scholarly journals Comparison of the histopathology of culprit lesions in chronic stable angina, unstable angina, and myocardial infarction

1997 ◽  
Vol 20 (7) ◽  
pp. 651-655 ◽  
Author(s):  
Jacob I. Haft ◽  
Domenic L. Mariano ◽  
Jonathan Goldstein ◽  
Bruce Waller
Keyword(s):  
Myocardial Infarction ◽  
Unstable Angina ◽  
Stable Angina ◽  
Chronic Stable Angina

P5525Impact of clinical presentation at admission on long-term clinical outcomes in patients undergoing percutaneous coronary interventions - a contemporary registry data

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L Piatek ◽  
L Zandecki ◽  
J Kurzawski ◽  
A Janion-Sadowska ◽  
M Zabojszcz ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Unstable Angina ◽  
Stable Angina ◽  
Clinical Presentation ◽  
P Value ◽  
Cardiac Events ◽  
St Segment Elevation ◽  
St Segment ◽  
Adverse Cardiac Events ◽  
Percutaneous Coronary

Abstract Background Both unstable angina (UA) and non-ST-segment elevation myocardial infarction (NSTEMI) are still classified together in non-ST-elevation acute coronary syndromes despite the fact they substantially differ in both clinical profile and prognosis. Purpose The aim of the present study was to evaluate contemporary clinical characteristics and outcomes of UA patients after percutaneous coronary intervention (PCI) in comparison with stable angina (SCAD) and myocardial infarction (NSTEMI as well as STEMI) in Swietokrzyskie District of Poland in years 2014–2017. Methods A total of 7'187 patients after PCI from ORPKI Registry (38% with diagnosis of UA) were included into the analysis. Impact of clinical presentation (UA, SCAD, NSTEMI, STEMI) on 3-year outcomes were determined. Results UA patients were older that SCAD but younger than NSTEMI individuals. Diabetes and hypertension were more often encountered into UA group than in NSTEMI but less often than in SCAD cases. In UA group the percentage of previous myocardial infarction (MI), PCI or coronary artery bypass grafting (CABG) was the highest among all analyzed groups. In 3-year observation the risk of death as well as myocardial infarction (MI) and major adverse cardiac events (MACE) in unstable angina after PCI was higher than in stable angina but considerably lower than in NSTEMI group. Multivariate analysis confirmed that prognosis in NSTEMI was substantially worse in comparison with UA (RR 1.365, 95% CI: 1.126–1.655, p=0.0015). On the contrary there were no difference in mortality risk between UA and SCAD patients (RR 1.189, 95% CI: 0.932–1.518, p=0.1620). Parallel results were observed in respect of MI and MACE. Independ predictors of death were: age, kidney disease, hypertension, diabetes, previous stroke or previous PCI. Multivariate logistic regression analyse Clinical presentation Death Myocardial infarction MACE RR 95% CI p-value RR 95% CI p-value RR 95% CI p-value NSTEMI/UA 1.365 1.126–1.655 0.0015 1.822 1.076–3.055 0.0260 1.514 1.267–1.807 <0.0001 NSTEMI/SCAD 1.624 1.251–2.109 0.0003 1.882 0.982–3.789 0.0568 1.604 1.275–2.094 <0.0001 UA/SCAD 1.189 0.932–1.518 0.1620 1.033 0.557–2.034 0.9219 1.060 0.855–1.323 0.6023 MACE, major adverse cardiac events; NSTEMI, non-ST-segment elevation myocardial infarction; UA, unstable angina; SCAD, stable angina. Conclusion Unstable angina accounted for 38% of all cases and was the most common diagnosis in patients that underwent PCI in that time. 3-year prognosis in UA was considerable better in comparison with NSTEMI. On contrary there was no difference in outcomes (death, MI, MACE) between UA and SCAD patients.

scholarly journals Diagnostic Role of Plasma MicroRNA-21 in Stable and Unstable Angina Patients and Association with Aging

