scholarly journals Traditional Chinese medicine for ischemic heart disease: clinical manifestations and objective indicators

2020 ◽  
Author(s):  
Jiangquan Liao ◽  
Jiaxing Tian ◽  
Mingjing Shao ◽  
Zhe Wang ◽  
Kangkang Wei ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Disease ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Ischemic Heart Disease ◽  
Clinical Manifestations ◽  
Ischemic Heart ◽  
Level Of Evidence ◽  
History Of ◽  
Objective Indicators

Abstract Background: The clinical practice of Traditional Chinese medicine (TCM) has a history of more than 2000 years. Modern clinical trials and experimental researches of TCM have been conducted for decades and provided support for the application of TCM in the prevention and treatment of ischemic heart disease (IHD). However the level of evidence and the proper application of TCM were still barely satisfactory.Methods: In this study, we divided IHD into 5 different stages, including stable angina, unstable angina, acute myocardial infarction, post myocardial infarction and chronic heart failure. Then we systematically reviewed and meta-analyzed the existing RCTs on both clinical manifestations and objective indicators, in these 5 aspects.Results: The results indicate that TCM can both improve the clinical manifestations and ameliorate the objective parameters in different courses of IHD. Some of the improvements lead to potential long-term benefits.Conclusions: TCM is effective on CVD in different stages of diseases, both in improving clinical manifestations and objective indicators. To acquire more solid and comprehensive evidence of TCM in treating CVD, more rigorously designed RCTs with longer follow-up duration are warranted.

scholarly journals Initial Invasive Versus Conservative Management of Stable Ischemic Heart Disease in Patients With a History of Heart Failure or Left Ventricular Dysfunction

Circulation ◽  
2020 ◽  
Vol 142 (18) ◽  
pp. 1725-1735
Author(s):  
Renato D. Lopes ◽  
Karen P. Alexander ◽  
Susanna R. Stevens ◽  
Harmony R. Reynolds ◽  
Gregg W. Stone ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Primary Outcome ◽  
Cardiovascular Death ◽  
Left Ventricular ◽  
Ischemic Heart ◽  
Conservative Strategy ◽  
Stable Ischemic Heart Disease ◽  
History Of

Background: Whether an initial invasive strategy in patients with stable ischemic heart disease and at least moderate ischemia improves outcomes in the setting of a history of heart failure (HF) or left ventricular dysfunction (LVD) when ejection fraction is ≥35% but <45% is unknown. Methods: Among 5179 participants randomized into ISCHEMIA (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches), all of whom had left ventricular ejection fraction (LVEF) ≥35%, we compared cardiovascular outcomes by treatment strategy in participants with a history of HF/LVD at baseline versus those without HF/LVD. Median follow-up was 3.2 years. Results: There were 398 (7.7%) participants with HF/LVD at baseline, of whom 177 had HF/LVEF >45%, 28 HF/LVEF 35% to 45%, and 193 LVEF 35% to 45% but no history of HF. HF/LVD was associated with more comorbidities at baseline, particularly previous myocardial infarction, stroke, and hypertension. Compared with patients without HF/LVD, participants with HF/LVD were more likely to experience a primary outcome composite of cardiovascular death, nonfatal myocardial infarction, or hospitalization for unstable angina, HF, or resuscitated cardiac arrest (4-year cumulative incidence rate, 22.7% versus 13.8%; cardiovascular death or myocardial infarction, 19.7% versus 12.3%; and all-cause death or HF, 15.0% versus 6.9%). Participants with HF/LVD randomized to the invasive versus conservative strategy had a lower rate of the primary outcome (17.2% versus 29.3%; difference in 4-year event rate, −12.1% [95% CI, −22.6 to −1.6%]), whereas those without HF/LVD did not (13.0% versus 14.6%; difference in 4-year event rate, −1.6% [95% CI, −3.8% to 0.7%]; P interaction = 0.055). A similar differential effect was seen for the primary outcome, all-cause mortality, and cardiovascular mortality when invasive versus conservative strategy–associated outcomes were analyzed with LVEF as a continuous variable for patients with and without previous HF. Conclusions: ISCHEMIA participants with stable ischemic heart disease and at least moderate ischemia with a history of HF or LVD were at increased risk for the primary outcome. In the small, high-risk subgroup with HF and LVEF 35% to 45%, an initial invasive approach was associated with better event-free survival. This result should be considered hypothesis-generating. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01471522.

Family history of ischemic heart disease and risk of acute myocardial infarction

2003 ◽  
Vol 37 (3) ◽  
pp. 183-187 ◽  
Author(s):  
Michaela Bertuzzi ◽  
Eva Negri ◽  
Alessandra Tavani ◽  
Carlo La Vecchia
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Heart Disease ◽  
Family History ◽  
Ischemic Heart Disease ◽  
Ischemic Heart ◽  
History Of

Pathogenesis Of Clinical Events In Coronary Artery Disease. Clinical Observations

1981 ◽  
Author(s):  
A Maseri
Keyword(s):  
Myocardial Infarction ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Coronary Spasm ◽  
Clinical Manifestations ◽  
Ischemic Heart ◽  
Variable Degree ◽  
Clinical Events ◽  
Functional Factors ◽  
Angina At Rest

