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Anginal drugs

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https://www.readbyqxmd.com/read/29699500/in-flight-angina-pectoris-an-unusual-presentation
#1
Firas Al-Janabi, Regina Mammen, Grigoris Karamasis, John Davies, Thomas Keeble
BACKGROUND: An unusual case of typical angina which occurred on a long haul flight is presented. This case is notable as this was the index presentation, with no previous symptoms prior to this. Physiological changes at altitude can be marked, and include hypoxia, tachycardia and an increase in cardiac output. These changes were enough to expose underlying angina in our patient. CASE PRESENTATION: A 68 year old man presented with typical cardiac chest pain on a long haul flight...
April 5, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29673511/coronary-sinus-reducer-implantation-for-the-treatment-of-chronic-refractory-angina-a-single-center-experience
#2
Francesco Giannini, Luca Baldetti, Francesco Ponticelli, Neil Ruparelia, Satoru Mitomo, Azeem Latib, Matteo Montorfano, Richard J Jabbour, Andrea Aurelio, Luca Ferri, Antonio Mangieri, Damiano Regazzoli, Marco Ancona, Matteo Pagnesi, Alessia Faccini, Alaide Chieffo, Lorenzo Azzalini, Mauro Carlino, Antonio Colombo
OBJECTIVES: The aim of this study was to assess the safety and efficacy of the Reducer in a real-world cohort of patients presenting with refractory angina. BACKGROUND: The coronary sinus Reducer is a novel device to aid in the management of patients with severe angina symptoms refractory to optimal medical therapy and not amenable to further revascularization. METHODS: Fifty patients with refractory angina and objective evidence of myocardial ischemia who were judged unsuitable for revascularization were treated with coronary sinus Reducer implantation at a single center between March 2015 and August 2016...
April 23, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29371959/modulating-the-metabolism-by-trimetazidine-enhances-myoblast-differentiation-and-promotes-myogenesis-in-cachectic-tumor-bearing-c26-mice
#3
Lucia Gatta, Laura Vitiello, Stefania Gorini, Sergio Chiandotto, Paola Costelli, Anna Maria Giammarioli, Walter Malorni, Giuseppe Rosano, Elisabetta Ferraro
Trimetazidine (TMZ) is a metabolic reprogramming agent able to partially inhibit mitochondrial free fatty acid β-oxidation while enhancing glucose oxidation. Here we have found that the metabolic shift driven by TMZ enhances the myogenic potential of skeletal muscle progenitor cells leading to MyoD, Myogenin, Desmin and the slow isoforms of troponin C and I over-expression. Moreover, similarly to exercise, TMZ stimulates the phosphorylation of the AMP-activated protein kinase (AMPK) and up-regulates the peroxisome proliferator-activated receptor gamma coactivator 1-α (PGC1α), both of which are known to enhance the mitochondrial biogenesis necessary for myoblast differentiation...
December 26, 2017: Oncotarget
https://www.readbyqxmd.com/read/29299356/fluoropyrimidine-induced-cardiac-toxicity-challenging-the-current-paradigm
#4
Suparna C Clasen, Bonnie Ky, Rupal O'Quinn, Bruce Giantonio, Ursina Teitelbaum, Joseph R Carver
Background: Fluoropyrimidine chemotherapy [5-fluorouracil (5-FU) and capecitabine] are commonly used agents in the treatment of various solid malignancies. However, their use has been limited by cardiac toxicity, presenting as a wide spectrum of asymptomatic (e.g., EKG changes) and symptomatic (e.g., chest pain) manifestations related to coronary vasospasm leading to myocardial ischemia. Historically, patients with suspected coronary vasospasm have been treated with traditional acute ischemic workup and various combinations of anti-anginal therapies...
December 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28913755/management-and-clinical-outcome-of-stable-coronary-artery-disease-in-austria-results-from-5-years-of-the-clarify-registry
#5
Irene M Lang, Roza Badr-Eslam, Nicola Greenlaw, Robin Young, Philippe Gabriel Steg
BACKGROUND: The population of patients with established coronary artery disease (CAD) is growing because of an improvement in outcomes and survival from acute disease episodes. Nevertheless, these patients remain at high risk of cardiovascular events. Thus, CAD management is important in prevention of disease progression. The objective of this analysis was to describe disease management and clinical outcome of Austrian outpatients with stable CAD over 5 years by using data from the international CLARIFY registry...
