scholarly journals Ranolazine: a better understanding of pathophysiology and patient profile to guide treatment of chronic stable angina

2021 ◽  
Author(s):  
Juan Tamargo ◽  
Jose Lopez-Sendon
Keyword(s):  
Stable Angina ◽  
Chronic Stable Angina ◽  
Patient Profile ◽  
Increased Risk ◽  
First Choice ◽  
Hemodynamic Profile ◽  
Traditional Therapies ◽  
Artery Disease ◽  
Pathophysiologic Mechanisms

Chronic stable angina pectoris, the most prevalent symptomatic manifestation of coronary artery disease, greatly impairs quality of life and is associated with an increased risk for adverse cardiovascular outcomes. Better understanding of the pathophysiologic mechanisms of myocardial ischemia permitted new therapeutic strategies to optimize the management of angina patients. Ideally, antianginal drug treatment should be tailored to individual patient’s profile and chosen according to the pathophysiology, hemodynamic profile, adverse effects, potential drug interactions and comorbidities. In this respect, and because of its peculiar mechanism of action, ranolazine represents an alternative therapeutic approach in patients with chronic stable angina and may be considered the first choice in presence of comorbidities that difficult the use of traditional therapies.

A Targeted Literature Review of the Disease Burden in Patients With Symptomatic Peripheral Artery Disease

Angiology ◽  
2019 ◽  
Vol 71 (4) ◽  
pp. 303-314
Author(s):  
Rupert Bauersachs ◽  
Sebastian Debus ◽  
Mark Nehler ◽  
Maria Huelsebeck ◽  
Janita Balradj ◽  
...  
Keyword(s):  
Peripheral Artery Disease ◽  
Disease Burden ◽  
Ankle Brachial Index ◽  
Peripheral Artery ◽  
Economic Burden Of Disease ◽  
Surgical Interventions ◽  
Treatment Practice ◽  
Patient Profile ◽  
Increased Risk ◽  
Artery Disease

Patients with peripheral artery disease (PAD) have an increased risk of cardiovascular (CV) and limb events, but the disease is frequently underdiagnosed and treatment options are limited. This review examines the disease burden of symptomatic PAD as well as key guideline recommendations. Publications were identified using the ProQuest portal to access the Medline, Medline In-Process, and Embase databases. Search terms for symptomatic PAD were combined with terms relevant to epidemiology, burden, treatment practice, and physiopathology. Articles in English published between January 2001 and September 2016 were screened according to the population, interventions, comparator, outcomes, and study design criteria. Relevant publications (n = 200) were identified. The reported incidence and prevalence of PAD varied depending on the definitions used and the study populations. Patients generally had a poor prognosis, with an increased risk of mortality, CV, and limb events and decreased quality of life. Guideline recommendations included ankle–brachial index measurements, exercise testing, and angiography for diagnosis and risk factor modification, antiplatelets, cilostazol, exercise therapy, or surgical interventions for treatment, depending on the patient profile. The clinical, humanistic, and economic burden of disease in patients with symptomatic PAD is substantial and needs to be reduced through improved PAD management.

scholarly journals Impaired Renal Function is Associated with Severe Coronary Artery Disease in Chronic Stable Angina Patients

2014 ◽  
Vol 7 (1) ◽  
pp. 17-23
Author(s):  
JN Saha ◽  
AAS Majumder ◽  
NA Chowdhury ◽  
M Ullah ◽  
MG Azam ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Artery Disease ◽  
Renal Function ◽  
Stable Angina ◽  
Impaired Renal Function ◽  
Chronic Stable Angina ◽  
Gensini Score ◽  
Function Group ◽  
Artery Disease ◽  
Renal Function Group

