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https://www.readbyqxmd.com/read/27935738/the-coronary-sinus-reducer-clinical-evidence-and-technical-aspects
#1
Francesco Giannini, Andrea Aurelio, Richard J Jabbour, Luca Ferri, Antonio Colombo, Azeem Latib
Chronic refractory angina is often a disabling condition, predominantly due to severe obstructive coronary artery disease, that is inadequately controlled by optimal medical therapy and not amenable to further percutaneous or surgical revascularization. Mortality rates associated with this condition are relatively low in clinically stable patients. However, it is associated with a high hospitalization rate and a reduction in both exercise capacity and quality of life. Due to the paucity of available treatment options, there is an unmet need for new therapies for these patients and for a reduction in the associated economic healthcare burden...
December 9, 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27880009/antianginal-efficacy-of-ivabradine-metoprolol-combination-in-patients-with-stable-angina
#2
John Zarifis, Manolis Kallistratos, Apostolos Katsivas
Medical treatment is the main clinical strategy for controlling patients with chronic stable angina and improving their quality of life (QoL). Ivabradine treatment on top of metoprolol decreases angina symptoms and improves QoL in patients with stable angina and coronary artery disease (CAD). This is a post hoc analysis (636 CAD patients given ivabradine/metoprolol free combination) of a prospective, noninterventional study that included 2403 patients with CAD and stable angina. Data were recorded at baseline at 1 and 4 months after inclusion...
November 23, 2016: Clinical Cardiology
https://www.readbyqxmd.com/read/27855810/computed-tomography-and-cardiac%C3%A2-magnetic-resonance-in-ischemic%C3%A2-heart%C3%A2-disease
#3
REVIEW
Marc R Dweck, Michelle C Williams, Alastair J Moss, David E Newby, Zahi A Fayad
Ischemic heart disease is a complex disease process caused by the development of coronary atherosclerosis, with downstream effects on the left ventricular myocardium. It is characterized by a long preclinical phase, abrupt development of myocardial infarction, and more chronic disease states such as stable angina and ischemic cardiomyopathy. Recent advances in computed tomography (CT) and cardiac magnetic resonance (CMR) now allow detailed imaging of each of these different phases of the disease, potentially allowing ischemic heart disease to be tracked during a patient's lifetime...
November 15, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27846245/non-communicable-disease-clinical-practice-guidelines-in-brazil-a-systematic-assessment-of-methodological-quality-and-transparency
#4
Caroline de Godoi Rezende Costa Molino, Nicolina Silvana Romano-Lieber, Eliane Ribeiro, Daniela Oliveira de Melo
BACKGROUND: Annually, non-communicable diseases (NCDs) kill 38 million people worldwide, with low and middle-income countries accounting for three-quarters of these deaths. High-quality clinical practice guidelines (CPGs) are fundamental to improving NCD management. The present study evaluated the methodological rigor and transparency of Brazilian CPGs that recommend pharmacological treatment for the most prevalent NCDs. METHODS: We conducted a systematic search for CPGs of the following NCDs: asthma, atrial fibrillation, benign prostatic hyperplasia, chronic obstructive pulmonary disease, congestive heart failure, coronary artery disease and/or stable angina, dementia, depression, diabetes, gastroesophageal reflux disease, hypercholesterolemia, hypertension, osteoarthritis, and osteoporosis...
2016: PloS One
https://www.readbyqxmd.com/read/27836292/impact-of-coronary-collateral-circulation-on-angiographic-in-stent-restenosis-in-patients-with-stable-coronary-artery-disease-and-chronic-total-occlusion
#5
Zhen Kun Yang, Ying Shen, Jian Hu, Qi Zhang, Feng Hua Ding, Rui Yan Zhang, Lin Lu, Wei Feng Shen
OBJECTIVE: This study aimed to evaluate the relationship between coronary collateralization and in-stent restenosis (ISR) in stable coronary artery disease patients with chronic total occlusion (CTO) after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation. METHODS: The degree of coronary collaterals supplying the distal aspect of a total occlusion from the contra-lateral vessel was graded according to Rentrop classification in 216 patients with stable angina undergoing successful DES based PCI for CTO...
