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Stable angina

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https://www.readbyqxmd.com/read/29155984/cysteine-rich-angiogenic-inducer-61-cyr61-a-novel-soluble-biomarker-of-acute-myocardial-injury-improves-risk-stratification-after-acute-coronary-syndromes
#1
Roland Klingenberg, Soheila Aghlmandi, Christoph Liebetrau, Lorenz Räber, Baris Gencer, David Nanchen, David Carballo, Alexander Akhmedov, Fabrizio Montecucco, Stefan Zoller, Chad Brokopp, Dik Heg, Peter Jüni, Helena Marti Soler, Pedro-Manuel Marques-Vidal, Peter Vollenweider, Oliver Dörr, Nicolas Rodondi, François Mach, Stephan Windecker, Ulf Landmesser, Arnold von Eckardstein, Christian W Hamm, Christian M Matter, Thomas F Lüscher
Aims: We aimed to identify a novel biomarker involved in the early events leading to an acute coronary syndrome (ACS) and evaluate its role in diagnosis and risk stratification. Methods and results: Biomarker identification was based on gene expression profiling. In coronary thrombi of ACS patients, cysteine-rich angiogenic inducer 61 (Cyr61, CCN1) gene transcripts were highly up-regulated compared with peripheral mononuclear cells. In a murine ischaemia-reperfusion model (I/R), myocardial Cyr61 expression was markedly increased compared with the controls...
November 16, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29151028/variations-in-use-of-optimal-medical-therapy-in-patients-with-nonobstructive-coronary-artery-disease-a-population-based-study
#2
Adam Oxner, Gabby Elbaz-Greener, Feng Qui, Shannon Masih, Nevena Zivkovic, Sami Alnasser, Asim N Cheema, Harindra C Wijeysundera
BACKGROUND: There is a paucity of data on the need for optimal medical therapy (OMT) in nonobstructive coronary artery disease . We sought to understand if there was variation in the use of OMT between hospitals for patients with nonobstructive coronary artery disease, the factors associated with such variation, and its clinical consequences. METHODS AND RESULTS: Using a population-level clinical registry in Ontario, Canada, we identified all patients >66 years undergoing coronary angiography for the indication of stable angina, who had nonobstructive coronary artery disease between November 1, 2010, and October 31, 2013...
November 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29148291/effectiveness-and-safety-of-anti-ischemic-trimetazidine-in-patients-with-stable-angina-pectoris-and-type-2-diabetes
#3
Zsófia Meiszterics, Attila Kónyi, Gábor Hild, Zsolt Sárszegi, Balázs Gaszner
Aim & methods: This 6-month prospective, observational, noninterventional, open-label clinical study assessed the effectiveness/safety of trimetazidine in 737 patients with stable angina pectoris and Type 2 diabetes mellitus (OGYI/51534-1/2014). RESULTS: Trimetazidine-based therapy was effective in stable coronary artery disease, with significant improvements from baseline (p < 0.05) in: number of angina attacks/week (2.9 ± 2.4 vs 1.1 ± 1.6), angina severity (Canadian Cardiovascular Society Classification 1...
November 17, 2017: Journal of Comparative Effectiveness Research
https://www.readbyqxmd.com/read/29138258/challenges-in-delivering-computed-tomography-coronary-angiography-as-the-first-line-test-for-stable-chest-pain
#4
John G Dreisbach, Edward D Nicol, Carl A Roobottom, Simon Padley, Giles Roditi
OBJECTIVE: The National Institute for Health and Care Excellence (NICE) clinical guidelines 'chest pain of recent onset: assessment and diagnosis' (update 2016) state CT coronary angiography (CTCA) should be offered as the first-line investigation for patients with stable chest pain. However, the current provision in the UK is unknown. We aimed to evaluate this and estimate the requirements for full implementation of the guidelines including geographical variation. Ancillary aims included surveying the number of CTCA-capable scanners and accredited practitioners in the UK...
