Angina Pectoris: The symptom of paroxysmal pain consequent to MYOCARDIAL ISCHEMIA usually of distinctive character, location and radiation. It is thought to be provoked by a transient stressful situation during which the oxygen requirements of the MYOCARDIUM exceed that supplied by the CORONARY CIRCULATION.Angina, Unstable: Precordial pain at rest, which may precede a MYOCARDIAL INFARCTION.Angina Pectoris, Variant: A clinical syndrome characterized by the development of CHEST PAIN at rest with concomitant transient ST segment elevation in the ELECTROCARDIOGRAM, but with preserved exercise capacity.Angina, Stable: Persistent and reproducible chest discomfort usually precipitated by a physical exertion that dissipates upon cessation of such an activity. The symptoms are manifestations of MYOCARDIAL ISCHEMIA.Microvascular Angina: ANGINA PECTORIS or angina-like chest pain with a normal coronary arteriogram and positive EXERCISE TEST. The cause of the syndrome is unknown. While its recognition is of clinical importance, its prognosis is excellent. (Braunwald, Heart Disease, 4th ed, p1346; Jablonski Dictionary of Syndromes & Eponymic Diseases, 2d ed). It is different from METABOLIC SYNDROME X, a syndrome characterized by INSULIN RESISTANCE and HYPERINSULINEMIA, that has increased risk for cardiovascular disease.Ludwig's Angina: Severe cellulitis of the submaxillary space with secondary involvement of the sublingual and submental space. It usually results from infection in the lower molar area or from a penetrating injury to the mouth floor. (From Dorland, 27th ed)Coronary Vasospasm: Spasm of the large- or medium-sized coronary arteries.Coronary Angiography: Radiography of the vascular system of the heart muscle after injection of a contrast medium.Myocardial Infarction: NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION).Ergonovine: An ergot alkaloid (ERGOT ALKALOIDS) with uterine and VASCULAR SMOOTH MUSCLE contractile properties.Coronary Disease: An imbalance between myocardial functional requirements and the capacity of the CORONARY VESSELS to supply sufficient blood flow. It is a form of MYOCARDIAL ISCHEMIA (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels.Electrocardiography: Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY.Myocardial Ischemia: A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (CORONARY ARTERY DISEASE), to obstruction by a thrombus (CORONARY THROMBOSIS), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (MYOCARDIAL INFARCTION).Exercise Test: Controlled physical activity which is performed in order to allow assessment of physiological functions, particularly cardiovascular and pulmonary, but also aerobic capacity. Maximal (most intense) exercise is usually required but submaximal exercise is also used.Nitroglycerin: A volatile vasodilator which relieves ANGINA PECTORIS by stimulating GUANYLATE CYCLASE and lowering cytosolic calcium. It is also sometimes used for TOCOLYSIS and explosives.Coronary Artery Disease: Pathological processes of CORONARY ARTERIES that may derive from a congenital abnormality, atherosclerotic, or non-atherosclerotic cause.Counterpulsation: A technique for assisting the circulation by decreasing the afterload of the left ventricle and augmenting the diastolic pressure. It may be achieved by intra-aortic balloon, or by implanting a special pumping device in the chest, or externally by applying a negative pressure to the lower extremities during cardiac systole.Acetanilides: Compounds based on N-phenylacetamide, that are similar in structure to 2-PHENYLACETAMIDES. They are precursors of many other compounds. They were formerly used as ANALGESICS and ANTIPYRETICS, but often caused lethal METHEMOGLOBINEMIA.Isosorbide Dinitrate: A vasodilator used in the treatment of ANGINA PECTORIS. Its actions are similar to NITROGLYCERIN but with a slower onset of action.Coronary Vessels: The veins and arteries of the HEART.Chest Pain: Pressure, burning, or numbness in the chest.Angioplasty, Balloon, Coronary: Dilation of an occluded coronary artery (or arteries) by means of a balloon catheter to restore myocardial blood supply.Coronary Artery Bypass: Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion.Myocardial Revascularization: The restoration of blood supply to the myocardium. (From Dorland, 28th ed)Follow-Up Studies: Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.Prospective Studies: Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.Atherectomy, Coronary: Percutaneous transluminal procedure for removing atheromatous plaque from the coronary arteries. Both directional (for removing focal atheromas) and rotational (for removing concentric atheromatous plaque) atherectomy devices have been used.Treatment Outcome: Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.Electrocardiography, Ambulatory: Method in which prolonged electrocardiographic recordings are made on a portable tape recorder (Holter-type system) or solid-state device ("real-time" system), while the patient undergoes normal daily activities. It is useful in the diagnosis and management of intermittent cardiac arrhythmias and transient myocardial ischemia.Risk Factors: An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.Acute Coronary Syndrome: An episode of MYOCARDIAL ISCHEMIA that generally lasts longer than a transient anginal episode that ultimately may lead to MYOCARDIAL INFARCTION.Double-Blind Method: A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment.Recurrence: The return of a sign, symptom, or disease after a remission.Coronary Circulation: The circulation of blood through the CORONARY VESSELS of the HEART.Cardiovascular Agents: Agents that affect the rate or intensity of cardiac contraction, blood vessel diameter, or blood volume.Prognosis: A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.Vasodilator Agents: Drugs used to cause dilation of the blood vessels.Time Factors: Elements of limited time intervals, contributing to particular results or situations.Coronary Thrombosis: Coagulation of blood in any of the CORONARY VESSELS. The presence of a blood clot (THROMBUS) often leads to MYOCARDIAL INFARCTION.Adrenergic beta-Antagonists: Drugs that bind to but do not activate beta-adrenergic receptors thereby blocking the actions of beta-adrenergic agonists. Adrenergic beta-antagonists are used for treatment of hypertension, cardiac arrhythmias, angina pectoris, glaucoma, migraine headaches, and anxiety.Nicorandil: A derivative of the NIACINAMIDE that is structurally combined with an organic nitrate. It is a potassium-channel opener that causes vasodilatation of arterioles and large coronary arteries. Its nitrate-like properties produce venous vasodilation through stimulation of guanylate cyclase.Platelet Aggregation Inhibitors: Drugs or agents which antagonize or impair any mechanism leading to blood platelet aggregation, whether during the phases of activation and shape change or following the dense-granule release reaction and stimulation of the prostaglandin-thromboxane system.Biological Markers: Measurable and quantifiable biological parameters (e.g., specific enzyme concentration, specific hormone concentration, specific gene phenotype distribution in a population, presence of biological substances) which serve as indices for health- and physiology-related assessments, such as disease risk, psychiatric disorders, environmental exposure and its effects, disease diagnosis, metabolic processes, substance abuse, pregnancy, cell line development, epidemiologic studies, etc.Coronary Stenosis: Narrowing or constriction of a coronary artery.C-Reactive Protein: A plasma protein that circulates in increased amounts during inflammation and after tissue damage.Troponin T: One of the three polypeptide chains that make up the TROPONIN complex. It is a cardiac-specific protein that binds to TROPOMYOSIN. It is released from damaged or injured heart muscle cells (MYOCYTES, CARDIAC). Defects in the gene encoding troponin T result in FAMILIAL HYPERTROPHIC CARDIOMYOPATHY.Cardiac Catheterization: Procedures in which placement of CARDIAC CATHETERS is performed for therapeutic or diagnostic procedures.Predictive Value of Tests: In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.Syndrome: A characteristic symptom complex.Nifedipine: A potent vasodilator agent with calcium antagonistic action. It is a useful anti-anginal agent that also lowers blood pressure.Calcium Channel Blockers: A class of drugs that act by selective inhibition of calcium influx through cellular membranes.Stents: Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting.Aspirin: The prototypical analgesic used in the treatment of mild to moderate pain. It has anti-inflammatory and antipyretic properties and acts as an inhibitor of cyclooxygenase which results in the inhibition of the biosynthesis of prostaglandins. Aspirin also inhibits platelet aggregation and is used in the prevention of arterial and venous thrombosis. (From Martindale, The Extra Pharmacopoeia, 30th ed, p5)Physical Exertion: Expenditure of energy during PHYSICAL ACTIVITY. Intensity of exertion may be measured by rate of OXYGEN CONSUMPTION; HEAT produced, or HEART RATE. Perceived exertion, a psychological measure of exertion, is included.Oxyfedrine: A drug used in the treatment of angina pectoris, heart failure, conduction defects, and myocardial infarction. It is a partial agonist at beta adrenergic receptors and acts as a coronary vasodilator and cardiotonic agent.Heart Rate: The number of times the HEART VENTRICLES contract per unit of time, usually per minute.Chronic Disease: Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care. (Dictionary of Health Services Management, 2d ed)Severity of Illness Index: Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.Fibrinopeptide A: Two small peptide chains removed from the N-terminal segment of the alpha chains of fibrinogen by the action of thrombin during the blood coagulation process. Each peptide chain contains 18 amino acid residues. In vivo, fibrinopeptide A is used as a marker to determine the rate of conversion of fibrinogen to fibrin by thrombin.Hirudin Therapy: Use of HIRUDINS as an anticoagulant in the treatment of cardiological and hematological disorders.Exercise Tolerance: The exercise capacity of an individual as measured by endurance (maximal exercise duration and/or maximal attained work load) during an EXERCISE TEST.Angiocardiography: Radiography of the heart and great vessels after injection of a contrast medium.Acute Disease: Disease having a short and relatively severe course.Ultrasonography, Interventional: The use of ultrasound to guide minimally invasive surgical procedures such as needle ASPIRATION BIOPSY; DRAINAGE; etc. Its widest application is intravascular ultrasound imaging but it is useful also in urology and intra-abdominal conditions.Collateral Circulation: Maintenance of blood flow to an organ despite obstruction of a principal vessel. Blood flow