November 2, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27791405/experimental-and-early-investigational-drugs-for-angina-pectoris
#6
Islam Y Elgendy, David E Winchester, Carl J Pepine
Ischemic heart disease (IHD) is a major cause of death and disability among Western countries and angina pectoris is the most prevalent symptomatic manifestation. Strategies to improve management of chronic stable angina are a priority. Areas covered: A comprehensive review was conducted using the Medline and Cochrane databases as well as the clinical trial databases in the United States and Europe. Traditional therapies for angina will be discussed. This review particularly emphasizes investigational therapies for angina (including pharmacological agents, cell and gene based therapies, and herbal medications)...
November 14, 2016: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/27780557/benefits-of-heart-rate-slowing-with-ivabradine-in-patients-with-systolic-heart-failure-and-coronary-artery-disease
#7
REVIEW
Jeffrey S Borer, Prakash C Deedwania, Jae B Kim, Michael Böhm
Heart rate (HR) is a risk factor in patients with chronic systolic heart failure (HF) that, when reduced, provides outcome benefits. It is also a target for angina pectoris prevention and a risk marker in chronic coronary artery disease without HF. HR can be reduced by drugs; however, among those used clinically, only ivabradine reduces HR directly in the sinoatrial nodal cells without other known effects on the cardiovascular system. This review provides current information regarding the safety and efficacy of HR reduction with ivabradine in clinical studies involving >36,000 patients with chronic stable coronary artery disease and >6,500 patients with systolic HF...
December 15, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27779436/observational-prospective-study-to-estimate-the-rates-of-outcomes-in-patients-undergoing-pci-with-drug-eluting-stent-implantation-who-take-statins-follow-up-optima-ii
#8
Yu Karpov, N Logunova, D Tomilova, V Buza, Yu Khomitskaya
OBJECTIVE: The OPTIMA II study sought to evaluate rates of major adverse cardiac and cerebrovascular events (MACCE) during the long-term follow-up of chronic statin users who underwent percutaneous coronary intervention (PCI) with implantation of a drug-eluting stent (DES). RESEARCH DESIGN AND METHODS: OPTIMA II was a non-interventional, observational study conducted at a single center in the Russian Federation. Included patients were aged ≥18 years with stable angina who had received long-term (≥1 month) statin therapy prior to elective PCI with DES implantation and who had participated in the original OPTIMA study...
October 25, 2016: Current Medical Research and Opinion
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
#9
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...
October 21, 2016: Clinical Drug Investigation
https://www.readbyqxmd.com/read/27761514/data-on-the-value-of-elevated-circulating-mimecan-levels-for-detecting-poor-coronary-collateralization-in-patients-with-stable-angina-and-chronic-total-occlusion
#10
Ying Shen, Feng Hua Ding, Rui Yan Zhang, Qi Zhang, Lin Lu, Wei Feng Shen
The data presented here support the research article "Association of serum mimecan with angiographic coronary collateralization in patients with stable coronary artery disease and chronic total occlusion" (Shen et al., 2016) [1] where elevated circulating mimecan levels reflected poor angiographic coronary collateralization in such patients. The data included in this article are composed by one figure and consist of (1) validation of serum mimecan measurement by assessing inter- and intra-assay variability in 45 samples; (2) findings on the relation of clinical and angiographic characteristics and biochemical parameters to coronary collateralization in 559 patients; (3) the diagnostic value of serum mimecan for poor collateralization, which was derived from plotting receiver-operating characteristic curves and logistic regression analysis...
December 2016: Data in Brief
https://www.readbyqxmd.com/read/27754552/a-prospective-study-of-patients-with-refractory-angina-outcomes-and-the-role-of-high-sensitivity-troponin-t
#11
Nilson T Poppi, Luís H W Gowdak, Luciana O C Dourado, Eduardo L Adam, Thiago N P Leite, Bruno M Mioto, José E Krieger, Luiz A M César, Alexandre C Pereira
BACKGROUND: The predictors of cardiovascular events in patients with chronic refractory angina are limited. High-sensitivity cardiac troponin T (hs-cTnT) assays are biomarkers that may be used to determine the prognosis of patients with stable coronary artery disease. HYPOTHESIS: Hs-cTnT is a predictor of death and nonfatal myocardial infarction (MI) in patients with refractory angina. METHODS: We prospectively enrolled 117 consecutive patients in this study...
