphere matches the matter stress in the disc). Instability is stronger when r_cor is larger with respect to r_m, that is, when the gravitational force is larger than the centrifugal force at the inner disc. In the cases of a small tilt of the magnetosphere, Theta=5 deg, and a small alpha-parameter of viscosity, alpha=0.02, the boundary is located at r_cor approx. 1.4 r_m. Instability becomes stronger at higher values of viscosity, and occurs at lower values of r_cor/r_m. At higher values of Theta, the variability associated with instability decreases. Simulation...

  14. Universality classes for unstable crystal growth.

    Science.gov (United States)

    Biagi, Sofia; Misbah, Chaouqi; Politi, Paolo

    2014-06-01

    Universality has been a key concept for the classification of equilibrium critical phenomena, allowing associations among different physical processes and models. When dealing with nonequilibrium problems, however, the distinction in universality classes is not as clear and few are the examples, such as phase separation and kinetic roughening, for which universality has allowed to classify results in a general spirit. Here we focus on an out-of-equilibrium case, unstable crystal growth, lying in between phase ordering and pattern formation. We consider a well-established 2+1-dimensional family of continuum nonlinear equations for the local height h(x,t) of a crystal surface having the general form ∂_{t}h(x,t)=-∇·[j(∇h)+∇(∇^{2}h)]: j(∇h) is an arbitrary function, which is linear for small ∇h, and whose structure expresses instabilities which lead to the formation of pyramidlike structures of planar size L and height H. Our task is the choice and calculation of the quantities that can operate as critical exponents, together with the discussion of what is relevant or not to the definition of our universality class. These aims are achieved by means of a perturbative, multiscale analysis of our model, leading to phase diffusion equations whose diffusion coefficients encapsulate all relevant information on dynamics. We identify two critical exponents: (i) the coarsening exponent, n, controlling the increase in time of the typical size of the pattern, L∼t^{n}; (ii) the exponent β, controlling the increase in time of the typical slope of the pattern, M∼t^{β}, where M≈H/L. Our study reveals that there are only two different universality classes, according to the presence (n=1/3, β=0) or the absence (n=1/4, β>0) of faceting. The symmetry of the pattern, as well as the symmetry of the surface mass current j(∇h) and its precise functional form, is irrelevant. Our analysis seems to support the idea that also space dimensionality is irrelevant.

  15. Projection-free approximate balanced truncation of large unstable systems

    Science.gov (United States)

    Flinois, Thibault L. B.; Morgans, Aimee S.; Schmid, Peter J.

    2015-08-01

    In this article, we show that the projection-free, snapshot-based, balanced truncation method can be applied directly to unstable systems. We prove that even for unstable systems, the unmodified balanced proper orthogonal decomposition algorithm theoretically yields a converged transformation that balances the Gramians (including the unstable subspace). We then apply the method to a spatially developing unstable system and show that it results in reduced-order models of similar quality to the ones obtained with existing methods. Due to the unbounded growth of unstable modes, a practical restriction on the final impulse response simulation time appears, which can be adjusted depending on the desired order of the reduced-order model. Recommendations are given to further reduce the cost of the method if the system is large and to improve the performance of the method if it does not yield acceptable results in its unmodified form. Finally, the method is applied to the linearized flow around a cylinder at Re = 100 to show that it actually is able to accurately reproduce impulse responses for more realistic unstable large-scale systems in practice. The well-established approximate balanced truncation numerical framework therefore can be safely applied to unstable systems without any modifications. Additionally, balanced reduced-order models can readily be obtained even for large systems, where the computational cost of existing methods is prohibitive.

  16. Unstable g-modes in Proto-Neutron Stars

    CERN Document Server

    Ferrari, V; Pons, J A

    2007-01-01

    In this article we study the possibility that, due to non-linear couplings, unstable g-modes associated to convective motions excite stable oscillating g-modes. This problem is of particular interest, since gravitational waves emitted by a newly born proto-neutron star pulsating in its stable g-modes would be in the bandwidth of VIRGO and LIGO. Our results indicate that nonlinear saturation of unstable modes occurs at relatively low amplitudes, and therefore, even if there exists a coupling between stable and unstable modes, it does not seem to be sufficiently effective to explain, alone, the excitation of the oscillating g-modes found in hydrodynamical simulations.

  17. Unstable g-modes in proto-neutron stars

    Energy Technology Data Exchange (ETDEWEB)

    Ferrari, V [Dipartimento di Fisica ' G Marconi' , Sapienza Universita di Roma and Sezione INFN ROMA1, piazzale Aldo Moro 2, I-00185 Rome (Italy); Gualtieri, L [Dipartimento di Fisica ' G Marconi' , Sapienza Universita di Roma and Sezione INFN ROMA1, piazzale Aldo Moro 2, I-00185 Rome (Italy); Pons, J A [Departament de Fisica Aplicada, Universitat d' Alacant, Apartat de correus 99, 03080 Alacant (Spain)

    2007-10-21

    In this paper we study the possibility that, due to nonlinear couplings, unstable g-modes associated with convective motions excite stable oscillating g-modes. This problem is of particular interest, since the gravitational waves emitted by a newly born proto-neutron star pulsating in its stable g-modes would be in the bandwidth of VIRGO and LIGO. Our results indicate that the nonlinear saturation of unstable modes occurs at relatively low amplitudes, and therefore, even if there exists a coupling between the stable and unstable modes, it does not seem to be sufficiently effective to explain, alone, the excitation of the oscillating g-modes found in hydrodynamical simulations.