is maintained through small vessels.Creatine Kinase: A transferase that catalyzes formation of PHOSPHOCREATINE from ATP + CREATINE. The reaction stores ATP energy as phosphocreatine. Three cytoplasmic ISOENZYMES have been identified in human tissues: the MM type from SKELETAL MUSCLE, the MB type from myocardial tissue and the BB type from nervous tissue as well as a mitochondrial isoenzyme. Macro-creatine kinase refers to creatine kinase complexed with other serum proteins.Risk Assessment: The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)Atenolol: A cardioselective beta-1 adrenergic blocker possessing properties and potency similar to PROPRANOLOL, but without a negative inotropic effect.Laser Therapy: The use of photothermal effects of LASERS to coagulate, incise, vaporize, resect, dissect, or resurface tissue.Trimetazidine: A vasodilator used in angina of effort or ischemic heart disease.Dipyridamole: A phosphodiesterase inhibitor that blocks uptake and metabolism of adenosine by erythrocytes and vascular endothelial cells. Dipyridamole also potentiates the antiaggregating action of prostacyclin. (From AMA Drug Evaluations Annual, 1994, p752)Retrospective Studies: Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.Angioscopy: Endoscopic examination, therapy or surgery performed on the interior of blood vessels.IodobenzenesDrug Therapy, Combination: Therapy with two or more separate preparations given for a combined effect.Metoprolol: A selective adrenergic beta-1 blocking agent that is commonly used to treat ANGINA PECTORIS; HYPERTENSION; and CARDIAC ARRHYTHMIAS.Heart: The hollow, muscular organ that maintains the circulation of the blood.Cineangiography: Motion pictures of the passage of contrast medium through blood vessels.Diltiazem: A benzothiazepine derivative with vasodilating action due to its antagonism of the actions of CALCIUM ion on membrane functions.Blood Pressure: PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS.Tomography, Emission-Computed, Single-Photon: A method of computed tomography that uses radionuclides which emit a single photon of a given energy. The camera is rotated 180 or 360 degrees around the patient to capture images at multiple positions along the arc. The computer is then used to reconstruct the transaxial, sagittal, and coronal images from the 3-dimensional distribution of radionuclides in the organ. The advantages of SPECT are that it can be used to observe biochemical and physiological processes as well as size and volume of the organ. The disadvantage is that, unlike positron-emission tomography where the positron-electron annihilation results in the emission of 2 photons at 180 degrees from each other, SPECT requires physical collimation to line up the photons, which results in the loss of many available photons and hence degrades the image.Ischemic Preconditioning, Myocardial: Exposure of myocardial tissue to brief, repeated periods of vascular occlusion in order to render the myocardium resistant to the deleterious effects of ISCHEMIA or REPERFUSION. The period of pre-exposure and the number of times the tissue is exposed to ischemia and reperfusion vary, the average being 3 to 5 minutes.Coronary Care Units: The hospital unit in which patients with acute cardiac disorders receive intensive care.Platelet Glycoprotein GPIIb-IIIa Complex: Platelet membrane glycoprotein complex important for platelet adhesion and aggregation. It is an integrin complex containing INTEGRIN ALPHAIIB and INTEGRIN BETA3 which recognizes the arginine-glycine-aspartic acid (RGD) sequence present on several adhesive proteins. As such, it is a receptor for FIBRINOGEN; VON WILLEBRAND FACTOR; FIBRONECTIN; VITRONECTIN; and THROMBOSPONDINS. A deficiency of GPIIb-IIIa results in GLANZMANN THROMBASTHENIA.Chi-Square Distribution: A distribution in which a variable is distributed like the sum of the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.Multivariate Analysis: A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.Nitrates: Inorganic or organic salts and esters of nitric acid. These compounds contain the NO3- radical.Heparin: A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts.Thallium Radioisotopes: Unstable isotopes of thallium that decay or disintegrate emitting radiation. Tl atoms with atomic weights 198-202, 204, and 206-210 are thallium radioisotopes.Propranolol: A widely used non-cardioselective beta-adrenergic antagonist. Propranolol has been used for MYOCARDIAL INFARCTION; ARRHYTHMIA; ANGINA PECTORIS; HYPERTENSION; HYPERTHYROIDISM; MIGRAINE; PHEOCHROMOCYTOMA; and ANXIETY but adverse effects instigate replacement by newer drugs.Clinical Trials as Topic: Works about pre-planned studies of the safety, efficacy, or optimum dosage schedule (if appropriate) of one or more diagnostic, therapeutic, or prophylactic drugs, devices, or techniques selected according to predetermined criteria of eligibility and observed for predefined evidence of favorable and unfavorable effects. This concept includes clinical trials conducted both in the U.S. and in other countries.Hemodynamics: The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM.Hospitalization: The confinement of a patient in a hospital.Plaque, Atherosclerotic: Lesions formed within the walls of ARTERIES.Percutaneous Coronary Intervention: A family of percutaneous techniques that are used to manage CORONARY OCCLUSION, including standard balloon angioplasty (PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY), the placement of intracoronary STENTS, and atheroablative technologies (e.g., ATHERECTOMY; ENDARTERECTOMY; THROMBECTOMY; PERCUTANEOUS TRANSLUMINAL LASER ANGIOPLASTY). PTCA was the dominant form of PCI, before the widespread use of stenting.Anticoagulants: Agents that prevent clotting.Heart Function Tests: Examinations used to diagnose and treat heart conditions.Spasm: An involuntary contraction of a muscle or group of muscles. Spasms may involve SKELETAL MUSCLE or SMOOTH MUSCLE.Proportional Hazards Models: Statistical models used in survival analysis that assert that the effect of the study factors on the hazard rate in the study population is multiplicative and does not change over time.Enoxaparin: Low-molecular-weight fragment of heparin, having a 4-enopyranosuronate sodium structure at the non-reducing end of the chain. It is prepared by depolymerization of the benzylic ester of porcine mucosal heparin. Therapeutically, it is used as an antithrombotic agent. (From Merck Index, 11th ed)Incidence: The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases, new or old, in the population at a given time.Sex Factors: Maleness or femaleness as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or effect of a circumstance. It is used with human or animal concepts but should be differentiated from SEX CHARACTERISTICS, anatomical or physiological manifestations of sex, and from SEX DISTRIBUTION, the number of males and females in given circumstances.Regression Analysis: Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable.Stroke Volume: The amount of BLOOD pumped out of the HEART per beat, not to be confused with cardiac output (volume/time). It is calculated as the difference between the end-diastolic volume and the end-systolic volume.Case-Control Studies: Studies which start with the identification of persons with a disease of interest and a control (comparison, referent) group without the disease. The relationship of an attribute to the disease is examined by comparing diseased and non-diseased persons with regard to the frequency or levels of the attribute in each group.Coronary Restenosis: Recurrent narrowing or constriction of a coronary artery following surgical procedures performed to alleviate a prior obstruction.Quality of Life: A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral and social environment; the overall condition of a human life.Echocardiography: Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic.Troponin: One of the minor protein components of skeletal muscle. Its function is to serve as the calcium-binding component in the troponin-tropomyosin B-actin-myosin complex by conferring calcium sensitivity to the cross-linked actin and myosin filaments.Nadroparin: A heparin fraction with a mean molecular weight of 4500 daltons. It is isolated from porcine mucosal heparin and used as an antithrombotic agent. (From Merck Index, 11th ed)Cohort Studies: Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.Fibrinolysis: The natural enzymatic dissolution of FIBRIN.Survival Analysis: A class of statistical procedures for estimating the survival function (function of time, starting with a population 100% well at a given time and providing the percentage of the population still well at later times). The survival analysis is then used for making inferences about the effects of treatments, prognostic factors, exposures, and other covariates on the function.Cardiovascular Diseases: Pathological conditions involving the CARDIOVASCULAR SYSTEM including the HEART; the BLOOD VESSELS; or the PERICARDIUM.Verapamil: A calcium channel blocker that is a class IV anti-arrhythmia agent.Thrombolytic Therapy: Use of infusions of FIBRINOLYTIC AGENTS to destroy or dissolve thrombi in blood vessels or bypass grafts.Practolol: A beta-1 adrenergic antagonist that has been used in the emergency treatment of CARDIAC ARRYTHMIAS.Amino Alcohols: Compounds possessing both a hydroxyl (-OH) and an amino group (-NH2).Fibrinolytic Agents: Fibrinolysin or agents that convert plasminogen to FIBRINOLYSIN.Spinal Cord Stimulation: Application of electric current to the spine for treatment of a variety of conditions involving innervation from the spinal cord.Creatine Kinase, MB Form: An isoenzyme of creatine kinase found in the CARDIAC MUSCLE.Placebos: Any dummy medication or treatment. Although placebos originally were medicinal preparations having no specific pharmacological activity against a targeted condition, the concept has been extended to include treatments or procedures, especially those administered to control groups in clinical trials in order to provide baseline measurements for the experimental protocol.Age Factors: Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.Logistic Models: Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.Death, Sudden: The abrupt cessation of all vital bodily functions, manifested by the permanent loss of total cerebral, respiratory, and cardiovascular functions.Arrhythmias, Cardiac: Any disturbances of the normal rhythmic beating of the heart or MYOCARDIAL CONTRACTION. Cardiac arrhythmias can be classified by the abnormalities in HEART RATE, disorders of electrical impulse generation, or impulse conduction.Heart Diseases: Pathological conditions involving the HEART including its structural and functional abnormalities.Perhexiline: 2-(2,2-Dicyclohexylethyl)piperidine. Coronary vasodilator used especially for angina of effort. It may cause neuropathy and hepatitis.