October 18, 2016: Clinical Cardiology
https://www.readbyqxmd.com/read/27729662/-coronary-sinus-reducer-implantation-a-new-treatment-for-chronic-refractory-angina
#12
Francesco Giannini, Andrea Aurelio, Alaide Chieffo
Refractory angina is a chronic condition characterized by the presence of disabling symptoms due to severe obstructive coronary artery disease not improved by either optimal medical therapy and/or percutaneous or surgical revascularization. Mortality rates associated with this condition are quite low in clinically stable patients on optimal medical therapy. However, rehospitalization rates are high. In this subgroup of patients there is thus a clinical need for new therapies targeting an improvement of symptoms but taking into account the potential impact in terms of healthcare and costs...
October 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/27703034/clinical-impact-of-subsequent-depression-in-patients-with-a-new-diagnosis-of-stable-angina-a-population-based-study
#13
Natalie Szpakowski, Maria C Bennell, Feng Qiu, Dennis T Ko, Jack V Tu, Paul Kurdyak, Harindra C Wijeysundera
BACKGROUND: Depression is prevalent among patients with myocardial infarction and is associated with a worse prognosis. However, little is known about its importance in patients with chronic stable angina. We conducted a retrospective population-based cohort study to determine the occurrence and predictors of developing depression in patients with a new diagnosis of chronic stable angina. In addition, we sought to understand its impact on subsequent clinical outcomes. METHODS AND RESULTS: Our cohort included patients in Ontario, Canada, with stable angina based on obstructive coronary artery disease found on angiogram...
October 4, 2016: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/27701488/xanthine-oxidase-inhibitors-in-ischaemic-heart-disease
#14
Mihnea Zdrenghea, Adela Sitar-Tăut, Gabriel Cismaru, Dumitru Zdrenghea, Dana Pop
Increased uric acid levels are correlated with cardiovascular disease, particularly with ischaemic heart disease. Xanthine oxidase inhibitors, especially allopurinol, lower the risk of ischaemic heart disease due to their effects on reactive oxygen species and endothelial function. In chronic stable angina pectoris, allopurinol increases the median time to ST depression, time to chest pain, and total exercise time. On the other hand, it has been reported that allopurinol has a beneficial effect on ischaemic patients referred for angioplasty, but there are insufficient data regarding its effect on acute myocardial infarction patients...
September 9, 2016: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/27678370/economic-evaluation-of-trimetazidine-in-the-management-of-chronic-stable-angina-in-greece
#15
Georgia Kourlaba, George Gourzoulidis, George Andrikopoulos, Konstantinos Tsioufis, Alexandra Beletsi, Nikos Maniadakis
BACKGROUND: To evaluate the cost-effectiveness of trimetazidine (TMZ) as add-on therapy to standard-of-care (SoC) compared to SoC alone in patients with chronic stable angina who did not respond adequately to first line therapy with b-blockers, nitrates or calcium channel antagonists in Greece. METHODS: A Markov model with 3-month cycles and 1-year time horizon was developed to assess the comparators. The analysis was conducted from a third-party payer perspective...
September 27, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27666568/trimetazidine-protects-against-cardiac-ischemia-reperfusion-injury-via-effects-on-cardiac-mirna%C3%A2-21-expression-akt-and-the-bcl%C3%A2-2-bax-pathway
#16
Ning Ma, Jingyun Bai, Weihua Zhang, Hong Luo, Xin Zhang, Donghai Liu, Chenhui Qiao
Trimetazidine is a piperazine-derived metabolic agent, which exerts cell protective effects and has been reported to be efficient in the treatment of chronic stable angina pectoris. In addition, it has been shown to exert protection against acute myocardial infarction. The present study aimed to investigate whether trimetazidine protects against cardiac ischemia/reperfusion (I/R) injury, and to determine whether its curative effects are associated with microRNA (miRNA)‑21 expression, Akt, and the B‑cell lymphoma 2 (Bcl‑2)/Bcl‑2‑associated X protein (Bax) pathway...
