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stabil angina

Jack H Boyd, Vedant S Pargaonkar, David H Scoville, Ian S Rogers, Takumi Kimura, Shigemitsu Tanaka, Ryotaro Yamada, Michael P Fischbein, Jennifer A Tremmel, Robert Scott Mitchell, Ingela Schnittger
BACKGROUND: Left anterior descending artery myocardial bridges (MBs) range from clinically insignificant incidental angiographic findings to a potential cause of sudden cardiac death. Within this spectrum, a group of patients with isolated, symptomatic, and hemodynamically significant MBs despite maximally tolerated medical therapy exist for whom the optimal treatment is controversial. We evaluated supraarterial myotomy, or surgical unroofing, of the left anterior descending MBs as an isolated procedure in these patients...
October 1, 2016: Annals of Thoracic Surgery
Islam Y Elgendy, Dharam J Kumbhani, Ahmed N Mahmoud, Xuerong Wen, Deepak L Bhatt, Anthony A Bavry
OBJECTIVES: To perform an updated systematic review comparing a routine invasive strategy with a selective invasive strategy for patients with non-ST-elevation acute coronary syndromes (NSTE-ACS) in the era of stents and antiplatelet therapy. BACKGROUND: Recent meta-analyses comparing both strategies have shown conflicting results. METHODS: Electronic databases were searched for randomized trials that compared a routine invasive strategy (i...
August 12, 2016: Catheterization and Cardiovascular Interventions
Matthew T James, Stephen B Wilton, Fiona M Clement, William A Ghali, Merril L Knudtson, Zhi Tan, Marcello Tonelli, Brenda R Hemmelgarn, Colleen M Norris
BACKGROUND: Although patients with kidney disease have potential to benefit from revascularization, they are also at higher risk of complications, which may affect quality of life. METHODS AND RESULTS: We studied a cohort of 8198 adults who underwent coronary angiography in Alberta, between 2004 and 2008, and completed health-related quality-of-life (HR-QOL) surveys. Changes in HR-QOL measures were most favorable among patients who received coronary artery bypass graft (CABG), but did not significantly differ by kidney function within groups of patients who received CABG, percutaneous coronary intervention (PCI), or medical therapy (P value for interaction between estimated glomerular filtration rate [eGFR] and revascularization status >0...
July 2016: Journal of the American Heart Association
Maddalena Lettino
Acute coronary syndromes (ACS) are a major health problem both in industrialized countries and in developing ones, and a leading cause of death and disability. The pathogenesis of ACS is multifactorial and complex, with approximately 65-70% of cases caused by the abrupt occlusion of a coronary vessel. This usually occurs as a result of thrombus formation over a vulnerable, lipid-rich atherosclerotic plaque, which undergoes rupture or erosion. High levels of LDL-cholesterol (LDL-C) are a well known risk factor for the development of atherosclerosis, and the reduction in plasma LDL-C is a fundamental treatment both in primary and secondary prevention...
April 2016: Giornale Italiano di Cardiologia
Carlos Martinez-Sanchez, Gabriela Borrayo, Jorge Carrillo, Ursulo Juarez, Juan Quintanilla, Carlos Jerjes-Sanchez
OBJECTIVE: To describe current management and clinical outcomes in patients hospitalized with an acute coronary syndrome (ACS) in Mexico. METHODS: RENASICA III was a prospective multicenter registry of consecutive patients hospitalized with an ACS. Patients had objective evidence of ischemic heart disease; those with type II infarction or secondary ischemic were excluded. Study design conformed to current quality recommendations. RESULTS: A total of 123 investigators at 29 tertiary and 44 community hospitals enrolled 8296 patients with an ACS (4038 with non-ST-elevation myocardial infarction/unstable angina [NSTEMI/UA], 4258 with ST-elevation myocardial infarction [STEMI])...