December 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/28610990/atrial-ventricular-differences-in-rabbit-cardiac-voltage-gated-na-currents-basis-for-atrial-selective-block-by-ranolazine
#6
Rachel E Caves, Hongwei Cheng, Stéphanie C Choisy, Hanne C Gadeberg, Simon M Bryant, Jules C Hancox, Andrew F James
BACKGROUND: Class 1 antiarrhythmic drugs are highly effective in restoring and maintaining sinus rhythm in atrial fibrillation patients but carry a risk of ventricular tachyarrhythmia. The antianginal agent ranolazine is a prototypic atrial-selective voltage-gated Na+ channel blocker but the mechanisms underlying its atrial-selective action remain unclear. OBJECTIVE: The present study examined the mechanisms underlying the atrial-selective action of ranolazine. METHODS: Whole-cell voltage-gated Na+ currents (INa ) were recorded at room temperature (∼22°C) from rabbit isolated left atrial and right ventricular myocytes...
November 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28571183/effect-of-ranolazine-in-patients-with-chest-pain-and-normal-coronaries-a-hospital-based-study
#7
Swapan Saha, Tony Ete, Manish Kapoor, Pravin Kumar Jha, Rinchin Dorjee Megeji, Gaurav Kavi, Synrang Batngen Warjri, Animesh Mishra
INTRODUCTION: There is an important role of coronary microcirculation in the clinical presentation and prognosis of patients who have typical chest pain despite normal epicardial coronary arteries (microvascular angina). Treatment of these patients is empirical because of the incomplete knowledge of its cause. Limited data has shown that ranolazine reduces angina and improves exercise performance in such patients with frequent angina. AIM: To evaluate the effect of ranolazine in patients with chest pain and normal epicardial coronaries (micro-vascular angina)...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28468975/physiology-of-angina-and-its-alleviation-with-nitroglycerin-insights-from-invasive-catheter-laboratory-measurements-during-exercise
#8
Kaleab N Asrress, Rupert Williams, Timothy Lockie, Muhammed Z Khawaja, Kalpa De Silva, Matthew Lumley, Tiffany Patterson, Satpal Arri, Sana Ihsan, Howard Ellis, Antoine Guilcher, Brian Clapp, Philip J Chowienczyk, Sven Plein, Divaka Perera, Michael S Marber, Simon R Redwood
BACKGROUND: The mechanisms governing exercise-induced angina and its alleviation by the most commonly used antianginal drug, nitroglycerin, are incompletely understood. The purpose of this study was to develop a method by which the effects of antianginal drugs could be evaluated invasively during physiological exercise to gain further understanding of the clinical impact of angina and nitroglycerin. METHODS: Forty patients (mean age, 65.2±7.6 years) with exertional angina and coronary artery disease underwent cardiac catheterization via radial access and performed incremental exercise using a supine cycle ergometer...
July 4, 2017: Circulation
https://www.readbyqxmd.com/read/28405132/antianginal-efficacy-and-tolerability-of-ranolazine-as-an-add-on-drug-to-concomitant-medications-primarily-metoprolol-in-chronic-stable-angina-patients-a-prospective-open-label-study
#9
Anant Mahaveer Khot, H V Anuradha, V S Prakash, M C Shivamurathy
OBJECTIVE: To evaluate the efficacy and tolerability of ranolazine as an add-on drug in chronic stable angina patients and the impact of ranolazine on the quality of life in chronic stable angina patients receiving other antianginal medications. MATERIALS AND METHODS: It was a prospective, open-label, hospital-based study involving 144 patients with chronic stable angina. First group received either metoprolol 12.5 or 25 mg/day or other antianginal medications; if the symptoms persist, the dose of metoprolol was increased to 50 mg/day, and to the second group, ranolazine 500 mg BD or 1 g OD was added along with metoprolol or others if the anginal attacks were not subsiding...