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

    Science.gov (United States)

    Börjesson, Mats; Andréll, Paulin; Mannheimer, Clas

    2011-11-01

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

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

    Science.gov (United States)

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

    2013-03-15

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

  1. THE UNSTABLE MODES OF NATURAL CONVECTION BOUNDARY LAYER

    Institute of Scientific and Technical Information of China (English)

    Tao Jianjun; Zhuang Fenggan; Yan Dachun

    2000-01-01

    The instability of natural convection boundary layer around a vertical heated flat plate is analyzed theoretically in this paper. The results illustrate that the “loop” in the neutral curve is not a real loop but a twist of the curve is the frequencywave number-Grashof number space, and there is only one unstable mode at small Prandtl numbers. Specially, when the Prandtl number is large enough two unstable modes will be found in the “loop” region. Along the amplifying surface intersection the two unstable modes have the same Grashof number, wave number and frequency but different amplifying rates. Their instability characteristics are analyzed and the criterion for determining the existence of the multi-unstable modes is also discussed.

  2. The effect of nonlinearity on unstable zones of Mathieu equation

    Indian Academy of Sciences (India)

    M GH SARYAZDI

    2017-03-01

    Mathieu equation is a well-known ordinary differential equation in which the excitation term appears as the non-constant coefficient. The mathematical modelling of many dynamic systems leads to Mathieu equation. The determination of the locus of unstable zone is important for the control of dynamic systems. In this paper, the stable and unstable regions of Mathieu equation are determined for three cases of linear and nonlinear equations using the homotopy perturbation method. The effect of nonlinearity is examined in the unstable zone. The results show that the transition curves of linear Mathieu equation depend on the frequency of the excitation term. However, for nonlinear equations, the curves depend also on initial conditions. In addition, increasing the amplitude of response leads to an increase in the unstable zone.

  3. Unstable dimension variability and synchronization of chaotic systems

    CERN Document Server

    Viana, R L; Viana, Ricardo L.; Grebogi, Celso

    1999-01-01

    An aspect of the synchronization dynamics is investigated in this work. We argue analytically and confirm numerically that the chaotic dynamics on the synchronization manifold exhibits unstable dimension variability. Unstable dimension variability is a cause of severe modeling difficulty for physical phenomena, since trajectories obtained from the mathematical model may not be related to trajectories of the actual system. We present and example of unstable dimension variability occurring in a system of two coupled chaotic maps, considering the dynamics in the synchronization manifold and its corresponding transversal direction, where a tongue-like structure is formed. The unstable dimension variability is revealed in the statistical distribution of the finite-time transversal Lyapunov exponent, having both negative and positive values.

  4. Absence of quantum states corresponding to unstable classical channels

    DEFF Research Database (Denmark)

    Herbst, Ira; Skibsted, Erik

    2008-01-01

    We develop a general theory of absence of quantum states corresponding to unstable classical scattering channels. We treat in detail Hamiltonians arising from symbols of degree zero in x and outline a generalization in an Appendix....

  5. TROMBO GIGANTE DE AURÍCULA DERECHA COMO CAUSA DE ANGINA Y SÍNCOPE / Giant thrombus in right atrium as a cause of angina and syncope

    OpenAIRE

    José L. Aparicio Suárez; Mario E. Nápoles Lizano; Roberto Bermúdez Yera; Jean L. Chao García; Roger Mirabal Rodríguez; Yuri Medrano Plana

    2012-01-01

    ResumenLas tumoraciones intracardíacas son poco frecuentes, y pueden ser de tipo neoplásicas y no neoplásicas. De estas últimas, los trombos, constituyen las masas más frecuentes. Se presenta un paciente joven, operado en el Cardiocentro "Ernesto Che Guevara" de Villa Clara, Cuba, con antecedentes de trastornos hematológicos desde la infancia, que comienza con episodios de disnea progresiva, angina y síncope; con diagnóstico preoperatorio de tumoración gigante en aurícula derecha que resultó ...

  6. 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.)

  7. Particle unstable nuclei in the Hartree-Fock theory

    Energy Technology Data Exchange (ETDEWEB)

    Kruppa, A.T. [Magyar Tudomanyos Akademia, Debrecen (Hungary). Atommag Kutato Intezete; Heenen, P.H. [Brussels Univ. (Belgium). Service de Physique Nucleaire Theorique; Flocard, H. [Paris-11 Univ., 91 - Orsay (France). Inst. de Physique Nucleaire; Liotta, R.J. [Manne Siegbahn Inst. of Physics, Stockholm (Sweden)

    1997-12-31

    Ground state energies and decay widths of particle unstable nuclei are calculated within the Hartree-Fock approximation by performing a complex scaling of the many-body Hamiltonian. Through this transformation, the wave functions of the resonant state become square integrable. The method is implemented with Skyrme effective interactions. Several Skyrme parametrizations are tested on four unstable nuclei: {sup 10}He, {sup 12}O, {sup 26}O and {sup 28}O. (author). 24 refs.

  8. How to define physical properties of unstable particles

    OpenAIRE

    Gegelia, J.; Scherer, S.

    2009-01-01

    In the framework of effective quantum field theory we address the definition of physical quantities characterizing unstable particles. With the aid of a one-loop calculation, we study this issue in terms of the charge and the magnetic moment of a spin-1/2 resonance. By appealing to the invariance of physical observables under field redefinitions we demonstrate that physical properties of unstable particles should be extracted from the residues at complex (double) poles of the corresponding S-...