Elevated levels of C-reactive protein at discharge in patients with unstable angina predict recurrent instability. (1/1246)

BACKGROUND: In a group of patients admitted for unstable angina, we investigated whether C-reactive protein (CRP) plasma levels remain elevated at discharge and whether persistent elevation is associated with recurrence of instability. METHODS AND RESULTS: We measured plasma levels of CRP, serum amyloid A protein (SAA), fibrinogen, total cholesterol, and Helicobacter pylori and Chlamydia pneumoniae antibody titers in 53 patients admitted to our coronary care unit for Braunwald class IIIB unstable angina. Blood samples were taken on admission, at discharge, and after 3 months. Patients were followed for 1 year. At discharge, CRP was elevated (>3 mg/L) in 49% of patients; of these, 42% had elevated levels on admission and at 3 months. Only 15% of patients with discharge levels of CRP <3 mg/L but 69% of those with elevated CRP (P<0.001) were readmitted because of recurrence of instability or new myocardial infarction. New phases of instability occurred in 13% of patients in the lower tertile of CRP (/=8.7 mg/L, P<0.001). The prognostic value of SAA was similar to that of CRP; that of fibrinogen was not significant. Chlamydia pneumoniae but not Helicobacter pylori antibody titers significantly correlated with CRP plasma levels. CONCLUSIONS: In unstable angina, CRP may remain elevated for at >/=3 months after the waning of symptoms and is associated with recurrent instability. Elevation of acute-phase reactants in unstable angina could represent a hallmark of subclinical persistent instability or of susceptibility to recurrent instability and, at least in some patients, could be related to chronic Chlamydia pneumoniae infection.  (+info)