July 2016: Archivos de Cardiología de México
Stephanie Dumas, Etienne Rouleau-Mailloux, Nawal Bouchama, Halema Lahcene, Mario Talajic, Jean-Claude Tardif, Marie-José Gaulin, Sylvie Provost, Marie-Pierre Dubé, Sylvie Perreault
BACKGROUND: Warfarin, a frequently prescribed oral anticoagulant, is well known for its narrow therapeutic index. Adherence to warfarin may help to achieve a stable international normalized ratio (INR), but little data are available regarding the impact of using a pillbox as a potential adherence aid device. OBJECTIVE: To evaluate the association between pillbox use and time in therapeutic range (TTR) < 60% and INR instability pattern. METHODS: This study was based on a prospective cohort of 1,069 new warfarin users who initiated warfarin between May 2010 and July 2013 within 17 hospitals in Quebec, Canada...
June 2016: Journal of Managed Care & Specialty Pharmacy
Karin A L Müller, Dominik Rath, Martina Schmid, Heiko Schoenleber, Meinrad Gawaz, Tobias Geisler, Iris I Müller
BACKGROUND: Chronic inflammation promotes atherosclerosis and is a prognostic factor in coronary artery disease (CAD). Patients with type 2 diabetes mellitus (DM2) are at risk for progressive atherosclerosis. Macrophage migration inhibitory factor (MIF) is a key player in atherosclerosis, mediating pro-inflammatory responses. Its endogenous antagonist Gremlin-1 inhibits foam-cell formation and atheroprogression by binding MIF, neutralizing its proatherosclerotic functions. HYPOTHESIS: Plasma levels of MIF and Gremlin-1 correlate with the stability of CAD in patients with DM2...
April 2016: Clinical Cardiology
Ankita D Chonkar, J Venkat Rao, Renuka S Managuli, Srinivas Mutalik, Swapnil Dengale, Prateek Jain, N Udupa
Lercanidipine is a vasoselective dihydropyridine calcium antagonist, mainly used for the treatment of hypertension and angina pectoris. However, it suffers from food dependent absorption, poor solubility, low permeability and considerable first pass metabolism, resulting in highly variable and low bioavailability of 10%. Nanoparticles of lercanidipine were incorporated in fast dissolving oral films (FDO) via preparation of nanosuspension by evaporative antisolvent precipitation method. Prepared nanosuspensions were incorporated in FDO without lyophilizing or spray drying...
June 2016: European Journal of Pharmaceutics and Biopharmaceutics
Pyung Chun Oh, Woong Chol Kang, Jeonggeun Moon, Yae Min Park, Sihun Kim, Myeong Gun Kim, Kyounghoon Lee, Taehoon Ahn, Eak Kyun Shin
BACKGROUND: While recent guidelines have suggested the potential for beta-blockers as first-line agents in chronic stable angina, few data regarding comparative anti-anginal and metabolic effects between beta-blockers with and without vasodilating properties have been reported, particularly in patients with angina pectoris. OBJECTIVE: Our objective was to compare the anti-anginal and metabolic effects of carvedilol and atenolol in patients with stable angina pectoris...
June 2016: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
Marouane Boukhris, Salvatore Azzarelli, Salvatore Davide Tomasello, Zied Ibn Elhadj, Francesco Marzà, Alfredo R Galassi
Regardless of the clinical setting, a good back-up represents one of the most important conditions to ensure guide wire and balloon advancement and stent delivery. As a "mother and child" system, the GuideLiner catheter (Vascular Solutions Inc., Minneapolis, MN, USA) provides an extension to the guide catheter with better coaxial alignment and stability. We report two didactic cases showing the usefulness of the GuideLiner device in everyday catheterization laboratory practice. The first case was a primary percutaneous coronary intervention (PCI) in a 71-year-old diabetic man admitted for inferior ST-elevation myocardial infarction, related to tight proximal stenosis in a dominant tortuous and calcified left circumflex...