  9. Investigation for Electromechanical Coupling Unstability of Rolling Mill

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    The unsteady condition of rolling Mill vibration that was caused by flexural vibration of strip was investigated. The parametric flexural vibration equation of rolled strip was established. The parametric flexural vibration stability of rolled strip was studied and region of stability and unstability was determined based on Floquet theory and perturbation method. The flexural-vibration of strip was unstable if the frequency of variable tension was twice as the natural frequency of flexural-vibration strip. ...

  10. Tracking unstable fixed points in parametrically dynamic systems

    Science.gov (United States)

    Mondragón, Raúl J.; Arrowsmith, David K.

    1997-02-01

    The method of Ott, Grebogi and Yorke is extended to control a two-parameter system when one of the parameters is time dependent and the other is used as the control-parameter. As one of the parameters changes, the unstable fixed point follows its branch of the bifurcation tree. We control a chaotic orbit such that it tracks this “moving” unstable fixed point using an adaptive control method.

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

    DEFF Research Database (Denmark)

    Egstrup, K

    1988-01-01

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

  12. Neutron Capture Experiments on Unstable Nuclei

    Energy Technology Data Exchange (ETDEWEB)

    Jon M. Schwantes; Ralf Sudowe; Heino Nitsche; Darleane C. Hoffman

    2003-12-16

    A primary objective of this project is to study neutron capture cross sections for various stable and unstable isotopes that will contribute to the Science Based Stockpile Stewardship (SBSS) program by providing improved data for modeling and interpretation of nuclear device performance. The information obtained will also be important in astrophysical modeling of nucleosynthesis. During this reporting period, the emphasis has been on preparing a radioactive target of {sup 155}Eu (half-life = 4.7 years), and several stable targets, including isotopically separated {sup 154}Sm, {sup 151}Eu, and {sup 153}Eu. Measurements of their neutron capture cross sections will be conducted in collaboration with researchers at the Los Alamos Neutron Science Center (LANSCE) facility using the Detector for Advanced Neutron Capture Experiments (DANCE). A suitable backing material (beryllium) for the targets has been selected after careful calculations of its contribution to the background of the measurements. In addition, a high voltage plating procedure has been developed and optimized. Stable targets of {sup 151}Eu and {sup 153}Eu and a target of natural Eu ({approx}50% {sup 151}Eu and {approx}50% {sup 153}Eu) have each been plated to a mass thickness of >1 mg/cm{sup 2} and delivered to the DANCE collaboration at Los Alamos National Laboratory (LANL). Natural Eu targets will be tested first to confirm that the target dimensions and backing are appropriate prior to performing measurements on the extremely valuable targets of separated isotopes. In order to prepare a target of the radioactive {sup 155}Eu, it must first be separated from the {sup 154}Sm target material that was irradiated in a very high neutron flux of 1.5x1015 neutrons/cm{sup 2}/s for 50 days. The reaction is {sup 154}Sm (n,f){sup 155}Sm (half-life = 22 minutes) {sup 155}Eu. Considerable progress has been made in developing a suitable high-yield and high-purity separation method for separating Eu from targets

  13. Randomized double-blind comparison of metoprolol, nifedipine, and their combination in chronic stable angina

    DEFF Research Database (Denmark)

    Egstrup, K

    1988-01-01

    In a randomized double-blind study, treatment with either metoprolol, nifedipine, or their combination was compared for effects on ischemic variables and heart rate obtained during ambulatory monitoring in 42 patients with chronic stable angina. All patients had severe chronic stable angina...... of at least 6 months' duration despite medical treatment, and exhibited coronary artery stenosis of 75% in one or more coronary arteries. Metoprolol reduced the frequency of total (p less than 0.01) and asymptomatic ischemic episodes (p less than 0.05), the duration of ischemia (p less than 0.......05), and the ischemic burden (p less than 0.05), which contrasted to the lack of any similar significant effect during nifedipine monotherapy. During combination therapy, there was a tendency to further improvement, which did not reach statistical significance compared with metoprolol monotherapy. Heart rate...

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

    Science.gov (United States)

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

    2016-01-01

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

  15. 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.

  16. Percutaneous Device to Narrow the Coronary Sinus: Shifting Paradigm in the Treatment of Refractory Angina?

    Directory of Open Access Journals (Sweden)

    Daniela Benedetto

    2016-10-01

    Full Text Available Refractory angina pectoris is defined as a chronic debilitating condition characterized by the presence of chronic anginal symptoms due to a severe obstructive and/or diffuse coronary artery disease that cannot be controlled by the combination of medical therapy and / or revascularization (percutaneous or surgical. In addition the presence of myocardial ischemia as a cause of the symptoms must have been documented. The coronary sinus Reducer (CSR is a recently introduced percutaneous device to treat patients with severe anginal symptoms refractory to optimal medical therapy and not amenable to conventional revascularization. The purpose of this review is to describe the current evidence from available studies measuring the clinical effect of the CSR implantation on the health and well-being of patients with refractory angina.

  17. The Neuromatrix Theory of Pain and Angina during Exercise Stress Testing: Results from the PIMI Study

    Science.gov (United States)

    2011-05-27

    al., 1988; Glusman et al., 1996). In these individuals, the opioid reactivity would produce stronger analgesia of pain from most inputs, including...pain thresholds in silent ischemics might generalize to other areas as well. Pain tests in areas such as the toe, finger or dental pain thresholds...induced opioid Angina and the Neuromatrix 20 analgesia . Indeed, perhaps people who genetically have greater β-endorphin reactivity to stress

  18. 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

  19. Chronic pseudo-angina left precordial chest pain caused by a thoracic meningioma

    OpenAIRE

    Azabou, Eric; Kumako, Vincent; Moussawi, Mahmoud; Berger, Colette; André-Obadia, Nathalie; Kocher, Laurence; Gonnaud, Pierre-Marie

    2013-01-01

    International audience; Left precordial chest pain (LPCP) evokes above all angina. Eliminating a cardiac origin is then always the first priority. When cardiac causes are eliminated, non-cardiac causes are sought in order to avoid leaving patients with undiagnosed or undifferentiated chest pain. There is a myriad of non-cardiac causes ranging from heartburn, panic attacks, pleurisy, pulmonary embolism, pneumothorax, Tietze syndrome, bruises and fractures of the ribs, to spine meningioma, neur...