A role for changes in platelet production in the cause of acute coronary syndromes. (2/1246)

Platelets are heterogeneous with respect to their size, density, and reactivity. Large platelets are more active hemostatically, and platelet volume has been found to be increased both in patients with unstable angina and with myocardial infarction. Furthermore, platelet volume is a predictor of a further ischemic event and death when measured after myocardial infarction. Platelets which are anucleate cells with no DNA are derived from their precursor, the megakaryocyte. Therefore, it is suggested that changes in platelet size are determined at thrombopoiesis in the megakaryocyte and that those changes might precede acute cardiac events. Understanding of the signaling system that controls platelet production may also further elucidate the cascade of events leading to acute vascular occlusion in some patients.  (+info)

Cardioprotection by opening of the K(ATP) channel in unstable angina. Is this a clinical manifestation of myocardial preconditioning? Results of a randomized study with nicorandil. CESAR 2 investigation. Clinical European studies in angina and revascularization. (3/1246)

AIMS: To assess the anti-ischaemic and anti-arrhythmic effects and overall safety of nicorandil, an ATP sensitive potassium (K+) channel opener, with 'cardioprotective' effects, in patients with unstable angina. METHODS: In a multicentre, randomized, double-blind, parallel-group, placebo-controlled study, oral nicorandil 20 mg twice daily or a matching placebo was administered for a minimum of 48 h to patients admitted with unstable angina. Treatment was standardized to include, where tolerated, oral aspirin, a beta-blocker and diltiazem. Continuous Holter ECG monitoring was performed for 48 h to assess the frequency and duration of transient myocardial ischaemia and any tachyarrhythmia, as the predefined end-points of the study. A pain chart recorded the incidence and severity of chest pain throughout the study period. Patients with myocardial infarction identified retrospectively from troponin-T analysis were excluded. RESULTS: Two hundred and forty-five patients were recruited into the study. Forty-three patients were excluded with an index diagnosis of myocardial infarction, two were not randomized and 12 had unsatisfactory tape data. In the remaining 188 patients, six out of 89 patients (6.7%) on nicorandil experienced an arrhythmia, compared with 17 out of 99 patients (17.2%) on placebo (P=0.04). Three nicorandil patients experienced three runs of non-sustained ventricular tachycardia compared to 31 runs in 10 patients on placebo (P=0.087 patients; P<0.0001 runs). Three nicorandil patients had four runs of supraventricular tachycardia, compared to 15 runs in nine patients on placebo (P=0.14 patients; P=0.017 runs). Eleven (12.4%) patients on nicorandil had 37 episodes of transient myocardial ischaemia (mostly silent) compared with 74 episodes in 21 (21.2%) patients on placebo (P=0.12 patients; P=0.0028 episodes). In the overall safety analysis, which included all patients who received at least one dose of study medication, there were no significant differences in the rates of myocardial infarction or death between the nicorandil or placebo-treated groups. CONCLUSIONS: Nicorandil, added to aggressive anti-anginal treatment for unstable angina, reduces transient myocardial ischaemia, non-sustained ventricular, and supraventricular arrhythmia compared to placebo. The anti-arrhythmic activity with nicorandil is probably a secondary effect resulting from its anti-ischaemic action and we suggest that this may be related to its effect on the ATP sensitive potassium channel causing pharmacological preconditioning.  (+info)

Platelet activation in patients after an acute coronary syndrome: results from the TIMI-12 trial. Thrombolysis in Myocardial Infarction. (4/1246)

This study was designed to determine the magnitude and time course of platelet activation during therapy of acute coronary syndromes with an oral platelet antagonist. BACKGROUND: Platelet activation and aggregation are central to the pathogenesis of the acute coronary syndromes (ACS). However, few data are available on levels of platelet activation over time in patients with ACS, especially in the setting of chronic glycoprotein (GP) IIb/IIIa inhibition. METHODS: The Thrombolysis in Myocardial Infarction (TIMI) 12 trial was a phase II, double-blind trial evaluating the effects of sibrafiban, an oral, selective antagonist of the platelet glycoprotein IIb/IIIa receptor in patients stabilized after an ACS. A subset of 90 of the 329 patients in the study had measurement of platelet activation as assessed by the expression of platelet associated P-Selectin on days 0, 7 and 28. Platelet activation was measured in blood samples that were fixed either immediately (spontaneous activation) or after 5 minute incubation with 0, 1 microM or 5 microM ADP in order to assess platelet responsiveness to very low or moderate stimulation. RESULTS: At baseline there was a significant elevation of spontaneous platelet activation as compared to samples obtained from normal donors or from patients who did not have acute coronary syndromes (ACS patients 27.6+/-18.7%, Normal controls 8.5+/-4.4%, Patient controls 10.9+/-7.1%, p < 0.005 for both). In addition, there was a significant decrease in the levels of platelet activation with time during the 28 days of treatment with sibrafiban. Nevertheless, even on day 28, the TIMI-12 patients continued to show elevated platelet activation in comparison to the control groups (p < 0.05 for both). CONCLUSIONS: These results suggest that platelets remain activated long after clinical stabilization post ACS. Although platelet activation decreased after one month of oral GPIIb/IIIa inhibition, levels remained higher than normal, suggesting the need for long-term antiplatelet therapy following ACS.  (+info)