January 2017: Journal of Pharmacology & Pharmacotherapeutics
https://www.readbyqxmd.com/read/28319269/withdrawn-trimetazidine-for-stable-angina
#10
REVIEW
Agustín Ciapponi, Rudolf Pizarro, Jeff Harrison
BACKGROUND: Patients with stable angina not controlled by monotherapy with nitrates, beta blockers, or calcium channel blockers are often treated with combinations of these drugs. There may be adverse effects from, or contraindications to, the use of combinations. In low risk groups, medical treatment appears to be as good an option as percutaneous transluminal coronary angioplasty in terms of averting myocardial infarction, death, or subsequent revascularization. Revascularization procedures are too costly or inaccessible for many patients in developing countries therefore effective and safe medical treatment is needed...
March 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28294866/-treatment-of-patients-with-stable-ischemic-heart-disease-in-real-clinical-practice-in-russia-the-choice-2-program
#11
G Glezer M, On Behalf Of The Choice-Study Participants On Behalf Of The Choice-Study Participants
OBJECTIVE: in the framework of an open post-marketing observational national program CHOICE-2 to assess correspondence between recommendations for management of patients with stable angina and actual clinical practice, as well as to assess effect of treatment with cytoprotector trimetazidine on clinical course of the disease. MATERIAL AND METHODS: Participating physicians (n=185 from 46 regions of Russian Federation) recruited 896 patients with ischemic heart disease (IHD)...
May 2016: Kardiologiia
https://www.readbyqxmd.com/read/28178363/ranolazine-for-stable-angina-pectoris
#12
REVIEW
Carlos A Salazar, Juan E Basilio Flores, Liz E Veramendi Espinoza, Jhon W Mejia Dolores, Diego E Rey Rodriguez, César Loza Munárriz
BACKGROUND: Stable angina pectoris is a chronic medical condition with significant impact on mortality and quality of life; it can be macrovascular or microvascular in origin. Ranolazine is a second-line anti-anginal drug approved for use in people with stable angina. However, the effects of ranolazine for people with angina are considered to be modest, with uncertain clinical relevance. OBJECTIVES: To assess the effects of ranolazine on cardiovascular and non-cardiovascular mortality, all-cause mortality, quality of life, acute myocardial infarction incidence, angina episodes frequency and adverse events incidence in stable angina patients, used either as monotherapy or as add-on therapy, and compared to placebo or any other anti-anginal agent...
February 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28120185/drug-therapy-for-stable-angina-pectoris
#13
REVIEW
Talla A Rousan, Sunil T Mathew, Udho Thadani
Chronic stable angina pectoris refers to the predictable, reproducible occurrence of pressure or a choking sensation in the chest or adjacent areas caused by myocardial ischemia in association with physical or emotional stress, and cessation of exertion and or sublingual nitroglycerin invariably relieves the discomfort. It is a common presenting symptom of severe narrowing of one or more coronary arteries, non-obstructive coronary arteries, or even when the coronary arteries are angiographically normal. Patients often avoid activities which precipitate symptoms and have impaired quality of life...
March 2017: Drugs
https://www.readbyqxmd.com/read/28077644/ultrasensitive-hiv-1-p24-assay-detects-single-infected-cells-and-differences-in-reservoir-induction-by-latency-reversal-agents
#14
COMPARATIVE STUDY
Caroline Pereira Bittencourt Passaes, Timothée Bruel, Jérémie Decalf, Annie David, Mathieu Angin, Valerie Monceaux, Michaela Muller-Trutwin, Nicolas Noel, Katia Bourdic, Olivier Lambotte, Matthew L Albert, Darragh Duffy, Olivier Schwartz, Asier Sáez-Cirión
The existence of HIV reservoirs in infected individuals under combined antiretroviral therapy (cART) represents a major obstacle toward cure. Viral reservoirs are assessed by quantification of HIV nucleic acids, a method which does not discriminate between infectious and defective viruses, or by viral outgrowth assays, which require large numbers of cells and long-term cultures. Here, we used an ultrasensitive p24 digital assay, which we report to be 1,000-fold more sensitive than classical enzyme-linked immunosorbent assays (ELISAs) in the quantification of HIV-1 Gag p24 production in samples from HIV-infected individuals...