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

    Science.gov (United States)

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

    1994-02-01

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

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

    Science.gov (United States)

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

    1989-11-01

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

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

    Science.gov (United States)

    Rømer, F K; Kornerup, H J

    1981-06-01

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

  3. Terminalia arjuna in Chronic Stable Angina: Systematic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Navjot Kaur

    2014-01-01

    Full Text Available Background. Terminalia arjuna is a popular Indian medicinal plant with its bark been used for over centuries as cardiotonic. The bark has been found to contain several bioactive compounds including saponins and flavonoids. A number of experimental and clinical studies have been conducted to explore therapeutic potential of Terminalia arjuna in cardiovascular ailments specially in patients of coronary heart disease. A number of narrative reviews have been done but no systematic review has been conducted to date. Objective. To systematically review and conduct a meta-analysis on the available literature evaluating the efficacy of Terminalia arjuna in patients of chronic stable angina. Study selection. We included randomised, pseudo-randomized and before-after comparative studies which compared Terminalia arjuna/commercial preparation of Terminalia arjuna with current standard/ conventional treatment regimens in patients with chronic stable angina. Findings. Studies were found to be of poor methodological design. We found no significant difference in the Terminalia arjuna group as compared to control arm in the outcomes for which we were able to pool data and undertake meta-analysis. Conclusions. Currently, the evidence is insufficient to draw any definite conclusions in favour of or against Terminalia arjuna in patients of chronic stable angina. Further, well-controlled multicentric clinical trials need to be conducted in large number of patients to explore the therapeutic potential of Terminalia arjuna if any.

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

    Science.gov (United States)

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

    1998-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    M. A. Popova

    2015-01-01

    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.

  8. Unstable genes unstable mind: beyond the central dogma of molecular biology.

    Science.gov (United States)

    Hegde, Mahabaleshwar V; Saraph, Arundhati A

    2011-08-01

    Schizophrenia has a polygenic mode of inheritance and an estimated heritability of over 80%, but success in understanding its genetic underpinnings to date has been modest. Unlike in trinucleotide neurodegenerative disorders, the phenomenon of genetic anticipation observed in schizophrenia or bipolar disorder has not been explained. For the first time, we provide a plausible molecular explanation of genetic anticipation and pathophysiology of schizophrenia, at least in part, with supporting evidence. We postulate that abnormally increased numbers of CAG repeats in many genes being expressed in the brain, coding for glutamine, cumulatively press for higher demand of glutamine in the respective brain cells, resulting in a metabolic crisis and dysregulation of the glutamate-glutamine cycle. This can adversely affect the functioning of both glutamate and GABA receptors, which are known to be involved in psychosis, and may also affect glutathione levels, increasing oxidative stress. The resulting psychosis (gain in function), originating from unstable genes, is described as an effect "beyond the central dogma of molecular biology". The hypothesis explains genetic anticipation, as further expansions in subsequent generations may result in increased severity and earlier occurrence. Many other well described findings provide proof of concept. This is a testable hypothesis, does not deny any known facts and opens up new avenues of research.

  9. Hysteresis and Wavenumber Vacillation in Unstable Baroclinic Flows

    Science.gov (United States)

    Chou, Shih-Hung; Goodman, H. Michael (Technical Monitor)

    2001-01-01

    Hysteresis and wavenumber vacillation are studied numerically in a weakly stratified quasigeostrophic model. In general, the amplitude of the most unstable wave increases, as the flow becomes more unstable. When the wave becomes saturated, the next longer wave will grow at the expanse of the most unstable wave and becomes the dominant wave. However, once the longwave state is established, it may remain in that regime even as the instability is decreased beyond the threshold where it first developed, thus constituting a hysteresis loop. In a highly unstable case, the flow may not show a preference for any single wave. Instead, the dominant wave aperiodically varies among several long waves. This phenomenon is known as wavenumber vacillation. Hysteresis is further examined in terms of eddy heat flux. It is shown that total eddy heat flux increases as the flow becomes more unstable, but displays a sharp drop when transition to a longer wave occurs. However, in a longwave state, the heat flux always decreases with decreasing instability even pass the threshold when wave transition first occurs.

  10. Effects of Unstable Links on AODV Performance in Real Testbeds

    Directory of Open Access Journals (Sweden)

    Borgia Eleonora

    2007-01-01

    Full Text Available A link between a pair of nodes is defined unstable if it is characterized by a packet loss which is not negligible in one or both directions. The presence of unstable links in multihop ad hoc networks is very likely and it depends on several factors (e.g., different transmission capabilities of the devices, interferences caused by additional wireless devices. Their management by the routing protocols is of paramount importance since they negatively affect applications performance. In our previous experimental studies, we found that AODV is characterized by very low performance in some specific situations and, in this work, we demonstrate that it mainly depends on the wrong management of unstable links as valid routes. We present some policies that have been proposed in literature to avoid this problem, and we validate two of them through experimental results, exploiting also a direct comparison with the proactive routing protocol OLSR. Our results show that AODV is not able to avoid the use of unstable links, even when an alternative stable route exists. In the same conditions, OLSR outperforms AODV by correctly managing unstable links. In fact, it is able to guarantee a higher packet delivery ratio to the application by using the most stable path to reach the destination.