November 2016: Molecular Medicine Reports
https://www.readbyqxmd.com/read/27646423/percutaneous-coronary-intervention-versus-optimal-medical-therapy-for-stable-angina-in-advanced-ckd-a-decision-analysis
#17
Aisha Khattak, Ernest I Mandel, Matthew R Reynolds, David M Charytan
BACKGROUND: Percutaneous coronary intervention (PCI) use is low in the setting of stable symptomatic angina in individuals with advanced chronic kidney disease (CKD) despite high cardiovascular risk in this population, and PCI is frequently deferred out of concern for precipitating dialysis therapy. Whether this is appropriate is uncertain, and patient-centered data comparing the relative risks and benefits of continued medical therapy versus PCI in patients with advanced CKD and stable angina are scarce...
September 16, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/27638814/endocan-a-novel-biomarker-associated-with-well-developed-coronary-collateral-circulation-in-patients-with-stable-angina-and-chronic-total-occlusion
#18
Samim Emet, Ali Elitok, Imran Onur, Mehmet Kocaaga, Ahmet Kaya Bilge, Huseyin Oflaz, Berrin Umman, Aytac Oncul, Zehra Bugra, Kamil Adalet, Fehmi Mercanoglu
Angiogenesis and arteriogenesis have a crucial role in the formation of coronary collateral vessels. It has been shown that endocan and vascular cell adhesion molecule-1 (VCAM-1) are potential angiogenetic factors. We investigated the relationship between serum endocan levels and grade of coronary collaterals, and also the correlation of endocan levels with serum VCAM-1 levels. Patients with stable angina and at least one total coronary occlusion at invasive coronary angiography were included in our study. Collateral degree was graded according to Rentrop and Cohen's classification...
September 16, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27634834/prevalence-and-predictors-of-multiple-coronary-plaque-ruptures-in-vivo-3-vessel-optical-coherence-tomography-imaging-study
#19
Rocco Vergallo, Shiro Uemura, Tsunenari Soeda, Yoshiyasu Minami, Jin-Man Cho, Daniel S Ong, Aaron D Aguirre, Lei Gao, Luigi M Biasucci, Filippo Crea, Bo Yu, Hang Lee, Chong-Jin Kim, Ik-Kyung Jang
OBJECTIVE: Plaque rupture may be the local expression of a widespread coronary instability. This study aimed to investigate: (1) the prevalence and characteristics of nonculprit plaque rupture; (2) the pancoronary atherosclerotic phenotype in patients with and without nonculprit plaque rupture; and (3) the prevalence and predictors of multiple plaque ruptures. APPROACH AND RESULTS: Six hundred and seventy-five nonculprit plaques from 261 patients (34 acute myocardial infarction, 73 unstable angina pectoris, and 154 stable angina pectoris) were analyzed by 3-vessel optical coherence tomography...
September 15, 2016: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/27614723/efficacy-profile-of-ivabradine-in-patients-with-heart-failure-plus-angina-pectoris
#20
Jeffrey S Borer, Karl Swedberg, Michel Komajda, Ian Ford, Luigi Tavazzi, Michael Böhm, Christophe Depre, Yuna Wu, Juan Maya, Fabienne Dominjon
OBJECTIVES: In the Systolic Heart Failure Treatment with the If Inhibitor Ivabradine Trial (SHIFT), slowing of the heart rate with ivabradine reduced cardiovascular death or heart failure hospitalizations among patients with systolic chronic heart failure (CHF). Subsequently, in the Study Assessing the Morbidity-Mortality Benefits of the If Inhibitor Ivabradine in Patients with Coronary Artery Disease (SIGNIFY) slowing of the heart rate in patients without CHF provided no benefit for cardiovascular death or nonfatal myocardial infarction (primary composite end point), with secondary analyses suggesting possible harm in the angina subgroup...
September 10, 2016: Cardiology
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