March 15, 2017: Journal of Virology
https://www.readbyqxmd.com/read/28024133/ranolazine-in-treatment-of-stable-angina-in-woman-with-atrial-fibrillation-and-intermittent-left-bundle-branch-block-a-case-report
#15
REVIEW
Natalia Yuriivna Osovska, Natalia Vitaliivna Kuzminova
Stable angina is the most frequent manifestation of ischemic heart disease (IHD) in women as compared to men (65% versus 37%). IHD in women has more favorable clinical course because myocardial infarction develops twice as rare as in men. Coronary angiography of angina patients demonstrates normal coronary arteries more frequently in women than in men. Microvascular angina (MVA) is found to be a rather common form of stable IHD as that particular diagnosis is made later in 20-30% of patients who previously underwent coronary angiography...
December 22, 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/27881061/traditional-and-alternative-therapies-for-refractory-angina
#16
REVIEW
Duygu Kocyigit, Kadri Murat Gurses, Muhammed Ulvi Yalcin, Lale Tokgozoglu
Refractory angina (RFA) is an unfavourable condition that is characterized with persistent angina due to reversible myocardial ischemia in patients with coronary artery disease that remains uncontrollable despite an optimal combination of pharmacological agents and revascularization. Despite significant advances in revascularization techniques and agents used in pharmacological therapy, there is still a significant population suffering from RFA and the global prevalence is even increasing. Anti- anginal treatment and secondary risk-factor modification are the traditional approaches for this group of patients...
2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/27802856/when-life-threatening-conditions-appear-clinically-silent-an-atypical-presentation-of-spontaneous-coronary-artery-dissection-in-a-60-year-old-female
#17
Yenal Harper, Manyoo Agarwal, Krishna Gannamraj, Sneha Parmar, Inyong Hwang, Shadwan Alsafwah
Spontaneous coronary artery dissection is a poorly understood phenomenon that usually affects women during pregnancy or the immediate post-partum period. We present the case of a 60-year-old female with chronic obstructive pulmonary disease who presented with vague complaints of shortness of breath, dizziness, and weakness with a mildly elevated troponin. She denied any anginal symptoms. As part of her initial workup, a nuclear stress test revealed inferior wall reversible changes. Coronary angiography revealed spontaneous right coronary artery dissection which was treated with a drug-eluting stent...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27766510/ivabradine-in-patients-with-stable-coronary-artery-disease-a-rationale-for-use-in-addition-to-and-beyond-percutaneous-coronary-intervention
#18
REVIEW
Cosmo Godino, Antonio Colombo, Alberto Margonato
Heart rate is an established prognostic marker for longevity and is an important contributor in the pathophysiology of various cardiovascular diseases, including ischemic heart disease and heart failure. Most ischemic episodes are triggered by an increase in heart rate, which causes an imbalance between myocardial oxygen delivery and consumption. In addition, increased heart rate is a modifiable risk factor for chronic heart failure. Ivabradine, an inhibitor of If ion channels, is an approved second-line anti-ischemic drug for the treatment of angina...
February 2017: Clinical Drug Investigation
https://www.readbyqxmd.com/read/27725801/early-effects-of-treatment-low-dose-atorvastatin-on-markers-of-insulin-resistance-and-inflammation-in-patients-with-myocardial-infarction
#19
Olga Gruzdeva, Evgenya Uchasova, Yulia Dyleva, Olga Akbasheva, Victoria Karetnikova, Olga Barbarash
Dyslipidemia is one of the primary causes of cardiovascular disease. Therefore, attention has been focused on the development of drugs that normalize lipid levels and exert an effect on markers of atherothrombosis, insulin resistance (IR), and inflammation. Atorvastatin is a drug with not only lipid-lowering potential, but it has multiple non-lipid effects. This study aimed to evaluate atorvastatin effects on lipid, adipokine, IR, and inflammatory statuses in patients with myocardial infarction (MI) in an in-hospital setting...
2016: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/27686005/emerging-drugs-for-the-treatment-of-angina-pectoris
#20
REVIEW
Cher-Rin Chong, Gao J Ong, John D Horowitz
Angina pectoris, or symptomatic myocardial ischaemia, reflects an impairment of coronary blood flow, and usually a deficiency of available myocardial energetics. Treatment options vary with the precise cause, which may vary with regards to the roles of increased myocardial oxygen demand versus reduced supply. Traditionally, organic nitrates, β-adrenoceptor antagonists, and non-dihydropyridine calcium antagonists were the only commonly used prophylactic anti-anginal agents. However, many patients failed to respond adequately to such therapy, and/or were unsuitable for their use...
December 2016: Expert Opinion on Emerging Drugs
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