November 14, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29132879/rivaroxaban-with-or-without-aspirin-in-patients-with-stable-coronary-artery-disease-an-international-randomised-double-blind-placebo-controlled-trial
#5
Stuart J Connolly, John W Eikelboom, Jackie Bosch, Gilles Dagenais, Leanne Dyal, Fernando Lanas, Kaj Metsarinne, Martin O'Donnell, Anthony L Dans, Jong-Won Ha, Alexandr N Parkhomenko, Alvaro A Avezum, Eva Lonn, Liu Lisheng, Christian Torp-Pedersen, Petr Widimsky, Aldo P Maggioni, Camilo Felix, Katalin Keltai, Masatsugu Hori, Khalid Yusoff, Tomasz J Guzik, Deepak L Bhatt, Kelley R H Branch, Nancy Cook Bruns, Scott D Berkowitz, Sonia S Anand, John D Varigos, Keith A A Fox, Salim Yusuf
BACKGROUND: Coronary artery disease is a major cause of morbidity and mortality worldwide, and is a consequence of acute thrombotic events involving activation of platelets and coagulation proteins. Factor Xa inhibitors and aspirin each reduce thrombotic events but have not yet been tested in combination or against each other in patients with stable coronary artery disease. METHODS: In this multicentre, double-blind, randomised, placebo-controlled, outpatient trial, patients with stable coronary artery disease or peripheral artery disease were recruited at 602 hospitals, clinics, or community centres in 33 countries...
November 10, 2017: Lancet
https://www.readbyqxmd.com/read/29132649/doppler-versus-thermodilution-derived-coronary-microvascular-resistance-to-predict-coronary-microvascular-dysfunction-in-patients-with-acute-myocardial-infarction-or-stable-angina-pectoris
#6
Rupert P Williams, Guus A de Waard, Kalpa De Silva, Matthew Lumley, Kaleab Asrress, Satpal Arri, Howard Ellis, Awais Mir, Brian Clapp, Amedeo Chiribiri, Sven Plein, Paul F Teunissen, Maurits R Hollander, Michael Marber, Simon Redwood, Niels van Royen, Divaka Perera
Coronary microvascular resistance is increasingly measured as a predictor of clinical outcomes, but there is no accepted gold-standard measurement. We compared the diagnostic accuracy of 2 invasive indices of microvascular resistance, Doppler-derived hyperemic microvascular resistance (hMR) and thermodilution-derived index of microcirculatory resistance (IMR), at predicting microvascular dysfunction. A total of 54 patients (61 ± 10 years) who underwent cardiac catheterization for stable coronary artery disease (n = 10) or acute myocardial infarction (n = 44) had simultaneous intracoronary pressure, Doppler flow velocity and thermodilution flow data acquired from 74 unobstructed vessels, at rest and during hyperemia...
October 10, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29126583/effect-of-changes-in-physical-activity-on-risk-for-cardiac-death-in-patients-with-coronary-artery-disease
#7
Minna Lahtinen, Tomi Toukola, M Juhani Junttila, Olli-Pekka Piira, Samuli Lepojärvi, Maria Kääriäinen, Heikki V Huikuri, Mikko P Tulppo, Antti M Kiviniemi
Leisure-time physical activity (LTPA) is associated with longevity in patients with coronary artery disease (CAD). However, less is known about prognostic significance of longitudinally assessed LTPA in patients with stable CAD. The present study assessed the relationship between changes in LTPA and cardiac mortality in patients with CAD. Patients with angiographically documented CAD (n = 1,746) underwent clinical examination and echocardiography at the baseline. Lifestyle factors, including LTPA (inactive, irregularly active, active, highly active), were surveyed at baseline and after 2 years' follow-up...
October 19, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29126373/quality-assessment-in-percutaneous-coronary-interventions-the-qermid-belgian-pci-registry
#8
Claude Hanet, Marc J Claeys, Marc Carlier, Walter Desmet
BACKGROUND: The recent increase in the number of interventional cathlabs that followed a moratorium of several years has resulted in an abrupt increase in the number of PCI and a dilution of the experience per centre and per operator. METHODS: Based on data extracted from the national "Quality Oriented Electronic Registration of Medical Implant Devices" (QERMID) database, we compared the characteristics and outcome of patients treated in 2015 in the 21 newly (<3 years) approved PCI centres with those of patients treated in the 28 historical PCI centres...
November 10, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/29117276/clinical-efficacy-and-safety-of-evolocumab-in-high-risk-patients-receiving-a-statin-secondary-analysis-of-patients-with-low-ldl-cholesterol-levels-and-in-those-already-receiving-a-maximal-potency-statin-in-a-randomized-clinical-trial
#9
Robert P Giugliano, Anthony Keech, Sabina A Murphy, Kurt Huber, S Lale Tokgozoglu, Basil S Lewis, Jorge Ferreira, Armando Lira Pineda, Ransi Somaratne, Peter S Sever, Terje R Pedersen, Marc S Sabatine
Importance: Current guidelines for atherosclerotic cardiovascular disease focus on high-intensity statins and targeting or using a threshold low-density lipoprotein cholesterol (LDL-C) level of less than 70 mg/dL for the highest-risk patients. Whether further reduction of LDL-C beyond these boundaries would be beneficial is unknown. Objective: To compare outcomes of evolocumab vs placebo in patients with stable atherosclerotic cardiovascular disease and a baseline LDL-C of less than 70 mg/dL and in those receiving background treatment with a maximal-potency statin...