  11. Projection-free approximate balanced truncation of large unstable systems

    CERN Document Server

    Flinois, Thibault L B; Schmid, Peter J

    2015-01-01

    In this article, we show that the projection-free, snapshot-based, balanced truncation method can be applied directly to unstable systems. We prove that even for unstable systems, the unmodified balanced proper orthogonal decomposition algorithm theoretically yields a converged transformation that balances the Gramians (including the unstable subspace). We then apply the method to a spatially developing unstable system and show that it results in reduced-order models of similar quality to the ones obtained with existing methods. Due to the unbounded growth of unstable modes, a practical restriction on the final impulse response simulation time appears, which can be adjusted depending on the desired order of the reduced-order model. Recommendations are given to further reduce the cost of the method if the system is large and to improve the performance of the method if it does not yield acceptable results in its unmodified form. Finally, the method is applied to the linearized flow around a cylinder at Re = 100...

  12. 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

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

    Science.gov (United States)

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

    1987-10-01

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

  14. Symmetry energy, unstable nuclei, and neutron star crusts

    CERN Document Server

    Iida, Kei

    2013-01-01

    Phenomenological approach to inhomogeneous nuclear matter is useful to describe fundamental properties of atomic nuclei and neutron star crusts in terms of the equation of state of uniform nuclear matter. We review a series of researches that we have developed by following this approach. We start with more than 200 equations of state that are consistent with empirical masses and charge radii of stable nuclei and then apply them to describe matter radii and masses of unstable nuclei, proton elastic scattering and total reaction cross sections off unstable nuclei, and nuclei in neutron star crusts including nuclear pasta. We finally discuss the possibility of constraining the density dependence of the symmetry energy from experiments on unstable nuclei and even observations of quasi-periodic oscillations in giant flares of soft gamma-ray repeaters.

  15. Symmetry energy, unstable nuclei and neutron star crusts

    Energy Technology Data Exchange (ETDEWEB)

    Iida, Kei [Kochi University, Department of Natural Science, Kochi (Japan); RIKEN Nishina Center, Saitama (Japan); Oyamatsu, Kazuhiro [RIKEN Nishina Center, Saitama (Japan); Aichi Shukutoku University, Department of Human Informatics, Aichi (Japan)

    2014-02-15

    The phenomenological approach to inhomogeneous nuclear matter is useful to describe fundamental properties of atomic nuclei and neutron star crusts in terms of the equation of state of uniform nuclear matter. We review a series of researches that we have developed by following this approach. We start with more than 200 equations of state that are consistent with empirical masses and charge radii of stable nuclei and then apply them to describe matter radii and masses of unstable nuclei, proton elastic scattering and total reaction cross sections off unstable nuclei, and nuclei in neutron star crusts including nuclear pasta. We finally discuss the possibility of constraining the density dependence of the symmetry energy from experiments on unstable nuclei and even observations of quasi-periodic oscillations in giant flares of soft gamma-ray repeaters. (orig.)

  16. Flame spectra of solid propellants during unstable combustion.

    Science.gov (United States)

    Eisel, J. L.; Ryan, N. W.; Baer, A. D.

    1972-01-01

    The spectral and temporal details of the flames of a series of ammonium perchlorate-polyurethane propellants during both unstable and stable combustion were observed experimentally. A 400-scan per second optical spectrometer operating in the middle infrared region was used. During unstable combustion at low ratios of chamber free volume to nozzle throat area, three different frequencies were observed simultaneously. These were attributable to at least two mechanisms. During stable combustion periodic fluctuations in flame temperature and composition were also observed. Some aspects of theory of bulk mode instability were confirmed, but the assumptions of constant flame temperature and constant composition were found to be inaccurate.

  17. Generation of Solitary Rossby Waves by Unstable Topography

    Institute of Scientific and Technical Information of China (English)

    YANG Hong-Wei; YIN Bao-Shu; DONG Huan-He

    2012-01-01

    The effect of topography on generation of the solitary Rossby waves is researched. Here, the topography, as a forcing for waves generation, is taken as a function of longitude variable x and time variable t, which is called unstable topography. With the help of a perturbation expansion method, a forced mKdv equation governing the evolution of amplitude of the solitary Rossby waves is derived from quasi-geostrophic vortieity equation and is solved by the pseudo-spectral method. Basing on the waterfall plots, the generational features of the solitary Rossby waves under the influence of unstable topography and stable topography are compared and some conclusions are obtained.

  18. TREATMENT OF UNSTABLE THORACOLUMBAR FRACTURES IN PEDIATRIC PATIENTS

    Directory of Open Access Journals (Sweden)

    Roberto Chapa Sosa

    2015-09-01

    Full Text Available Objective:To analyze the characteristics of unstable thoracolumbar fractures in the pediatric population.Methods:A retrospective cross-sectional study was conducted with pediatric patients (0 to 15 years who presented with unstable thoracolumbar fracture with or without neurological damage. Twenty-four operated patients were analyzed: 13 male and 11 female.Results:Falls from height are the most common cause, being the thoracolumbar junction the anatomical site most frequently injured.Conclusion:The thoracolumbar fractures are rare in the pediatric population, as well as post-surgical instrumentation structural deformities.

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

    Directory of Open Access Journals (Sweden)

    Ali Bozorgi

    2015-10-01

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

  20. 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.