Background: Cardiovascular disease is the leading cause of morbidity and mortality in renal impaired patients. Many of the patients of chronic kidney disease die of cardiovascular disease before requiring dialysis. Cardiovascular disease in renal impaired patient is potentially preventable and treatable. The aim of this study was to evaluate the association between renal impairment and coronary artery disease severity in chronic stable angina patients. Methods: 110 patients with chronic stable angina who got admitted for coronary angiography were included in the study. They were divided into impaired renal function group (with estimated glomerular filtration rate [eGFR] <90 ml/min/1.73m2) and normal renal function group (eGFR e” 90 ml/min/1.73m2) on the basis of eGFR. The severity of the CAD was assessed by angiographic Vessel score and Gensini score. Results: Mean Gensini score was significantly high in impaired renal function group (42.30±24.9 vs 25.65±17.9, p <0.05). There was significant negative correlation between eGFR and vessel score (r=-0.30, p <0.05) and between eGFR and Gensini score (r =-0.65, P <0.05). In multivariate logistic regression analysis, after adjustment of factors eGFR remain independent predictors of severe CAD (P=0.002, OR -5.73). Conclusion: Impaired renal function, assessed by eGFR is associated with angiographic severe coronary artery disease in chronic stable angina patients and this association is independent of conventional cardiovascular risk factors. DOI: http://dx.doi.org/10.3329/cardio.v7i1.20796 Cardiovasc. j. 2014; 7(1): 17-23

The application of quercetin in liposomal form for optimization of metabolic therapy of coronary artery disease.

2021 ◽  
Vol 2021 (2) ◽  
pp. 118-123
Author(s):  
O.M. Korzh ◽  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Stable Angina ◽  
Exercise Tolerance ◽  
Clinical Course ◽  
Functional Class ◽  
Liposomal Form ◽  
Complex Therapy ◽  
Artery Disease

The study of the clinical efficacy and safety of the dietary supplement L-Quercet as part of the complex therapy of patients with coronary artery disease with stable angina of II functional class, taking into account their effect on the clinical course of the disease, exercise tolerance and functional state of the endothelium. It has been shown that the inclusion of L-Quercet in the complex therapy in patients with stable angina leads to an improvement in the clinical course of angina pectoris, allows to significantly increase exercise tolerance and the quality of life of patients. The use of L-Quercet improves the indicators of endothelial function according to the results of the cuff test, which is one of the main factors in the prevention of the development and progression of atherosclerosis and coronary artery disease, and also causes an increase in the effectiveness of antianginal pharmacotherapy

Chronic Stable Angina

2017 ◽  
Author(s):  
Benjamin J Scirica ◽  
J. Antonio T. Gutierrez
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Heart Disease ◽  
Percutaneous Coronary Intervention ◽  
Heart Disease ◽  
Coronary Artery ◽  
Stable Angina ◽  
Chronic Stable Angina ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
Artery Disease

By definition, chronic stable angina is angina that has been stable with regard to frequency and severity for at least 2 months. Chronic stable angina is the initial manifestation of coronary heart disease in approximately 50% of patients. Typically, this type of angina occurs in the setting of atherosclerotic coronary arterial narrowing, although other causes are possible. This review covers the epidemiology, pathophysiology, initial evaluation, differential diagnosis, management, and treatment of patients with chronic stable angina. Figures show noninvasive testing and the probability of coronary artery disease; diagnosis of patients with suspected ischemic heart disease; probability of severe coronary artery disease; coronary outcomes for high- versus low-intensity statin therapy; optimal medical therapy (OMT) versus OMT and percutaneous coronary intervention for chronic angina; OMT versus percutaneous coronary intervention for stable coronary heart disease; and coronary artery bypass grafting versus percutaneous coronary intervention for diabetes and coronary artery disease. Tables list the grading of angina pectoris by the Canadian Cardiovascular Society classification system, the differential diagnosis of chest pain, conditions promoting myocardial oxygen supply and demand mismatch, the features of typical angina, the classification of chest pain, a comparison of the pretest likelihood of coronary heart disease (CHD) in low-risk and high-risk symptomatic patients, the posttest probability of significant CHD based on pretest probabilities of CHD and normal or abnormal results of noninvasive studies, survival according to risk groups based on Duke treadmill scores, high- and moderate-intensity statin therapy, revascularization to improve survival compared with medical therapy, revascularization to improve symptoms with significant anatomic (≥ 50% left main or ≥ 70% nonleft main coronary artery disease) or physiologic (fractional flow reserve ≤ 0.80) coronary artery stenoses, and questions recommended by an expert panel for patients with chronic stable angina at follow-up visits. This review contains 7 highly rendered figures, 13 tables, and 109 references.