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Md Sayed Ali Sheikh
Keyword(s):  
Unstable Angina ◽  
Stable Angina ◽  
Healthy Subjects ◽  
Age Groups ◽  
Chronic Stable Angina ◽  
Roc Curves ◽  
Circulating Microrna ◽  
Clinical Value ◽  
Coronary Patients ◽  
Plasma Microrna

The present study explored the clinical value of plasma microRNA-21 as a novel biomarker for early prediction of stable and unstable angina patients and its relationship with aging. A total of 255 participants, 123 patients with chronic stable angina, 82 patients with unstable angina, and 50 healthy subjects, were included in our study. Stable coronary and unstable coronary patients were confirmed following AHA/ACC clinical protocols. Total RNA was extracted from plasma by using miRNA-based TRIzol reagent. Plasma miR-21 expression levels were determined by real-time polymerase chain reaction. To evaluate the diagnosis accuracy, the receiver operating characteristic (ROC) curves were used. Plasma microRNA-21 concentration levels were significantly elevated in stable and unstable angina patients as compared with control subjects P<0.001. The area under the ROC curves of circulating microRNA-21 was accurately distinguished in stable angina patients (AUC 0.921) and unstable angina patients (AUC 0.944) from healthy subjects. MicroRNA-21 expression gradually elevated with increasing aging in all the populations. Moreover, the current study also demonstrated that the expression of plasma miR-21 levels was significantly associated with different age groups within healthy subjects and stable and unstable angina patients P<0.001. This research finding suggested that plasma microRNA-21 may be considered as a suitable new biomarker for early detection of stable and unstable angina patients, and it has a strong correlation with aging.

Direct Evidence of Endothelial Injury in Acute Myocardial Infarction and Unstable Angina by Demonstration of Circulating Endothelial Cells

Blood ◽  
1999 ◽  
Vol 93 (9) ◽  
pp. 2951-2958 ◽  
Author(s):  
Murielle Mutin ◽  
Isabelle Canavy ◽  
Andrew Blann ◽  
Michel Bory ◽  
José Sampol ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Endothelial Cells ◽  
Chest Pain ◽  
Unstable Angina ◽  
Adhesion Molecule ◽  
Stable Angina ◽  
Direct Evidence ◽  
Endothelial Injury ◽  
Circulating Endothelial Cells

Abstract 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 &lt; .01 analysis of variance [ANOVA]) and UA (4.5; 0.75 to 13.25 cells/mL, P &lt; .01) within 12 hours after 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 &lt; .05 repeated measures ANOVA), but fell steadily after UA. Regardless of acute coronary events, the isolated cells displayed morphologic and immunologic features of vascular endothelium. The CECs were predominantly of macrovascular origin. They did not express the activation markers intercellular adhesion molecule (ICAM)-1, vascular cell adhesion molecule (VCAM)-1, and E-selectin, although some were positive for tissue factor. CECs failed to exhibit characteristics of apoptosis (TUNEL assay) excluding this event as a possible mechanism of cell detachment. The presence of CECs provides direct evidence of endothelial injury in AMI and UA, but not in stable angina, confirming that these diseases have different etiopathogenic mechanisms.

scholarly journals Epidemiology and risk factors of patients with types of acute coronary syndrome presenting to a tertiary care hospital in Sri Lanka

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Udaya Ralapanawa ◽  
Pallegoda Vithanage Ranjith Kumarasiri ◽  
Kushalee Poornima Jayawickreme ◽  
Prabashini Kumarihamy ◽  
Yapa Wijeratne ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Sri Lanka ◽  
Unstable Angina ◽  
Stable Angina ◽  
Strong Association ◽  
Coronary Syndrome ◽  
History Of ◽  
St Elevation

