No abstract available.
Angina, Stable

No abstract available.
Angina, Stable* ; Tumor Necrosis Factor-alpha*

Professor
Acupuncture ; Acupuncture Therapy ; Angina, Stable ; Combined Modality Therapy ; Humans ; Moxibustion

Humans ; Angina, Stable ; COVID-19 ; Risk Factors ; Patients

BACKGROUND: Trimetazidine(Vastinan(R)) is a new antianginal agent of different action mechanism specifically targeted at the metabolic cellular consequences of myocardial ischemia. The clinical efficacy of the Trimetazidine in angina pectoris is still to be defined. METHOD: To determine the antianginal effect of trimetazidine in the treatment of ischemic heart disease, 15 patients with stable angina(12 male, 3 female, mean age : 59.3 years) were studied. In 6 cases as a single agent and in 9 cases as an additive regimen to conventional antianginal medications. Trimetazidine(20mg 3 times daily) was given for 30 days or more to evaluate the clinical effect. Graded exercise tests were carried out before the trial of Trimetazidine and on the 30th day of the treatment period. RESULTS: 1) The number of episodes of anginal attacks decreased from 4.2+/-2.7 to 2.0+/-0.5 a week(p<0.05) after treatment with Trimetazidine. 2) Trimetazidine also significantly increased the duration of total exercise from 12.1+/-4.7 min to 14.5+/-3.3 min(p<0.05), and the time to 1mm ST segment depression from 7.7+/-5.9 min to 11.7+/-5.2 min(p<0.05) on treadmill exercise by modified Bruce protocol. 3) Total workload (METs) and rate pressure double product(heart rate x systolic blood pressure) slightly increased, but the differences were not significant statistically. 4) No serious clinical side effects were observed during the treatment. CONCLUSION: These results suggest that the Trimetazidine is an effective and safe as an antianginal drug in the treatment of stable angina patients as a single agent and as an additive regimen when the patients are refractory to conventional drugs.
Angina Pectoris ; Angina, Stable* ; Depression ; Exercise Test ; Female ; Humans ; Male ; Myocardial Ischemia ; Trimetazidine

BACKGROUND AND OBJECTIVES: The causal relationship of clinically-significant atrioventricular block (AVB) and coronary artery disease (CAD) is uncertain. We investigated whether CAD is related to irreversible AVB that requires treatment with a permanent pacemaker. SUBJECTS AND METHODS: We included 188 consecutive patients with new-onset AVB considering pacemaker, who had undergone invasive or noninvasive coronary evaluation. Patients were divided into one of 2 groups: irreversible AVB who underwent implantation of permanent pacemaker {irreversible block (IB) group, n=173} or reversible AVB {reversible block (RB) group, n=15}. RESULTS: In IB group, significant CAD was observed in 44 patients (25.4%) and there were 2 (1.2%) patients with acute myocardial infarction (AMI). In RB group, 14 patients (93.3%) had CAD (p<0.001) and 13 patients (86.7%) presented with AMI (p<0.001). On the aspect of CAD type and reversibility of AVB, 13/15 (86.7%) patients of AMI, 0/2 (0%) of unstable angina, and 1/41 (2.4%) of stable angina had reversible AVB. CONCLUSION: AVB in patients with AMI is usually reversible. Therefore, permanent pacemaker implantation should be delayed in cases of AMI. AVB in patients with CAD other than AMI is usually irreversible.
Angina, Stable ; Angina, Unstable ; Atrioventricular Block ; Coronary Artery Disease ; Coronary Vessels ; Humans ; Myocardial Infarction ; Retrospective Studies

BACKGROUND: The diagnostic significance of ECG ergonovine test and the incidence of vasospastic angina in patients with chest pain are still uncertain. METHODS: From May 1998 to June 1999, 133 consecutive patients with chest pain were admitted for diagnostic coronary angiography. ECG ergonovine provocation tests were performed in 64 patients who have a clinical history suggesting vasospatic angina, including 27 of 28 patients with vasospastic angina documented electrocardiographically, or who's coronary angiographic findings could not be explained by their clinical history. Ergonovine was administered intravenously in incremental dose of 0.05, 0.1, 0.2, 0.3, 0.4 mg up to total cumulative dosage of 1.0mg during coronary angiography(41 cases), in the exercise laboratory(21 cases) or both(2 cases). RESULTS: Of 133 patients with chest pain, vasospastic angina was documented in 32(24%), unstable angina in 52(34%), stable angina in 10(8%), and others in 39(29%). Angiography demonstrated coronary spasm in 4 additional patients as well as 22 patients with vasospastic angina documented electrocardiographically, but ergonovine tests in the exercise laboratory showed positive response in 5 of 6 patients with vasospastic angina documented. Among the 25 patients with coronary spasm proved angiographically during ergonovine test, ECG findings at the time of coronary spasm were ST segment elevation in 21(84%), depression in 1(4%) and no change in 3(12%) patients, who had branch vessel spasm, 3 vessel spasm or incomplete spasm on coronary angiogram. Of the 31 patients with vasospastic angina who underwent ergonovine tests, positive response occurred in 24(77%) after a cumulative dose of < or = 0.4mg and in additional 3(10%) after the higher dose of >0.4mg. However the other 4(13%) had no ECG changes even after the higher dose(>0.4mg) of ergonovine. CONCLUSION: This results suggest that vasospastic angina appear to be a common cause of chest pain, and ECG ergonovine test with high dose can improve diagnostic sensitivity but cannot detect some patients with vasospastic angina.
Angina, Stable ; Angina, Unstable ; Angiography ; Chest Pain ; Coronary Angiography ; Depression ; Electrocardiography* ; Ergonovine* ; Humans ; Incidence ; Spasm

