scholarly journals Management of refractory angina pectoris

2004 ◽  
Vol 132 (11-12) ◽  
pp. 453-457
Author(s):  
Andjelka Ristic ◽  
Lazar Angelkov ◽  
Milorad Damnjanovic ◽  
Branislav Baskot
Keyword(s):  
Coronary Artery Disease ◽  
Angina Pectoris ◽  
Objective Measures ◽  
Refractory Angina ◽  
Transmyocardial Laser Revascularization ◽  
Number Of Patients ◽  
Conventional Medical Therapy ◽  
Artery Disease ◽  
Refractory Angina Pectoris ◽  
Enhanced External Counterpulsation

An increasing number of patients with coronary artery disease have ischemie symptoms that are unresponsive to both conventional medical therapy and revascularization techniques. The objective of this study was to define the population of patients with refractory angina pectoris and to present the therapeutic options currently available for this condition. Among many techniques, the enhanced external counterpulsation, transmyocardial laser revascularization and neurostimulation have been shown to reduce angina and to improve objective measures of myocardial ischemia in patients with refractory angina.

Intermediate-Term Clinical Outcome Following Transmyocardial Laser Revascularization in Patients With Refractory Angina Pectoris

Circulation ◽  
1999 ◽  
Vol 100 (suppl_2) ◽  
Author(s):  
Carolyn K. Landolfo ◽  
Kevin P. Landolfo ◽  
G. Chad Hughes ◽  
Edward R. Coleman ◽  
Robin B. Coleman ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Angina Pectoris ◽  
Perfusion Imaging ◽  
Functional Class ◽  
Refractory Angina ◽  
Transmyocardial Laser Revascularization ◽  
Artery Disease ◽  
Refractory Angina Pectoris

Background —This study was conducted to examine the intermediate-term clinical outcomes in patients with refractory angina pectoris treated with transmyocardial laser revascularization (TMR) at our institution. TMR is an alternative surgical technique for the treatment of myocardial ischemia and angina pectoris not amenable to conventional percutaneous or surgical revascularization. Limited data exist evaluating the natural history and duration of clinical improvement in angina pectoris following TMR. Methods and Results —Thirty-four patients with severe coronary artery disease unsuitable for treatment with standard revascularization techniques underwent TMR in myocardial regions determined to be ischemic by preoperative SPECT 201 Tl perfusion imaging following dipyridamole stress. Patients were assessed postoperatively at 3, 6, and 12 months for clinical outcomes including death, myocardial infarction, functional class of angina pectoris, and hospitalizations for unstable angina. Myocardial perfusion imaging by 201 Tl scintigraphy was also assessed at these temporal end points. Overall mortality at 1 year was 14.7% (n=5). Nonfatal myocardial infarction occurred in 3 patients (8.8%). Among the patients with complete 12-month follow-up (n =27), mean anginal class improved from 3.5±0.5 pre-TMR to 2.8±0.7 and 2.5±0.7 at 3 and 6 months, respectively, and 2.8±0.9 at 12 months. Overall improvement in angina pectoris was sustained at 1 year by at least one functional class in 50% of patients. Mean hospitalizations per year for unstable angina declined from 2.4±1.6 pre-TMR to 1.7±2.0 post-TMR ( P =0.01). There was no significant improvement in perfusion by SPECT 201 Tl imaging at any temporal end point post-TMR. Conclusions —Despite the lack of demonstrable improvement in perfusion by SPECT 201 Tl imaging, TMR improved the functional class of angina pectoris in patients with end stage coronary artery disease to a modest degree. Although the maximal benefit in symptoms occurred at 6 months post-TMR, mild sustained clinical improvement above baseline was evident in 50% of patients at 1 year.

scholarly journals Chronic-intermittent urokinase therapy in patients with end-stage coronary artery disease and refractory angina pectoris-A pilot study

1996 ◽  
Vol 19 (2) ◽  
pp. 115-120 ◽  
Author(s):  
F. C. Schoebel ◽  
M. Leschke ◽  
T. W. Jax ◽  
D. Stein ◽  
B. E. Strauer
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Pilot Study ◽  
Angina Pectoris ◽  
Refractory Angina ◽  
Artery Disease ◽  
Refractory Angina Pectoris ◽  
End Stage

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

1997 ◽  
Vol 134 (4) ◽  
pp. 587-602 ◽  
Author(s):  
Frank C. Schoebel ◽  
O.Howard Frazier ◽  
Gilian A.J. Jessurun ◽  
Mike J.L. De Jongste ◽  
Kamuran A. Kadipasaoglu ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Angina Pectoris ◽  
Refractory Angina ◽  
Therapeutic Concepts ◽  
Artery Disease ◽  
Refractory Angina Pectoris ◽  
End Stage

scholarly journals Long-term intermittent urokinase therapy in patients with end-stage coronary artery disease and refractory angina pectoris: A randomized dose-response trial

1996 ◽  
Vol 27 (3) ◽  
pp. 575-584 ◽  
Author(s):  
Matthias Leschke ◽  
Frank-Chris Schoebel ◽  
Wolf-Gang Mecklenbeck ◽  
Dirk Stein ◽  
Thomas Walter Jax ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Angina Pectoris ◽  
Dose Response ◽  
Refractory Angina ◽  
Artery Disease ◽  
Refractory Angina Pectoris ◽  
End Stage ◽  
Response Trial

scholarly journals Refractory Angina—An Overview and Recent Trends

2017 ◽  
Vol 02 (04) ◽  
pp. 094-098
Author(s):  
Meenakshi Kadiyala ◽  
Rameshwar Roopchandar ◽  
Chandrshekaran Krishnaswamy
Keyword(s):  
Angina Pectoris ◽  
Coronary Bypass ◽  
Refractory Angina ◽  
Coronary Insufficiency ◽  
Poor General Health ◽  
Percutaneous Coronary ◽  
Recent Trends ◽  
Artery Disease ◽  
Refractory Angina Pectoris ◽  
Improvement In Survival

AbstractBecause of improvement in survival from coronary artery disease and increasing life expectancy of the population, chronicity and resistance to therapy have become growing problems confronting the cardiologist. Refractory angina pectoris is an entity based on clinical diagnosis, and it refers to recurrent and sustained chest pain more than 3 months duration caused by coronary insufficiency that is unamenable to conventional modalities of treatment, including drugs, percutaneous coronary interventions, or coronary bypass grafting. Individuals with this entity may have an impaired quality of life, with recurrent angina, poor general health and psychological distress impairing functional and productive sustenance. A multitude of therapeutic options exists for patients with refractory angina pectoris, and randomized trials have shown them to be reasonably effective in reducing symptoms, though further research is warranted.

scholarly journals Reduced peripheral vascular reactivity in refractory angina pectoris: Effect of enhanced external counterpulsation

2012 ◽  
Vol 8 (4) ◽  
pp. 215-223 ◽  
Author(s):  
Bondesson Susanne M ◽  
Edvinsson Marie-Louise ◽  
Pettersson Thomas ◽  
Edvinsson Lars
Keyword(s):  
Angina Pectoris ◽  
Vascular Reactivity ◽  
Refractory Angina ◽  
Peripheral Vascular ◽  
External Counterpulsation ◽  
Refractory Angina Pectoris ◽  
Enhanced External Counterpulsation
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