Does coronary artery morphology predict favorable results of intracoronary thrombolysis in patients with unstable angina pectoris? (5/1246)

The efficacy of intracoronary thrombolysis (ICT) for unstable angina pectoris (UAP) has been limited, despite the similar pathogenesis between UAP and acute myocardial infarction. To ascertain the subset of UAP suitable for ICT, the clinical responses to ICT were assessed in patients with UAP. Eighty-2 patients with medically refractory angina were divided into 2 groups according to the coronary artery morphology of the culprit lesion before ICT: (1) lesions with acute cut off and/or filling defects (AC) and (2) lesions with a tapered shape (TA). The TIMI flow grade was determined from coronary angiograms before and immediately after ICT. The diameter stenosis (%DS) and minimal lumen diameter (MLD) of the culprit lesion were determined using quantitative coronary angiographic analysis before and immediately after ICT. In addition, inhospital cardiac event rates including urgent/emergency coronary angioplasty or bypass surgery, nonfatal myocardial infarction or cardiac death were compared between the 2 groups. Multivariate logistic regression analysis was performed using 13 clinical factors contributing to successful ICT. The results showed that all 3 coronary angiographic parameters (TIMI flow, %DS, and MLD) significantly improved in the AC group (p<0.01, p<0.01 and p<0.05, respectively), whereas none of these parameters improved in the TA group. The inhospital cardiac event rate after ICT was significantly higher in the TA group (76%) than in the AC group (48%; p=0.016). Odds ratio predicting successful ICT was 7.09 (p<0.01) for the AC lesion, and 2.54 (p<0.01) for new angina. In conclusion the AC lesions are more commonly associated with coronary thrombosis that responds to ICT than are the TA lesions. Thus, the coronary angiographic morphology may be an important predictor for a successful ICT in patients with medically refractory UAP.  (+info)

Coronary artery stenting in unstable angina pectoris: a comparison with stable angina pectoris. (6/1246)

OBJECTIVE: To compare early complication rates in unselected cases of coronary artery stenting in patients with stable v unstable angina. SETTING: Tertiary referral centre. PATIENTS: 390 patients with stable angina pectoris (SAP) and 306 with unstable angina (UAP). Patients treated for acute myocardial infarction (primary angioplasty) or cardiogenic shock were excluded. INTERVENTIONS: 268 coronary stents were attempted in 211 patients (30.3%). Stents used included AVE (63%), Freedom (14%), NIR (7%), Palmaz-Schatz (5%), JO (5%), and Multilink (4%). Intravascular ultrasound was not used in any of the cases. All stented patients were treated with ticlopidine and aspirin together with periprocedural unfractionated heparin. RESULTS: 123 stents were successfully deployed in 99 SAP patients v 132 stents in 103 UAP patients. Failed deployment occurred with nine stents in SAP patients, v four in UAP patients (NS). Stent thrombosis occurred in four SAP patients and 11 UAP patients. Multivariate analysis showed no relation between stent thrombosis and clinical presentation (SAP v UAP), age, sex, target vessel, stent length, or make of stent. Stent thrombosis was associated with small vessel size (p < 0.001) and bailout stenting (p = 0.01) compared with elective stenting and stenting for suboptimal PTCA, with strong trends toward smaller stent diameter (p = 0.052) and number of stents deployed (p = 0.06). Most stent thromboses occurred in vessels < 3 mm diameter. CONCLUSIONS: Coronary artery stenting in unstable angina is safe in vessels >/= 3 mm diameter, with comparable initial success and stent thrombosis rates to stenting in stable angina.  (+info)

Treatment with the antibiotic roxithromycin in patients with acute non-Q-wave coronary syndromes. The final report of the ROXIS Study. (7/1246)

AIMS: Mounting evidence suggests infection, specifically Chlamydia pneumoniae, plays a role in atherosclerosis. We tested whether antibiotic treatment with the macrolide roxithromycin improves clinical outcome in patients with acute non-Q-wave coronary syndromes. Preliminary reports revealed a reduction in events in the roxithromycin group at 30 days. We now report the long-term follow-up results. METHODS AND RESULTS: Sixty-four per cent of the initial 202 patients with unstable angina who were randomly assigned to receive either roxithromycin or placebo for 30 days completed the active treatment period. At day 30, the primary triple and double end-point rates were 9% and 4% in the placebo group compared to 2% and 0% in the roxithromycin group (unadjusted P = 0.032 and 0.058, respectively). The secondary triple and double end-point rates were again higher in the placebo group at day 90 (12.5% and 6.25% vs 4.37% and 0%, unadjusted P = 0.065 and 0.029, respectively), and at day 180 (14.6% and 7.29% vs 8.69% and 2.17%, unadjusted P = 0.259 and 0.17, respectively). Anti-C, pneumoniae IgG titres were unchanged in both groups while C-reactive protein levels decreased in both strategies, with a more significant decrease in the roxithromycin arm (P = 0.03). Elevated C-reactive protein levels predicted the need for revascularization. CONCLUSIONS: In this pilot trial, roxithromycin appears to extend the clinical benefit of preventing death and re-infarction for at least 6 months after initial treatment.  (+info)

Diagnostic marker cooperative study for the diagnosis of myocardial infarction. (8/1246)

BACKGROUND: Millions of patients present annually with chest pain, but only 10% to 15% have myocardial infarction. Lack of diagnostic sensitivity and specificity of clinical and conventional markers prevents or delays treatment and leads to unnecessary costly admissions. Comparative data are lacking on the new markers, yet using all of them is inappropriate and expensive. METHODS AND RESULTS: The Diagnostic Marker Cooperative Study was a prospective, multicenter, double-blind study with consecutive enrollment of patients with chest pain presenting to the emergency department. Diagnostic sensitivity and specificity and frequency of increase in patients with unstable angina were determined for creatine kinase-MB (CK-MB) subforms, myoglobin, total CK-MB (activity and mass), and troponin T and I on the basis of frequent serial sampling for +info)