November 8, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29116618/treatment-of-stable-angina-with-a-new-fixed-dose-combination-of-ivabradine-and-metoprolol-effectiveness-and-tolerability-in-routine-clinical-practice
#10
Dimitar Divchev, Georg Stöckl
INTRODUCTION: In this prospective, multicenter, observational cohort study, the effectiveness and tolerability of the first fixed-dose combination (FDC) formulation of the selective heart rate reducing agent ivabradine and the beta-blocker metoprolol was evaluated in stable angina pectoris (AP) patients in a clinical practice setting. METHODS: Stable AP outpatients received a FDC of ivabradine and metoprolol (b.i.d.) for 4 months, in addition to cardiovascular standard therapy...
December 2017: Cardiology and Therapy
https://www.readbyqxmd.com/read/29107310/management-of-chronic-stable-angina
#11
REVIEW
Michele Ann Walters
Chronic stable angina (CSA) is a symptomatic problem that is precipitated by ischemic heart disease. CSA is diagnosed when symptoms are present for at least 2 months without changes in severity, character, or triggering circumstances. This article is a summary of current treatment strategies aimed to prevent progression of atherosclerosis, and medication therapies to control angina symptoms and improve quality of life for the individual.
December 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/29103734/relationship-between-optical-coherence-tomography-derived-morphological-criteria-and-functional-relevance-as-determined-by-fractional-flow-reserve
#12
Eisuke Usui, Taishi Yonetsu, Yoshihisa Kanaji, Masahiro Hoshino, Masao Yamaguchi, Masahiro Hada, Tadashi Fukuda, Hiroaki Ohya, Yohei Sumino, Rikuta Hamaya, Yoshinori Kanno, Tadashi Murai, Tetsumin Lee, Tsunekazu Kakuta
BACKGROUND: Although several previous studies have indicated that optical coherence tomography (OCT)-derived minimal lumen area (MLA) correlates with fractional flow reserve (FFR) severity, other morphologic criteria for functionally significant coronary stenosis assessed by FFR have not been fully elucidated. This study aimed to identify OCT-based morphological predictors of physiologically significant ischemia assessed by FFR in angiographically intermediate coronary lesions. METHODS: We investigated 194 de novo intermediate coronary lesions in 178 patients with stable angina pectoris who underwent OCT imaging and FFR measurement...
November 2, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29103657/last-nail-in-the-coffin-for-pci-in-stable-angina
#13
David L Brown, Rita F Redberg
No abstract text is available yet for this article.
November 1, 2017: Lancet
https://www.readbyqxmd.com/read/29103656/percutaneous-coronary-intervention-in-stable-angina-orbita-a-double-blind-randomised-controlled-trial
#14
Rasha Al-Lamee, David Thompson, Hakim-Moulay Dehbi, Sayan Sen, Kare Tang, John Davies, Thomas Keeble, Michael Mielewczik, Raffi Kaprielian, Iqbal S Malik, Sukhjinder S Nijjer, Ricardo Petraco, Christopher Cook, Yousif Ahmad, James Howard, Christopher Baker, Andrew Sharp, Robert Gerber, Suneel Talwar, Ravi Assomull, Jamil Mayet, Roland Wensel, David Collier, Matthew Shun-Shin, Simon A Thom, Justin E Davies, Darrel P Francis
BACKGROUND: Symptomatic relief is the primary goal of percutaneous coronary intervention (PCI) in stable angina and is commonly observed clinically. However, there is no evidence from blinded, placebo-controlled randomised trials to show its efficacy. METHODS: ORBITA is a blinded, multicentre randomised trial of PCI versus a placebo procedure for angina relief that was done at five study sites in the UK. We enrolled patients with severe (≥70%) single-vessel stenoses...
November 1, 2017: Lancet
https://www.readbyqxmd.com/read/29102362/drug-eluting-stents-in-elderly-patients-with-coronary-artery-disease-senior-a-randomised-single-blind-trial
#15
Olivier Varenne, Stéphane Cook, Georgios Sideris, Sasko Kedev, Thomas Cuisset, Didier Carrié, Thomas Hovasse, Philippe Garot, Rami El Mahmoud, Christian Spaulding, Gérard Helft, José F Diaz Fernandez, Salvatore Brugaletta, Eduardo Pinar-Bermudez, Josepa Mauri Ferre, Philippe Commeau, Emmanuel Teiger, Kris Bogaerts, Manel Sabate, Marie-Claude Morice, Peter R Sinnaeve
BACKGROUND: Elderly patients regularly receive bare-metal stents (BMS) instead of drug-eluting stents (DES) to shorten the duration of double antiplatelet therapy (DAPT). The aim of this study was to compare outcomes between these two types of stents with a short duration of DAPT in such patients. METHODS: In this randomised single-blind trial, we recruited patients from 44 centres in nine countries. Patients were eligible if they were aged 75 years or older; had stable angina, silent ischaemia, or an acute coronary syndrome; and had at least one coronary artery with a stenosis of at least 70% (≥50% for the left main stem) deemed eligible for percutaneous coronary intervention (PCI)...
