Recent developments in the understanding and management of angina pectoris in patients with stable coronary artery disease

1991 ◽  
Vol 6 (4) ◽  
pp. 503-510 ◽  
Author(s):  
Thomas C. Andrews ◽  
Peter H. Stone
1990 ◽  
Vol 63 (03) ◽  
pp. 336-339 ◽  
Author(s):  
K Huber ◽  
I Resch ◽  
Th Stefenelli ◽  
I Lang ◽  
P Probst ◽  
...  

SummaryIncreased plasma levels of plasminogen activator inhibitor-1 (PAI-1) have been shown to exist in 40 to 60% of patients with stable coronary artery disease and have been suggested to be responsible for the development of coronary thrombotic complications. However, it is also discussed whether PAI-1 elevation might mainly be due to variables like increased age or to reactive mechanisms caused e.g. by the chest pain itself. To exclude age dependent ui pain related influences, age-matched patients with stable angina pectoris (NHYA II) and angiographically proven coronary artery disease (CAD, n = 16) or without evidence for coronary sclerosis (variant angina, n = 10; angina-like syndrome with normal coronary angiogram, n = 5; non-CAD, n = 15) have been investigated for their plasma PAI-1 activity and t-PA antigen levels. The mean PAI activity in CAD patients (17.5 U/ml) was significantly higher than in non-CAD patients (9.6 U/ml) (p <0.0001). In the CAD patients no significant variation in plasma PAI-1 values could be demonstrated when related to the extent of the disease or to a history of previous myocardial infarction t-PA antigen was also elevated m CAD patients as compared to the non-CAD group (p <0.02). The results suggest therefore a strong correlation between coronary artery disease itself and elevated levels of components of the plasma fibrinolytic system.


2015 ◽  
Vol 12 (1) ◽  
pp. 32-36
Author(s):  
O Yu Mironova

Aim. The aim of our study was to assess the prevalence of myocardial infarction (MI) type 4a and myocardial damage due to planned percutaneous interventions (PCI) in patients with stable coronary artery disease (CAD) and arterial hypertension (AH).Material and methods. 281 patients were screened before the enrollment in our study. 183 patients with stable CAD were included in our study whose levels of cardiac troponin I and CK-MB (creatine kinase-MB fraction) were studied after PCI. We divided patients into the groups according to their levels of cardiac troponin I after PCI and CK-MB (group 1 - no elevation; 2 - elevation 1-3 upper limits of normal - ULN; III - more than 3 ULN).167 patients had AH. In case of detected rise of CK-MB and/or troponin echocardiography and cardiac magnetic resonance imaging (MRI) were performed. Results. The prevalence of MI type 4a was 10,8% and periprocedural myocardial damage - 16,2% respectively. After performing the discriminant analysis we sought to build a prognostic model and calculate the formula of periprocedural myocardial damage probability: 0,871 × gender (male = 0; female = 1)+0,516 × angina pectoris functional class + 0,022 × age (years) - 0,011 × (estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease - MDRD formula) + 0,27 × number of diseased coronary arteries ≥2,731.Conclusion. Women with low EGFR (MDRD), mutivessel disease and angina pectoris class 3-4 (NYHA) have the highest risk of MI type 4a. The most difficult localization for PCI is circumflex artery.


Diabetes ◽  
1997 ◽  
Vol 46 (9) ◽  
pp. 1491-1496 ◽  
Author(s):  
M. Maki ◽  
P. Nuutila ◽  
H. Laine ◽  
L. M. Voipio-Pulkki ◽  
M. Haaparanta ◽  
...  

2020 ◽  
Vol 27 (7) ◽  
pp. 1052-1080 ◽  
Author(s):  
Evangelos Oikonomou ◽  
Gerasimos Siasos ◽  
Vasiliki Tsigkou ◽  
Evanthia Bletsa ◽  
Maria-Evi Panoilia ◽  
...  

Coronary artery disease is the leading cause of morbidity and mortality worldwide. The most common pathophysiologic substrate is atherosclerosis which is an inflammatory procedure that starts at childhood and develops throughout life. Endothelial dysfunction is associated with the initiation and progression of atherosclerosis and is characterized by the impaired production of nitric oxide. In general, endothelial dysfunction is linked to poor cardiovascular prognosis and different methods, both invasive and non-invasive, have been developed for its evaluation. Ultrasound evaluation of flow mediated dilatation of the branchial artery is the most commonly used method to assessed endothelial function while intracoronary administration of vasoactive agents may be also be used to test directly endothelial properties of the coronary vasculature. Endothelial dysfunction has also been the subject of therapeutic interventions. This review article summarizes the knowledge about evaluation of endothelial function in acute coronary syndromes and stable coronary artery disease and demonstrates the current therapeutic approaches against endothelial dysfunction.


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