Abstract Background Acute Coronary Syndrome (ACS) is one of the leading causes of death worldwide and studies have shown higher mortality rates and premature death in South Asian countries. The occurrence and effect of risk factors differ by type ofACS.Epidemiological studies in the Sri Lankan population are limited. Methods This is a cross sectional descriptive study conducted at the Teaching Hospital Peradeniya, Sri Lanka among patients presenting with ACS. Data was collected by an interviewer administered structured questionnaire and epidemiological patterns and risk factors were analyzed. Results The sample of 300 patients had a mean age of 61.3+/− 12.6 and male sex showed higher association with all three type of ACS compared to female with a P value of 0.001. This study showed higher mean age of 62.2 ± 11.4 years amongst unstable angina (UA) patients and 61.9 ± 14.5 years amongst non ST elevation myocardial infarction (NSTEMI) patients compared to 59.2 ± 11.2 years for ST elevation myocardial infarction (STEMI) patients with no significant statistical difference (P = 0.246). Approximately 55.8% STEMI patients, 39.8% UA and 35.5% NSTEMI patients were smokers indicating a significant association between smoking and STEMI (P = 0.017). Nearly 54.5% STEMI, 35.4% UA and 32.7% NSTEMI patients consumed alcohol and there was a very strong association between alcohol consumption and STEMI (P = 0.006). Almost 51.8% NSTEMI patients, 47.8% UA patients and 29.9% STEMI patients had hypertension(HT) (P = 0.008) indicating significant association of HT with UA and NSTEMI. About 33.6% UA patients and 30.0% NSTEMI patients had DM whilst only 22.1% of STEMI patients had DM of no significance (p = 0.225). Around 15.0% patients with UA, 25.5% with NSTEMI and 11.7% with STEMI had dyslipidemia (P = 0.032). There was a very strong association between a past history of ACS or stable angina with NSTEMI and UA (P = 0.001). Conclusion Smoking and alcohol abuse are significantly associated with STEMI.Patients with NSTEMI or Unstable Angina had higher rates of hypertension and were more likely to have a history of ACS or stable angina than STEMI patients. Patients with NSTEMI were more likely than patients with STEMI or UA to have dyslipidemia.

Lactate dehydrogenase isoenzymes in serum during unstable angina.

1986 ◽  
Vol 32 (8) ◽  
pp. 1566-1567 ◽  
Author(s):  
Z Rotenberg ◽  
I Weinberger ◽  
A Sagie ◽  
J Fuchs ◽  
O Sperling ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Lactate Dehydrogenase ◽  
Unstable Angina ◽  
Stable Angina ◽  
Myocardial Damage ◽  
Functional Evaluation ◽  
Normal Range ◽  
The Mean ◽  
Lactate Dehydrogenase Isoenzymes

Abstract Values for total lactate dehydrogenase (LD, EC 1.1.1.27) activity in serum, LD isoenzymes 1 and 2, and the LD 1:2 ratio in 25 patients with unstable angina were compared with the same variables in 25 patients whose angina was stable 24, 48, and 72 h after admission. Mean total LD activity and mean LD-2 activity were found to be within the normal range, both in the unstable angina and stable angina groups of patients. In the unstable angina group the mean LD-1 was significantly higher (p less than 0.01) than in the stable angina group at each time studied. The mean LD 1:2 ratio was also significantly different (p less than 0.001) between the two groups of patients. In the unstable angina group of patients the ratio was increased (0.85, SD 0.09), as in patients with acute myocardial infarction, whereas in the stable angina group of patients the ratio was normal (0.60, SD 0.06). We conclude that a high LD 1:2 ratio, even in the presence of normal total LD activity, may indicate myocardial damage in some patients with unstable angina and could therefore help in the clinical and functional evaluation of patients with unstable angina.

Platelet-monocyte cross talk and tissue factor expression in stable angina vs. unstable angina/non ST-elevation myocardial infarction

Platelets ◽  
2011 ◽  
Vol 22 (7) ◽  
pp. 530-536 ◽  
Author(s):  
Christoph W. Kopp ◽  
Thomas Gremmel ◽  
Sabine Steiner ◽  
Daniela Seidinger ◽  
Erich Minar ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Unstable Angina ◽  
Tissue Factor ◽  
Cross Talk ◽  
Stable Angina ◽  
St Elevation Myocardial Infarction ◽  
Tissue Factor Expression ◽  
Factor Expression ◽  
St Elevation
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