October 31, 2017: Lancet
https://www.readbyqxmd.com/read/29097450/clinical-outcomes-and-cost-effectiveness-of-fractional-flow-reserve-guided-percutaneous-coronary-intervention-in-patients-with-stable-coronary-artery-disease-three-year-follow-up-of-the-fame-2-trial-fractional-flow-reserve-versus-angiography-for-multivessel
#16
William F Fearon, Takeshi Nishi, Bernard De Bruyne, Derek B Boothroyd, Emanuele Barbato, Pim Tonino, Peter Jüni, Nico H J Pijls, Mark A Hlatky
BACKGROUND : Previous studies found that percutaneous coronary intervention (PCI) does not improve outcome compared with medical therapy (MT) in patients with stable coronary artery disease, but PCI was guided by angiography alone. FAME 2 trial (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) compared PCI guided by fractional flow reserve with best MT in patients with stable coronary artery disease to assess clinical outcomes and cost-effectiveness. METHODS : A total of 888 patients with stable single-vessel or multivessel coronary artery disease with reduced fractional flow reserve were randomly assigned to PCI plus MT (n=447) or MT alone (n=441)...
November 2, 2017: Circulation
https://www.readbyqxmd.com/read/29097387/neopterin-as-an-effect-modifier-of-the-cardiovascular-risk-predicted-by-total-homocysteine-a-prospective-2-cohort-study
#17
Espen Ø Bjørnestad, Robert A Borsholm, Gard F T Svingen, Eva R Pedersen, Reinhard Seifert, Øivind Midttun, Per M Ueland, Grethe S Tell, Kaare H Bønaa, Ottar Nygård
BACKGROUND: Plasma total homocysteine (tHcy) is related to plasma neopterin, an indicator of interferon-γ-mediated immune activation, and both biomarkers positively predict cardiovascular risk. We examined whether the association between tHcy and subsequent risk of acute myocardial infarction (AMI) was modified by systemic concentrations of neopterin and C-reactive protein among patients with coronary heart disease. METHODS AND RESULTS: By Cox modeling, we explored the association between tHcy and risk of AMI in 4164 patients with suspected stable angina pectoris...
November 2, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29097361/heart-stents-for-stable-angina-show-no-benefit-over-placebo-study-finds
#18
Jacqui Wise
No abstract text is available yet for this article.
November 2, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29096805/sex-related-differences-in-vasomotor-function-in-patients-with-angina-and%C3%A2-unobstructed-coronary-arteries
#19
Ahmed Aziz, Henrik Steen Hansen, Udo Sechtem, Eva Prescott, Peter Ong
BACKGROUND: Coronary vasomotor dysfunction is an important mechanism for angina in patients with unobstructed coronary arteries. OBJECTIVES: The purpose of this study was to determine sex differences in the prevalence and clinical presentation of vasomotor dysfunction in a European population and to examine sex differences in the dose of acetylcholine leading to a positive acetylcholine provocation test (ACH test). METHODS: Between 2007 and 2014, we included 1,379 consecutive patients with stable angina, unobstructed coronaries and ACH test performed for epicardial vasospasm or coronary microvascular dysfunction (CMD) due to microvascular spasm...
November 7, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29081147/-clinical-characteristics-and-prognosis-in-the-patients-of-stroke-after-percutaneous-coronary-intervention
#20
X F Tang, Z Gao, J J Xu, Y Song, Y L Ma, H H Wang, L Jiang, P Jiang, R Liu, L J Gao, Y Zhang, L Song, J Chen, Y J Yang, R L Gao, B Xu, J Q Yuan
Objective: To investigate the clinical characteristics and prognosis in patients with stroke after percutaneous coronary intervention (PCI). Methods: From January 2013 to December 2013, 10 724 consecutive patients undergoing PCI including acute coronary syndrome and stable angina pectoris were enrolled.A two years' follow up was conducted among these patients to investigate the clinical characteristics and prognosis of patients with stroke and of those without. A comparison was done between the two groups. Results: One hundred and forty-five patients had stroke (1...
October 24, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
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