BACKGROUND AND OBJECTIVES: Success rates of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) have recently been reported to range from 80% to 90%. A better understanding of the pathologic characteristics of the CTO lesion may helpful to improving CTO PCI success rates. We evaluated the CTO lesion in patients with stable angina (SA) by virtual histology-intravascular ultrasound (VH-IVUS). SUBJECTS AND METHODS: The study population consisted of 149 consecutive patients with SA underwent VH-IVUS examination. We analyzed demographic and VH-IVUS findings in 22 CTO patients (17 males; mean, 62.3 years old) compared with 127 non-CTO patients (82 males; mean, 61.3 years old). RESULTS: A significantly lower ejection fraction (57.6+/-13.0% vs. 65.4+/-8.8%, p=0.007) was detected in the CTO group compared with the non-CTO group. Reference vessel lumen area of the proximal and distal segment was significantly less in CTO group than in non-CTO group. The lesion length of the CTO group was significantly longer than those of the non-CTO group (24.4+/-9.6 mm vs. 17.2+/-7.4 mm, p<0.001). Total atheroma volume (224+/-159 mm3 vs. 143+/-86 mm3, p=0.006) and percent atheroma volume (63.2+/-9.6% vs. 55.8+/-8.5%, p=0.011) of the CTO group were also significantly greater than those of non-CTO group. However, the lesion length adjusted plaque composition of the CTO group was not significantly different compared with that of the non-CTO group. CONCLUSION: CTO lesions had a longer lesion length and greater plaque burden than the non-CTO lesion in patients with SA. However, lesion length adjusted plaque composition showed similar between the two groups. These results support that plaque characteristics of CTO lesions are similar to non-CTO lesions in patients with SA.
Angina Pectoris ; Angina, Stable ; Humans ; Male ; Percutaneous Coronary Intervention ; Plaque, Atherosclerotic ; Ultrasonography* ; Ultrasonography, Interventional

BACKGROUND AND OBJECTIVES: The relationship between lipid profile and coronary plaque tissue characteristics in patients with stable angina pectoris (SAP) is unclear. The aim of this study was to evaluate the relationship between tissue characteristics and lipid profile and predictors of unstable plaques (UPs) in patients with SAP by virtual histology intravascular ultrasonography (VH-IVUS). SUBJECTS AND METHODS: VH-IVUS was performed for target lesions in patients with SAP (61.7+/-9.2 years, 174 males, n=266) at the time of coronary angiography. UPs are characterized by thin-cap fibroatheroma, ruptured plaque, or remaining thrombus with VH-IVUS. RESULTS: The present study showed that 34 SAP patients had UPs (61.6+/-9.2 years, 24 males, 12.8%). The percentage of plaque area in the minimum luminal area in high low density lipoprotein-cholesterol (LDL-C)/high density lipoprotein-cholesterol (HDL-C) ratio patients was significantly higher than in low LDL-C/HDL-C ratio patients (72.7+/-9.5% vs. 69.9+/-9.3%, p=0.035). An LDL-C/HDL-C ratio >2.0 was an independent predictor for UPs in SAP patients (odds ratio 5.252, 95% confidence interval 1.132-24.372, p=0.034). CONCLUSION: An elevated LDL-C/HDL-C ratio is a positive predictor for coronary plaque vulnerability in patients with SAP.
Angina Pectoris ; Angina, Stable ; Coronary Angiography ; Humans ; Male ; Phenobarbital ; Plaque, Atherosclerotic ; Thrombosis ; Ultrasonography, Interventional

BACKGROUND: There are many evidences that inflammation is an important determinant of the development of atherosclerosis and one of the systemic markers of inflammation, C-reactive protein(CRP), is associated with extent of coronary artery disease and risk of coronary events. We assessed the time response of CRP response after coronary angioplasty and it's influence on the clinical restenosis in angina patients. MATERIALS AND METHODS: Patients included 36 angina patients undergoing single vessel angioplasty. Levels of CRP were measured before and 12, 24, 48, and 72 hours after angioplasty. Clinical restenosis was assessed at 6 months after procedure. RESULTS: Baseline CRP level was 0.30+/-0.01 mg/dL in stable and 0.46+/-0.28 mg/dL in unstable angina patients(p<0.05). After angioplasty, CRP level was increased with peak at 24 hour and persisted to 72 hours after angioplasty. At 24 hour after angioplasty, the magnitude of CRP change was 0.32+/-0.31 mg/dL in stable and 0.79+/-0.73 mg/dL in unstable angina patient(p<0.05). The change of CRP level was not associated with troponin-T after angioplasty. In unstable angina patients, clinical restenosis was developed in 8% of patients with low baseline CRP levels and in 50% of those with high baseline CRP levels more than 0.6 mg/dL(p<0.05). CONCLUSION: In unstable angina patients, inflammatory response is more increased than stable angina patients, and increased inflammatory response effects on the restenosis after coronary angioplasty.
Angina, Stable ; Angina, Unstable ; Angioplasty* ; Atherosclerosis ; C-Reactive Protein* ; Coronary Artery Disease ; Humans ; Inflammation ; Troponin T