Background: The presence of peripheral arterial disease (PAD) or cerebrovascular disease (CVD) increases the likelihood of significant coronary artery disease (CAD). The impact of PAD, CVD, prior CAD, or pre-existent disease in multiple arterial territories ("polyvascular" disease) in patients presenting with non-ST elevation acute coronary syndromes (ACS) has not been well studied.. Methods: A total of 95,749 patients enrolled from February 15, 2003 to September 30, 2006 at 484 sites in the Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the ACC/AHA Guidelines (CRUSADE) registry were analyzed. Patients were categorized as having prior 0, 1, 2, or 3 affected arterial beds. The rates of in-hospital mortality, myocardial infarction (MI), stroke, and congestive (CHF) were analyzed, as were the rates of non-bypass surgery red blood cell transfusions.. Results: On presentation, a total of 11,345 (11.9%) patients had established PAD, ...
The American College of Cardiology and the American Heart Association (ACC/AHA) have issued an update to their Unstable Angina/ Non-ST-Elevation Myocardial Infarction (UA/NSTEMI) guidelines, last published in 2002.
TY - JOUR. T1 - Pentraxin 3 in unstable angina and non-ST-segment elevation myocardial infarction. AU - Matsui, Shigeru. AU - Ishii, Junichi. AU - Kitagawa, Fumihiko. AU - Kuno, Atsuhiro. AU - Hattori, Kousuke. AU - Ishikawa, Makoto. AU - Okumura, Masanori. AU - Kan, Shino. AU - Nakano, Tadashi. AU - Naruse, Hiroyuki. AU - Tanaka, Ikuko. AU - Nomura, Masanori. AU - Hishida, Hitoshi. AU - Ozaki, Yukio. PY - 2010/5/1. Y1 - 2010/5/1. N2 - Purpose: We prospectively investigated the prognostic value of pentraxin 3 (PTX3) in patients with unstable angina and non-ST-segment elevation myocardial infarction (UA/NSTEMI). Background: PTX3 may be a useful marker for localized vascular inflammation and damage to the cardiovascular system. Recent studies have shown that plasma PTX3 is elevated in patients with UA/NSTEMI; however, its prognostic value in UA/NSTEMI remains unclear. Methods: PTX3, high-sensitivity C-reactive protein (hsCRP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and cardiac ...
It has long been recognized that coronary artery disease comprises a wide spectrum of conditions, ranging from chronic stable angina to acute myocardial infarction. Unstable angina, in the middle of this spectrum is a heterogeneous syndrome with widely variable symptoms and prognosis. In 1989, a classification of unstable angina was introduced1 ; this classification is based on the clinical history (accelerated exertional angina or rest pain, the timing of the latter in respect to presentation, and the clinical circumstances in which unstable angina developed), on the presence or absence of ECG changes, and on the intensity of anti-ischemic therapy.. Although the development of this classification was based on clinical experience, it has been validated in a number of prospective studies. For example, Calvin et al2 studied 393 patients with unstable angina and reported that a history of a myocardial infarction within 14 days (class C) and ST-segment depression on the presenting ECG were both ...
This study sought to identify differences in coronary anatomic pathology in patients with unstable angina and elevated versus nonelevated serum troponin T values. Previous studies have shown a worse prognosis in unstable angina patients with elevated
Video 24.8. Acute pulmonary embolism. TTE. Note dilated right heart with McConnells sign and paradoxical septal movements in a patient referred to the ER from the regional hospital due to suspected unstable angina. Echo-free space in front of the heart represents pericardial fat pad. Reproduced from Chapter 24: Echocardiography in the emergency room, in The EAE Textbook of Echocardiography. Edited by Leda Galiuto, Luigi Badano, Kevin Fox, Rosa Sicari, and Jose Luis Zamorano. © European Society of Cardiology. DOI: 10.1093/med/9780199599639.001.0001 The optimal therapy of patients presenting with unstable angina with or without enzyme rise but without ST elevation (UA/NSTEMI) is still debatable. Several (FRISC II, TACTICS-TIMI 18, RITA 3, ISAR-COOL, TIMACS), although not all (ICTUS, ELISA, OPTIMA, ABOARD, LIPSIA-NSTEMI), randomized trials have provided evidence in favour of an invasive strategy compared to conservative medical therapy in non-ST elevation acute coronary syndromes (NSTE-ACS). ...
Eugene Braunwald: Maestro Of American Cardiology pg. 7. For five "nail-biting" years, Braunwalds team waited for the results, which ultimately showed that patients who took pravastatin to lower serum cholesterol indeed reduced their risk for having another heart attack, stroke, or dying of cardiovascular causes.. More recent TIMI trials have examined the effect of driving cholesterol levels even lower, and have found not only that "lower is better," but that "much lower is much better." TIMI investigators are currently studying the effects of reducing a patients LDL to a level in the 50s, levels undreamed of ten years ago.. "Weve followed all of these patients extremely carefully and we dont see any serious side effects with even extreme cholesterol lowering," says Braunwald. "We have not yet reached the (LDL-concentration) floor.". For more than a half century as an academic physician-scientist, Braunwald has been instrumental in numerous discoveries that have saved millions of lives, and, ...
TY - JOUR. T1 - Postinfarction unstable angina. Pathophysologic basis for current modalities. AU - Becker, R. C.. AU - Gore, J. M.. AU - Alpert, J. S.. PY - 1989/1/1. Y1 - 1989/1/1. N2 - Unstable angina is an acute coronary syndrome characterized by the rapid progression of clinical symptoms which may culminate in acute myocardial infarction, infarct extension or sudden death. The pathologic substrate involves atherosclerotic plaque rupture with platelet deposition, thrombus formation and coronary arterial spasm. Patients with postinfarction angina represent a high-risk subgroup with severe multivessel disease, compromised collateral vessels and/or partially occlusive thrombi; their risk of infarct extension and death is significantly increased. Initial therapy includes nitrates, beta-adrenergic blockers, calcium channel antagonists, aspirin and possibly i.v. heparin, as well as prompt identification and control of exacerbating factors. Thrombolytic therapy may assume a more central role based ...
ABOARD: Angioplasty to Blunt the rise Of troponin in Acute coronary syndromes Randomized for an immediate or Delayed intervention. -Immediate versus Delayed Invasive Strategies in Patients with Non-ST Elevation ACS by Dr. Gilles Montalescot. ICTUS: Invasive Versus Conservative Treatment in Unstable Coronary Syndromes. -Early invasive strategy vs conservative, selective invasive strategy in troponin positive patients with non-STEMI ACS by Dr. Robbert J. De Winter. MATE: Medicine versus angiography in thrombolytic exclusion. -Triage angiography in suspected acute MI patients considered ineligible for reperfusion therapy by Dr. Peter A. McCullough. NRMI: National Registry of Myocardial Infarction. -Outcomes Among NSTEMI Patients Presenting to Hospitals With and Without Backup Cardiac Surgery by Dr. Yuri B. Pride. TACTICS TIMI 18: Treat Angina with Aggrastat + Determine Cost of Therapy with an Invasive or Conservative Strategy. -Treat Angina with Aggrastat + Determine Cost of Therapy with an ...