October 27, 2015: Journal of Tehran Heart Center
Shmuel Gottlieb, Shimon Kolker, Nir Shlomo, Shlomi Matetzky, Eran Leitersdorf, Amit Segev, Ilan Goldenberg, Dan Tzivoni, Giora Weisz, Mady Moriel
BACKGROUND: STEMI is thought to occur as a result of a vulnerable coronary plaque rupture. Statins possess hypolipidemic and pleotropic effects that stabilize coronary plaque. We sought to determine the association between LDL-C levels, statin use prior to the index event on the type of acute coronary syndrome (ACS) presentation: STEMI vs. non-STEMI/unstable angina. METHODS: Data was drawn from the ACS Israeli Survey (ACSIS), a biennial prospective survey of ACS patients hospitalized in all CCU/Cardiology departments during 2002-2010...
May 1, 2016: International Journal of Cardiology
Gautam Nichenametla, Vivian Samuel Thomas
INTRODUCTION: Acute coronary syndrome (ACS), a spectrum comprising unstable angina pectoris, ST Elevated Myocardial Infarction (STEMI) & Non ST Elevated Myocardial Infarction (NSTEMI) is the major cause of presentation in Emergency Department today. Though ECG and cardiac enzymes are used for diagnosis, they mislead the diagnosis sometimes and delay in treatment initiation. This leads us to search certain new parameters which reflect the pathophysiology of ACS. Markers of plaque stability like Pregnancy Associated Plasma Protein-A and D-Dimer, a marker of ongoing thrombosis are found to be better markers in early diagnosis...
January 2016: Journal of Clinical and Diagnostic Research: JCDR
Tadateru Takayama, Sei Komatsu, Yasunori Ueda, Seiji Fukushima, Takafumi Hiro, Atsushi Hirayama, Satoshi Saito
Diminishing yellow color, evaluated by coronary angioscopy, is associated with plaque stabilization and regression. Our aim was to assess the effect of aggressive lipid-lowering therapy with rosuvastatin on plaque regression and instability. Thirty-seven patients with stable angina or silent myocardial ischemia who planned to undergo elective percutaneous coronary intervention and had angioscopic yellow plaques of grade 2 or more were randomized to high-dose (group H, 20 mg/day, n = 18) or low-dose (group L, 2...
April 15, 2016: American Journal of Cardiology
Petra Rocic
Due to their exceptional stability in the circulation, microRNAs (miRs) are being identified as promising biomarkers. On the other hand, their propensity to regulate networks of functionally closely related genes and relative ease of delivery makes them attractive targets for therapy. However, neither application is without challenges, especially as it applies to ischemic coronary artery disease (CAD). This review: 1) describes miRs which have been most consistently found to be associated with the most common manifestations of CAD, including atherosclerosis, angina pectoris, myocardial infarction and myocardial reperfusion through arteriogenesis, 2) emphasizes those miRs which are also altered in metabolic syndrome and its component pathologies, 3) discusses challenges which currently prevent clinical application related to inconsistencies between findings in cell culture, animal models and among human studies, as well as technical challenges, and 4) offers some suggestions towards resolutions of these discrepancies...
January 31, 2016: Current Drug Targets
Xiaofang Wang, Xiaoyan Zhao, Ling Li, Haimu Yao, Yan Jiang, Jinying Zhang
BACKGROUND: In approximately 80% of cardiovascular disease-related deaths, patients suffer from coronary atherosclerotic heart disease. Ezetimibe is the first intestinal cholesterol absorption inhibitor. Its combination with statins for treating coronary atherosclerotic heart disease has attracted attention worldwide. METHODS: The study group comprised 106 patients with coronary atherosclerotic heart disease and hyperlipidaemia. Each was randomly assigned to one of two groups: (1) Ezetimibe (10mg, once a night) plus rosuvastatin (10mg, once a night) (n=55) or (2) Rosuvastatin alone (10mg, once a night) (n=51)...