Coronary artery disease: Chronic stable angina

2010 ◽  
pp. 29-44
Author(s):  
Juan Carlos Kaski
Keyword(s):  
Coronary Artery Disease ◽  
Stable Angina ◽  
Chronic Stable Angina ◽  
Pharmacological Therapy ◽  
Myocardial Reperfusion ◽  
Syndrome X ◽  
Variant Angina ◽  
Cardiac Syndrome ◽  
Artery Disease ◽  
Developed World

Overview of stable angina 32 Treatment of stable angina 34 Pharmacological therapy for stable angina 36 Myocardial reperfusion therapies for stable angina 40 Prinzmetal’s variant angina 40 Cardiac syndrome X 41 Further reading 41 Clinical trials 42 Ischaemic heart disease is the leading cause of morbidity and mortality in the developed world. The prevalence of stable angina increases with age, affecting 10–15% of women and 10–20% of men aged 65–74 years. Below the age of 50–55 years, a more distinct discrepancy between the sexes is seen, with a higher incidence seen among middle-aged men. In fact, approximately 70% of all patients with chronic stable angina are male....

scholarly journals Association between Neutrophil to Lymphocyte Ratio and Severity of Coronary Artery Disease in Chronic Stable Angina

2018 ◽  
Vol 10 (2) ◽  
pp. 164-170 ◽  
Author(s):  
Ratan Kumar Datta ◽  
Md Mamunur Rashid ◽  
MG Azam ◽  
Md Salahuddin Ulubbi ◽  
Mohammad Khalilur Rahman Siddiqui ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Stable Angina ◽  
Chronic Stable Angina ◽  
Neutrophil To Lymphocyte Ratio ◽  
Severe Coronary Artery Disease ◽  
Gensini Score ◽  
Severe Coronary Artery ◽  
Artery Disease ◽  
Vessel Score

Background: Neutrophil to lymphocyte ratio (NLR) has been proposed as a new prognostic marker in patients with chronic stable angina (CSA). NLR is a cheap, easily available, non-invasive and routinely done procedure to predict the severity of coronary artery disease.Methods: 110 patients with stable coronary artery disease were evaluated to calculate the NLR from January, 2016 to September, 2016. The patients were divided into two groups: Group I NLR>2.38 and group II NLRd”2.38. Coronary angiogram was done during index hospitalization. The severity of the coronary artery disease was assessed by vessel score and Gensini score and was compared between the groups.Results: NLR was significantly higher in the group of high vessel score and high Gensini score. We found significant weak association between NLR and vessel score (r=0.30, p=0.004) and a moderate positive correlation between NLR and Gensini score (r =0.65, P=0.001). With the increase of NLR, vessel score and Gensini score increases demonstrating more severe coronary artery disease. Univariate logistic regression analysis of variables of interest revealed that age, hypertension, dyslipidemia, serum creatinine, total WBC count and NLR were independent predictor of severe coronary artery disease with odds ratio (OR) being 1.88, 3.93, 5.01, 5.54, 4.05 and 5.70 respectively. In multivariate logistic regression analysis, after adjustment of factors NLR remain independent predictors of severe CSA (OR = 5.73; p = 0.002).Conclusion: Increased neutrophil to lymphocyte ratio is associated with angiographically severe coronary artery disease in chronic stable angina and this association is independent of conventional cardiovascular risk factors.Cardiovasc. j. 2018; 10(2): 164-170

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