This is the first UK study to show that patients admitted to DGHs with unstable angina or NSTEMI and who are stratified at high risk wait significantly longer for angiography and revascularisation than similar patients admitted to a hospital containing a tertiary centre for cardiac services. Specifically, DGH patients were found to wait over two and a half times longer for angiography and over twice as long for revascularisation. The study hypothesis has therefore been proved.. The baseline characteristics of the MRI and DGH groups of patients were well matched except that more MRI than DGH patients had previously undergone coronary revascularisation. This is probably due to the fact that patients who have had a coronary procedure tend to represent to the hospital where they had it done and often remain under regular follow up at the tertiary centre. It is not clear why significantly more DGH patients had raised cholesterol.. If the "hit list" for invasive assessment and treatment of patients ...
An increased tissue endothelin-1 (ET-1) immunoreactivity has been demonstrated at the site of the culprit lesion (CL) in patients with unstable angina (UA) thus suggesting that ET-1 may be involved in the abnormal vasoreactivity of the CL in UA. The aim of this study was to establish whether an enhanced local release of ET-1 is involved in the pathogenesis of the enhanced vasoreactivity of the unstable plaque in patients with UA. We studied 9 patients with UA and 9 patients with stable angina (SA) with a single proximal lesion of the left anterior descending coronary artery. Luminal diameter of the CL and of the proximal, middle and distal normal-appearing coronary segments were measured by quantitative coronary angiography at baseline, during cold pressor test (CPT) and after intracoronary administration of nitroglycerine (NTG). ET-1 levels were measured in blood samples obtained proximally and distally to the coronary CL before and after successful stent implantation. During CPT, the CL in ...
Another name for Unstable Angina is Angina. The long-term treatment of angina depends on the severity of the coronary artery disease, the condition of ...
Among elderly patients with NSTE-ACS, invasive therapy was beneficial at reducing adverse cardiovascular events compared with conservative therapy. This was due to a reduction in recurrent MI and urgent revascularization procedures. There was suggestion of harm for patients ,90 years of age; however, definitive conclusions in this group were not possible due to the limited number of patients. This trial is unique in that no crossovers occurred between the treatment groups, unlike previous trials in which a large proportion of conservative patients underwent angiography. Elderly patients are at high risk for adverse events after a NSTE-ACS, and invasive therapy remains the optimal treatment to reduce this risk.. ...
The Thrombolysis In Myocardial Infarction, or TIMI Study Group is an Academic Research Organization (ARO) affiliated with Brigham and Womens Hospital and Harvard Medical School. The group has its headquarters in Boston, Massachusetts, and a satellite location in Quincy. The TIMI Study Group was founded by Eugene Braunwald, MD in 1984. Dr. Braunwald held the chairmanship until 2010, when he appointed Marc Sabatine, MD to the position. The group has conducted numerous practice-changing clinical trials in patients with cardiovascular disease or risk factors for cardiovascular disease. Among the groups most important contributions to medicine is the TIMI Risk Score, which assess the risk of death and ischemic events in patients experiencing unstable angina (UA) or a non-ST elevation myocardial infarction (NSTEMI). In patients with UA/NSTEMI, the TIMI risk score is a simple prognostication scheme that categorizes a patients risk of death and ischemic events and provides a basis for therapeutic ...
New life-saving treatments for Angina in clinical trial on Seeking Oklahomans who have been diagnosed with chronic or unstable angina.
Diabetes mellitus is an etiologically and clinically heterogeneous group of metabolic disorders that share the commonality of hyperglycemia. Long-term hyperglycemia produces tissue damage, which ultimately manifests as microvascular and macrovascular disease, and neuropathy. The presence of macrovascular disease should alert clinicians to the possibility that the patient may have coronary artery disease, particularly because coronary artery disease and myocardial ischemia are likely to be silent. Elderly patients with diabetes mellitus are also more likely to develop congestive heart failure. Patients with unstable coronary syndromes, decompensated heart failure, and symptomatic cardiac arrhythmias are at increased risk of perioperative cardiovascular complications (myocardial infarction, heart failure, and sudden death) while undergoing noncardiac procedures. In addition, clinicians must avoid the risk of hypoglycemic episodes. Oral health care providers can expect to be called upon to care for ...
Chest pain is a nonspecific symptom that can have cardiac or noncardiac causes (see DDx). Unstable angina belongs to the spectrum of clinical presentations referred to collectively as acute coronary syndromes (ACSs), which range from ST-segment elevation myocardial infarction (STEMI) to non-STEMI (NSTEMI).
Chest pain is a nonspecific symptom that can have cardiac or noncardiac causes (see DDx). Unstable angina belongs to the spectrum of clinical presentations referred to collectively as acute coronary syndromes (ACSs), which range from ST-segment elevation myocardial infarction (STEMI) to non-STEMI (NSTEMI).
The study included adult patients with established or known CAD, which was defined as having a diagnosis of at least one of the following on their medical problem list: Coronary artery disease, chronic angina, or atherosclerosis of the aorta. Exclusion criteria were unstable angina or acute coronary syndrome, both ST and non-ST segment elevation myocardial infarctions within 60 days before the start of the program; current pregnancy; life expectancy less than 1 year such as in patients with terminal cancer or those under hospice care; current chemotherapy; advanced or end-stage organ disease; active alcohol or drug abuse problems; inability to tolerate a high-fiber diet secondary to active inflammatory bowel disease; inability to understand spoken English because the program includes videos that are available only in English; and previous participation in CHIP or the health education classes.. All patients were randomly assigned to either the CHIP group or HH group. In both groups, sessions ...
This guideline covers treatments for people aged 18 and over with unstable angina (recurring chest pain) or a type of heart attack called non-ST-segment-elevation myocardial infarction (NSTEMI). It aims to ensure that people get treatment quickly.
Unstable angina or sometimes referred to as acute coronary syndrome causes unexpected chest pain, and usually occurs while resting. The most common cause is reduced blood flow to the heart muscle because the coronary arteries are narrowed by fatty buildups (atherosclerosis) which can rupture causing injury to the coronary blood vessel resulting in blood clotting which blocks the flow of blood to the heart muscle ...
Covers causes of heart attack (myocardial infarction) and unstable angina. Discusses symptoms like chest pain or pressure. Explains MI and angina differences. Offers prevention tips. Covers diagnostic tests and treatment with medicines and surgery.
Covers causes of heart attack (myocardial infarction) and unstable angina. Discusses symptoms like chest pain or pressure. Explains MI and angina differences. Offers prevention tips. Covers diagnostic tests and treatment with medicines and surgery.