  1. Properties of the false vacuum as the quantum unstable state

    CERN Document Server

    Urbanowski, K

    2016-01-01

    We analyze properties of unstable vacuum states from the point of view of the quantum theory. In the literature one can find some suggestions that some of false (unstable) vacuum states may survive up to times when their survival probability has a non-exponential form. At asymptotically late times the survival probability as a function of time $t$ has an inverse power--like form. We show that at this time region the energy of the false vacuum states tends to the energy of the true vacuum state as $1/t^{2}$ for $t \\to \\infty$. This means that the energy density in the unstable vacuum state should have analogous properties and hence the cosmological constant $\\Lambda = \\Lambda (t)$ too. The conclusion is that $\\Lambda$ in the Universe with the unstable vacuum should have a form of the sum of the "bare" cosmological constant and of the term of a type $1/t^{2}$: $\\Lambda(t) \\equiv \\Lambda_{bare} + d/ t^{2}$ (where $\\Lambda_{bare}$ is the cosmological constant for the Universe with the true vacuum).

  2. Beam shaping characteristics of an unstable-waveguide hybrid resonator.

    Science.gov (United States)

    Xiao, Longsheng; Qin, Yingxiong; Tang, Xiahui; Wan, Chenhao; Li, Gen; Zhong, Lijing

    2014-04-01

    The unstable-waveguide hybrid resonator emits a rectangular, simple astigmatic beam with a large number of high-spatial-frequency oscillations in the unstable direction. To equalize the beam quality, in this paper, a beam shaping system with a spatial filter for the hybrid resonator was investigated by numerical simulation and experimental method. The high-frequency components and fundamental mode of the output beam of the hybrid resonator in the unstable direction are separated by a focus lens. The high-frequency components of the beam are eliminated by the following spatial filter. A nearly Gaussian-shaped beam with approximately equal beam propagation factor M² in the two orthogonal directions was obtained. The effects of the width of the spatial filter on the beam quality, power loss, and intensity distribution of the shaped beam were investigated. The M² factor in the unstable direction is changed from 1.6 to 1.1 by optimum design. The power loss is only 9.5%. The simulation results are in good agreement with the experimental results.

  3. Control of an under activated unstable nonlinear object

    DEFF Research Database (Denmark)

    Andersen, Nils Axel; Skovgaard, L.; Ravn, Ole

    2001-01-01

    This paper presents a comprehensive comparative study of several nonlinear controllers for stabilisation of the under actuated unstable nonlinear object known as the Acrobot in the literature. The object is a two DOF robot arm only actuated at the elbow. The study compares several control...

  4. Note About Unstable D-Brane with Dynamical Tension

    CERN Document Server

    Kluson, J

    2016-01-01

    We propose an action for unstable Dp-brane with dynamical tension. We show that the equations of motion are equivalent to the equations of motion derived from DBI and WZ actions for non-BPS Dp-brane. We also find Hamiltonian formulation of this action and analyze properties of the solutions corresponding to the tachyon vacuum and zero tension solution.

  5. Towards pair production near threshold with unstable particle effective theory

    Energy Technology Data Exchange (ETDEWEB)

    Beneke, M.; Kauer, N.; /Aachen, Tech. Hochsch.; Signer, A.; /Durham U., IPPP; Zanderighi, G.; /Fermilab

    2004-10-01

    We illustrate the use of effective theory techniques to describe processes involving unstable particles close to resonance. First, we present the main ideas in the context of a scalar resonance in an Abelian gauge-Yukawa model. We then outline the necessary modifications to describe W-pair production close to threshold in electron-positron collisions.

  6. RAYLEIGH–TAYLOR UNSTABLE FLAMES—FAST OR FASTER?

    Energy Technology Data Exchange (ETDEWEB)

    Hicks, E. P., E-mail: eph2001@columbia.edu [Center for Interdisciplinary Exploration and Research in Astrophysics (CIERA) and the Department of Physics and Astronomy, Northwestern University, Evanston, IL 60208 (United States)

    2015-04-20

    Rayleigh–Taylor (RT) unstable flames play a key role in the explosions of supernovae Ia. However, the dynamics of these flames are still not well understood. RT unstable flames are affected by both the RT instability of the flame front and by RT-generated turbulence. The coexistence of these factors complicates the choice of flame speed subgrid models for full-star Type Ia simulations. Both processes can stretch and wrinkle the flame surface, increasing its area and, therefore, the burning rate. In past research, subgrid models have been based on either the RT instability or turbulence setting the flame speed. We evaluate both models, checking their assumptions and their ability to correctly predict the turbulent flame speed. Specifically, we analyze a large parameter study of 3D direct numerical simulations of RT unstable model flames. This study varies both the simulation domain width and the gravity in order to probe a wide range of flame behaviors. We show that RT unstable flames are different from traditional turbulent flames: they are thinner rather than thicker when turbulence is stronger. We also show that none of the several different types of turbulent flame speed models accurately predicts measured flame speeds. In addition, we find that the RT flame speed model only correctly predicts the measured flame speed in a certain parameter regime. Finally, we propose that the formation of cusps may be the factor causing the flame to propagate more quickly than predicted by the RT model.

  7. Shearing box simulations in the Rayleigh unstable regime

    DEFF Research Database (Denmark)

    Nauman, Farrukh; Blackman, Eric G.

    2015-01-01

    We study the stability properties of Rayleigh unstable flows both in the purely hydrodynamic and magnetohydrodynamic (MHD) regimes for two different values of the shear $q=2.1, 4.2$ ($q = - d\\ln\\Omega / d\\ln r$) and compare it with the Keplerian case $q=1.5$. The Rayleigh stability criterion states...