May 2016: Heart, Lung & Circulation
Soon Yeng Soo Hoo, Robyn Gallagher, Doug Elliott
OBJECTIVE: To examine clinical and health-related quality of life (HRQOL) outcomes and predictors of HRQOL for uncomplicated field triage ST-elevation myocardial infarction (STEMI) patients aged ≥70 years and <70 years after primary percutaneous coronary intervention (PPCI). BACKGROUND: Pre-hospital field triage for PPCI is associated with lower mortality but the impact of age and other factors on HRQOL remains unknown. METHODS: 77 field triage STEMI patients were assessed for HRQOL using the Short Form-12 (SF-12) and the Seattle Angina Questionnaire (SAQ) at 4 weeks and 6 months after PPCI...
January 2016: Heart & Lung: the Journal of Critical Care
Michele M Pelter, Denise L Loranger, Teri M Kozik, Anita Kedia, Richard P Ganchan, Deborah Ganchan, Xiao Hu, Mary G Carey
BACKGROUND: Treatment for unstable angina (UA) or non-ST-elevation myocardial infarction (NSTEMI) is aimed at plaque stabilization to prevent infarction. Two treatment strategies are (1) invasive (ie, cardiac catheterization laboratory <24 hours after admission) or (2) selectively invasive (ie, medications with cardiac catheterization laboratory >24 hours for recurrent symptoms). However, it is not known if the frequency of transient myocardial ischemia (TMI) or complications during hospitalization varies by treatment...
July 2016: Journal of Cardiovascular Nursing
O V Byelan, O A Borzykh, T V Mamontova, I P Kaidashev
AIM: To investigate the clinical effectiveness of pioglitazone in the combination treatment of patients with asthma concurrent with coronary heart disease (CHD). SUBJECTS AND METHODS: Fifty patients aged 40-75 years with asthma concurrent with CHD were examined. External respiratory function (ERF), electrocardiograms, blood pressure (BP), and anthropometric measurements were assessed in all the patients. Blood and urine laboratory values and high-sensitivity C-reactive protein (hs-CRP) concentrations were estimated; endothelial function was determined measuring endothelium-dependent and endothelium-independent vasodilation (EDVD and EIVD)...
2015: Terapevticheskiĭ Arkhiv
Shoichi Miyamoto, Shunsuke Usami, Yasuhide Kuwabara, Takahiro Horie, Osamu Baba, Daihiko Hakuno, Yasuhiro Nakashima, Masataka Nishiga, Masayasu Izuhara, Tetsushi Nakao, Tomohiro Nishino, Yuya Ide, Fumiko Nakazeki, Jun Wang, Koji Ueyama, Takeshi Kimura, Koh Ono
BACKGROUND: Recently, it has been reported that specific microRNA (miRNA) levels are elevated in serum and can be used as biomarkers in patients with cardiovascular diseases. However, miRNAs expression profiles and their sources in pericardial fluid (PF) are unclear. METHODS AND RESULTS: The purpose of this study was to identify the levels of miRNAs in PF in relation to those in the serum in patients undergoing cardiac surgery. Serum (S) and PF from patients undergoing coronary artery bypass graft (CABG) due to stable angina pectoris (sAP) and unstable AP (uAP) and aortic valve replacement due to aortic stenosis (AS) were analyzed for the detection of miRNAs...
2015: PloS One
O Nastina
Changes of global and local myocardial contractility of Chernobyl accident clean-up workers (ChA CW) with stable angina were investigated. There were discovered that regular long-term treatment of ChA CW with stable angina using of antiischemic and metabolic drugs promoted to stabilization of global and local myocardial contractility indexes. Ejection fraction, degree of contraction of front-rear systolic left ventricle size, systolic thickness of interventricular septum sufficiently increased. Step-by-step worsening of global and local myocardial contractility indexes in cases of non-regular treatment was taken place...
September 2014: Likars'ka Sprava
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