Studies on angina at rest showing that an increase of myocardial demand beyond a fixed supply is not the only or even the most frequent cause of acute myocardial ischemia open a new avenue in our understanding of ischemic heart disease. Functional factors that transiently interfere with regional coronary blood supply, such as coronary spasm, seem to play a major role in determining the clinical events associated with coronary atherosclerotic heart disease. These functional factors appear to be the major cause of angina at rest, nocturnal, post-prandial and cold-induced angina and for variable threshold of exertional angina.Sudden death was also shown to be a possible consequence of coronary spasm which was shown to cause ventricular fibrillation and cardiac arrest during reversible ischemic episodes with or without anginal pain.Myocardial infarction consistently occurs in the same vascular bed shown to undergo transient ischemic episodes before the onset of the final, irreversible one. The transient episodes were shown to be caused by coronary spasm. The irreversible episode could not be relieved by intracoronary nitrates. A platelet mural thrombus was found at post mortem at the site of demonstrated persistent spasm.We suggest that coronary vasospasm and platelet aggregation may be responsible for the onset of acute myocardial infarction and, possibly, for the development of coronary thrombotic obstructions.Thus, the clinical manifestations of ischemic heart disease may largely depend on the presence and severity of functional factors, transiently and acutely interfering with flow, along with a variable degree of coronary atherosclerosis. In turn, prognosis may be determined by the severity of acute functional factors and the extent to which the coronary circulation and the myocardium are already chronically jeopardized by organic lesions.

scholarly journals ISCHEMIC HEART DISEASE;

2019 ◽  
Vol 26 (02) ◽  
Author(s):  
Shakeel Ahmad ◽  
Muhammad Nazim ◽  
Rizwan Munir ◽  
Hafiz Muhammad Faiq Ilyas ◽  
Naeem Asghar ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Heart Disease ◽  
Ischemic Heart Disease ◽  
Sample Size ◽  
Sedentary Lifestyle ◽  
Ischemic Heart ◽  
Number Of Patients ◽  
Study Results ◽  
History Of

Objectives: To analyze the association between sedentary life style and Ischemic heart disease. Design: Analytical study. Settings: Faisalabad institute of cardiology Faisalabad. Duration of Study: 1st November 2017 to 30 April 2018. Sample Size: Sample size was 200 as calculated by WHO sample size calculator. Sampling Technique: Non probability convenient sampling. Subjects: All patients diagnosed with acute myocardial infarction Patients and methods; 200 patients presenting in outdoor for routine follow up checkup who were diagnosed cases of ischemic heart disease included in the study. Results: 200 patients with a history of acute myocardial infarction and capable of responding to a questionnaire were included in the study. 43% of the patients had history of sedentary lifestyle. Among five major risk factors, SLS stood second after diabetes according to my study. Conclusions: In patients with acute MI, there was significant number of patients who had history of sedentary lifestyle. Sedentary Lifestyle is going to be a major risk factor of ischemic heart disease.

scholarly journals Changes in the prevalence of metabolic syndrome and smoking habits during a 10-year period and relation between these risk factors and ischemic heart disease among men aged 45–64 years

Medicina ◽  
2008 ◽  
Vol 44 (5) ◽  
pp. 400 ◽  
Author(s):  
Dalia Lukšienė ◽  
Liucija Černiauskienė ◽  
Lilija Margevičienė ◽  
Abdonas Tamošiūnas
Keyword(s):  
Myocardial Infarction ◽  
Metabolic Syndrome ◽  
Heart Disease ◽  
Angina Pectoris ◽  
Ischemic Heart Disease ◽  
Density Lipoprotein ◽  
Epidemiological Studies ◽  
Ischemic Heart ◽  
Smoking Habits ◽  
Previous Myocardial Infarction

The aim of this work was to compare the prevalence of metabolic syndrome and smoking habits smokingduring a 10-year period and to evaluate the association between metabolic syndrome and smoking habits, and ischemic heart disease among Kaunas men aged 45–64 years. Material and methods. In this study, we have used data from two epidemiological studies, which had been carried out according to the MONICA study protocol (359 men aged 45–64 years were enrolled in 1992–1993 and 408 men aged 45–64 years – in 2001–2002). The association between metabolic syndrome and smoking habits, and ischemic heart disease was established according to the data of 2001–2002 years. Ischemic heart disease was diagnosed based on the following criteria: previous myocardial infarction, angina pectoris, or ischemic changes in electrocardiogram. Metabolic syndrome was defined by Adult Treatment Panel III (ATP III) criteria. Results. The prevalence of ischemic heart disease did not change among men aged 45–64 years during a 10-year period. During this period, the decreased prevalence of metabolic syndrome was observed; decreased rate of hyperglycemia, decreased high-density lipoprotein cholesterol level, increased rate of hypertriglyceridemia, and increased waist circumference were noted. During this period, the proportion of regular male smokers increased significantly. After the evaluation of association between and metabolic syndrome and smoking habits, and ischemic heart disease (according to the data of 2001–2002 years), it was determined that the highest rate of ischemic heart disease was among regular smokers with metabolic syndrome (32.3%), and the lowest rate of ischemic heart disease was noted among men who had never smoked and were without metabolic syndrome (11.6%) (OR=3.63; P=0.013). The highest rate of previous myocardial infarction and/or angina pectoris was determined among regular smokers with metabolic syndrome (19.4%), and the lowest rate of ischemic heart disease was determined among men who had never smoked and were without metabolic syndrome (3.6%) (OR=6.43; P=0.008). Conclusion. Combination of metabolic syndrome and smoking is significantly associated with ischemic heart disease among men aged 45–64 years.

Sign in / Sign up

Export Citation Format

Share Document