  8. Unstable volatility functions: the break preserving local linear estimator

    DEFF Research Database (Denmark)

    Casas, Isabel; Gijbels, Irene

    The objective of this paper is to introduce the break preserving local linear (BPLL) estimator for the estimation of unstable volatility functions. Breaks in the structure of the conditional mean and/or the volatility functions are common in Finance. Markov switching models (Hamilton, 1989) and t...

  9. Creation of unstable particles and decoherence in semiclassical cosmology

    CERN Document Server

    Castagnino, M A; Lombardo, F C; Castagnino, Mario; Landau, Susana; Lombardo, Fernando C.

    1999-01-01

    We consider a simple cosmological model in order to show the importance of unstable particle creation for the validity of the semiclassical approximation. Using the mathematical structure of rigged Hilbert spaces we show that particle creation is the seed of decoherence which enables the quantum to classical transition.

  10. Stabilizing control for a class of delay unstable processes.

    Science.gov (United States)

    Lee, See Chek; Wang, Qing-Guo; Nguyen, Le Binh

    2010-07-01

    The stabilization of unstable first-order plus time-delay processes with a zero by means of simple controllers is investigated in detail. Explicit stabilizability conditions are established. And the computational methods for determining stabilizing controller parameters are also presented with illustrative examples.

  11. Wear Behavior of an Unstable Knee: Stabilization via Implant Design?

    Directory of Open Access Journals (Sweden)

    Jörn Reinders

    2014-01-01

    Full Text Available Background. Wear-related failures and instabilities are frequent failure mechanisms of total knee replacements. High-conforming designs may provide additional stability for the joint. This study analyzes the effects of a ligamentous insufficiency on the stability and the wear behavior of a high-conforming knee design. Methods. Two simulator wear tests were performed on a high-conforming total knee replacement design. In the first, a ligamentous-stable knee replacement with a sacrificed anterior cruciate ligament was simulated. In the second, a ligamentous-unstable knee with additionally insufficient posterior cruciate ligament and medial collateral ligament was simulated. Wear was determined gravimetrically and wear particles were analyzed. Implant kinematics was recorded during simulation. Results. Significantly higher wear rates (P≤0.001 were observed for the unstable knee (14.58±0.56 mg/106 cycles compared to the stable knee (7.97 ± 0.87 mg/106 cycles. A higher number of wear particles with only small differences in wear particle characteristics were observed. Under unstable knee conditions, kinematics increased significantly for translations and rotations (P≤0.01. This increase was mainly attributed to higher tibial posterior translation and internal rotations. Conclusion. Higher kinematics under unstable test conditions is a result of insufficient stabilization via implant design. Due to the higher kinematics, increased wear was observed in this study.

  12. The Implications of Unstable Yemen on Saudi Arabia

    Science.gov (United States)

    2012-02-28

    total illiteracy, overpopulation , poverty, and lawlessness draw quite a gloomy picture. Yemen has a rapidly growing population with limited resources...revenues. In conclusion, Yemen is becoming increasingly chaotic and unstable and the central government, always weak outside the urban areas, is

  13. A numerical study of unstable Hele-Shaw flow

    DEFF Research Database (Denmark)

    Hansen, Erik Bent; Rasmussen, Henning

    1999-01-01

    A numerical procedure which is based on an integral equation for the normal velocity at the interface is developed for the unstable flow with surface tension in a Hele-Shaw cell. The procedure has been validated by comparing solutions obtained by it with published results. It has also been applie...

  14. DIAGNÓSTICO DE ENFERMAGEM RISCO DE QUEDAS EM PACIENTES COM ANGINA INSTÁVEL

    Directory of Open Access Journals (Sweden)

    ALLYNE FORTES VITOR

    2010-01-01

    Full Text Available El riesgo de caídas puede ser considerado como fenómeno o diagnóstico de enfermería. Investigaciones han relacionado directamente isquemias de miocardio, como la angina inestable y el riesgo de caer. La meta de este estudio fue analizar el diagnóstico de enfermería Riesgo de caídas en casos de angina inestable a través de estudio transversal realizado en 57 individuos internados en un hospital académico, mediante examen físico y cuestionario. Para el análisis estadístico se utilizaron test de chi cuadrado, test exacto de Fisher, Mann-Whitney, test-t y Coeficiente Phi (p <0,05. El Riesgo de caídas fue el diagnóstico de enfermería más preponderante (87,71%, especialmente en los hombres, mayores, con menos años de estudio y renta inferior. Presencia de angina inestable, hipertensión arterial, remedios contra hipertensión, enfermedad vascular, dificultades visuales e insomnio presentaron asociación con el diagnóstico de enfermería Riesgo de caídas. Se concluye que es imprescindible el desarrollo de parámetros claros y objetivos para medir con más precisión el riesgo de caídas en el ámbito de un hospital.

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

    Science.gov (United States)

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

    2015-01-01

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

  16. 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.

  17. PHARMACOECONOMIC ASPECTS OF NICOTINE ADDICTION TREATMENT IN PATIENTS WITH ANGINA REQUIRING CARDIAC SURGERY

    Directory of Open Access Journals (Sweden)

    A. V. Rudakova

    2012-01-01

    Full Text Available Smoking is a major risk factor in patients with angina pectoris. Interventions that facilitate the rejection of it are an important part of the treatment. Aim. To analyze the cost effectiveness of the partial agonist of nicotinic receptors, varenicline, in patients with angina who require cardiac interventions. Material and methods. The estimation was conducted using a Markov model based on the results of clinical trials and epidemiological studies. The cost of treatment of complications were calculated on the basis of compulsory medical insurance rates for St. Petersburg in 2011. Results. The varenicline therapy in 70-year-old patients before cardiac surgery reduces hospital mortality at an extremely high cost-effectiveness (the cost of preventing one death - 148.8 thousand rubles. The cost/effectiveness ratio in the analysis for the period of survival of patients in this situation was 31.3 thousand rubles for 1 additional year of life. Life expectancy will be increased by an average of 0.147 years. Analysis for the period of survival of 50-year-old patients has shown that in patients after cardiac surgery cost-effectiveness of varenicline is extremely high (in the analysis from the perspective of the health care system the cost/effectiveness ratio was 36.0 thousand rubles for 1 additional year of life, in the analysis, taking into account the social perspective – 17.9 thousand rubles for 1 additional year of life. Increase in the life expectancy of 50 year-old patients will be 0.291 year in average. Conclusion. Varenicline therapy of patients with angina pectoris is the economy before cardiac surgery , and after their execution, and this applies not only young, but older patients. The desirability of varenicline including to federal and regional programs to reduce cardiovascular morbidity and mortality is shown.

  18. Study protocol: a randomised controlled trial investigating the effect of exercise training on peripheral blood gene expression in patients with stable angina

    Directory of Open Access Journals (Sweden)

    Crossman David C

    2010-10-01

    Full Text Available Abstract Background Exercise training has been shown to reduce angina and promote collateral vessel development in patients with coronary artery disease. However, the mechanism whereby exercise exerts these beneficial effects is unclear. There has been increasing interest in the use of whole genome peripheral blood gene expression in a wide range of conditions to attempt to identify both novel mechanisms of disease and transcriptional biomarkers. This protocol describes a study in which we will assess the effect of a structured exercise programme on peripheral blood gene expression in patients with stable angina, and correlate this with changes in angina level, anxiety, depression, and exercise capacity. Methods/Design Sixty patients with stable angina will be recruited and randomised 1:1 to exercise training or conventional care. Patients randomised to exercise training will attend an exercise physiology laboratory up to three times weekly for supervised aerobic interval training sessions of one hour in total duration. Patients will undergo assessments of angina, anxiety, depression, and peripheral blood gene expression at baseline, after six and twelve weeks of training, and twelve weeks after formal exercise training ceases. Discussion This study will provide comprehensive data on the effect of exercise training on peripheral blood gene expression in patients with angina. By correlating this with improvement in angina status we will identify candidate peripheral blood transcriptional markers predictive of improvements in angina level in response to exercise training. Trial Registration Clinicaltrials.gov identifier: NCT01147952

  19. A novel approach to modeling unstable EOR displacements. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Peters, E.J.

    1994-04-01

    Most enhanced oil recovery schemes involve the displacement of a more dense and more viscous oil by a less dense and less viscous fluid in a heterogeneous porous medium. The interaction of heterogeneity with the several competing forces, namely, viscous, capillary, gravitational, and dispersive forces, can conspire to make the displacements unstable and difficult to model and to predict. The objective of this research was to develop a systematic methodology for modeling unstable fluid displacements in heterogeneous media. Flow visualization experiments were conducted using X-ray computed tomography imaging and a video imaging workstation to gain insights into the dynamics of unstable displacements, acquire detailed quantitative experimental image data for calibrating numerical models of unstable displacements, and image and characterize heterogeneities in laboratory cores geostatistically. High-resolution numerical models modified for use on vector-architecture supercomputers were used to replicate the image data. Geostatistical models of reservoir heterogeneity were incorporated in order to study the interaction of hydrodynamic instability and heterogeneity in reservoir displacements. Finally, a systematic methodology for matching the experimental data with the numerical models and scaling the laboratory results to other systems were developed. The result is a new method for predicting the performance of unstable EOR displacements in the field based on small-scale displacements in the laboratory. The methodology is general and can be applied to forecast the performance of most processes that involve fluid flow and transport in porous media. Therefore, this research should be of interest to those involved in forecasting the performance of enhanced oil recovery processes and the spreading of contaminants in heterogeneous aquifers.

  20. Unstable Dynamical Properties of Spiral Cloud Bands in Tropical Cyclones

    Institute of Scientific and Technical Information of China (English)

    HUANG Hong; ZHANG Ming

    2009-01-01

    A nondivergent barotropic model (Model 1) and a barotropic primitive equation vortex model (Model 2) are linearized respectively in this paper. Then their perturbation wave spectrums are computed with a normal mode approach to study the instability problem on an appointed tropical cyclone (TC)-like vortex, thereby, the dynamic instability properties of spiral cloud bands of TCs are discussed. The results show that the unstable mode of both models exhibits a spiral band-like structure that propagates away from the vortex outside the radius of maximum winds. The discrete modal instability of the pure vortex Rossby wave can account for the generation of the eyewall and the inner spiral band. The unstable mode in Model 2 has three parts, i.e., eyewall, inner and outer spiral bands. This mode can be interpreted as a mixed vortex Rossby-inertia gravitational wave. The unbalanced property of the wave outside the stagnation radius of the vortex Rossby wave is one of the important reasons for the formation of the outer spiral band in TCs. Accordingly, the outer spiral band can be identified to possess properties of an inertial-gravitational wave.When the formation of unstable inner and outer spiral bands is studied, a barotropic vortex model shall be used. In this model, the most unstable perturbation bears the attributes of either the vortex Rossby wave or the inertial-gravitational wave, depending on the vortex radius. So such perturbations shall be viewed as an unbalanced and unstable mixed wave of these two kinds of waves.