Covers causes of heart attack (myocardial infarction) and unstable angina. Discusses symptoms like chest pain or pressure. Explains MI and angina differences. Offers prevention tips. Covers diagnostic tests and treatment with medicines and surgery.
The choice of an "invasive" or "conservative" strategy for the initial management of patients with acute coronary syndromes (ACSs) has been evaluated in 7 RCTs, the results of which have been summarized by 2 groups using meta-analysis. Although it seems that the 2 meta-analyses reached different conclusions, both groups supported the invasive strategy in their respective discussion sections. Several trial limitations have confused the debate on what used to be a contentious subject, but the evidence now favors percutaneous coronary intervention (PCI) for NSTEMI. First, the terms that describe the strategies need to be clarified. The "invasive strategy" refers to the routine use of cardiac catheterization, not coronary revascularization with PCI or coronary artery bypass graft (CABG) surgery. The "conservative strategy" limits the use of cardiac catheterization to patients with spontaneous or provokable ischemia, but the term does not convey the fact that 50% of patients allocated to this ...
Unstable angina is a potentially dangerous condition, and management should be tailored to prevent adverse outcomes. Patients should be admitted to the cardiac care unit, placed at bedrest, and begun on antianginal therapy with either P-blockers or calcium channel blockers, aspirin, and intravenous nitrates. (J-Blockers, when added to nitrates, have been shown to reduce symptoms […] Read more. ...
Unstable Angina and NSTEMIs: Management Principles. Meira Louis Lisa Campfens. Outline. Pick your/ cardios strategy Initial therapy...for everyone? Pick an anti-platelet...or two...or three... Protect the stomach??? PPI controversy Pick the right anti-coagulant Slideshow 2224058...
Among patients with NSTEMI/UA, treatment with clopidogrel in addition to standard therapy was associated with a reduction in death, MI, or stroke at 30 days and from 31 days to 1 year. For the primary endpoint plus refractory or severe ischemia, benefit was seen by the first 24 hours. However, for the primary endpoint alone, benefit was not observed until after day 7. This substudy did not address how PCI use affected these outcomes and the timing of the events. Finally, approximately 21% of patients in CURE underwent PCI, a much lower rate of PCI than what is typically used in the US in NSTEMI/UA patients. It is therefore unclear how applicable the data would be in a population treated more aggressively with PCI.. ...
Find out all information about angina at rest also known as unstable angina. This condition is marked by chest pain which appears while person is at rest
Angina is chest pain or discomfort due to coronary heart disease. It occurs when the heart muscle doesnt get as much blood as it needs. This usually happens because one or more of the hearts arteries is narrowed or blocked, also called ischemia. Stable angina refers to "predictable" chest discomfort associated with exertion or stress. Unstable angina refers to unexpected chest pain and usually occurs at rest. It is typically more severe and prolonged. Unstable angina should be treated as an emergency.. ...
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My chest pains started up again about 2 months ago after 9 months without. I had one really bad attack, but then went for 10 days with hardly any. Thursday and Friday I had prolonged low-grade chest ...
To the best of our knowledge, there have been no studies investigating the association among diabetes, angiogenic factors, and oxidative stress in human heart tissue affected by ischemic insult. The main findings of our study demonstrate an association between diabetes, reduced expression of HIF-1α and VEGF, and increment of iNOS, O2−, and nitrotyrosine levels in heart specimens of patients with unstable angina. Diabetes amplifies oxidative reaction and worsens the angiogenic process. In nondiabetic patients, we detected increased steady-state levels of HIF-1α and VEGF after unstable angina. This accumulation of both mRNA and protein was limited to the region of affected myocardium. No HIF-1α and VEGF transcripts or proteins were detectable in nonischemic specimens. In diabetic patients, the picture is quite different because both HIF-1α and VEGF levels were significantly lower than those in nondiabetic heart specimens. Thus, the roles of HIF-1α and VEGF in beginning angiogenic process ...
Decision Resources, Inc., one of the worlds leading research and advisory firms focusing on pharmaceutical and health care issues, announced today that robust growth is predicted for the unstable...
Sigma-Aldrich offers abstracts and full-text articles by [Ke-Fei Dou, Bo-Qia Xie, Xiao-Jin Gao, Yan Li, Yue-Jin Yang, Zuo-Xiang He, Min-Fu Yang].
2006 (Swedish)In: Läkartidningen, ISSN 0023-7205, Vol. 103, no 30-31, 2240-1; discussion 2241 p.Article in journal (Refereed) Published ...
Fibrin, Plasma, 1,4-butanediamine, Homocysteine, Plasminogen, Cardiac Death, Concentration, Death, Infarction, Myocardial Infarction, Stroke, Unstable Angina, Adp, ATP, Collagen, Estradiol, Estrogenic Effects, Hand, Methods, Orientation
Plavix is used for reducing the risk of stroke or heart attack in patients who have already had a heart attack or stroke, have other circulatory problems caused by narrowing and hardening of the arteries, or have certain other heart problems (eg, unstable angina ...
What is this medicine? DALTEPARIN (dal te PA rin) is used in combination with aspirin to prevent complications caused by unstable angina or heart attack.
BACKGROUND: The Thrombolysis In Myocardial Infarction (TIMI) Risk Score has been shown to predict prognosis in acute coronary syndromes (ACS) comprised of unstable angina (UA) and non-ST segment elevation myocardial infarction (STEMI). We sought to evaluate the impact of newer antiplatelet and antithrombotic therapies for ACS, such as glycoprotein IIb/IIIa inhibitors (GPI) and low molecular weight heparin (LMWH), on in-hospital outcomes over time in patients (pts) with similar TIMI risk scores.. METHODS: The baseline demographics and clinical outcomes of pts with ACS (UA and non-STEMI) in 1998 (Group 1998) and 2000 (Group 2000) at a single large university medical center were compared using a prospectively collected database. In-hospital major adverse cardiac events (MACE) included death, MI, or recurrent angina that resulted in urgent revascularization. Risk was estimated by utilizing the TIMI Risk Score, which uses 7 predictor variables: age , 65 years, at least 3 risk factors for coronary ...
References: Anderson JL, Adams CD, Antman EM, et al. ACC/AHA Guidelines for the Management of Patients With Unstable Angina and Non-ST-Segment Elevation Myocardial Infarction: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients with Unstable Angina). Circulation. 2007;116:803-877.. Goldman L. Approach to the patient with possible cardiovascular disease. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 50.. Sabatine MS, Cannon CP. Approach to the patient with chest pain. In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwalds Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 53.. Wright RS, Anderson JL, Adams CD, et al. 2011 ACCF/AHA Focused Update of the Guidelines for the Management of Patients with Unstable Angina/Non-ST-Elevation Myocardial Infarction (Updating the 2007 Guideline). ...
Objectives: This study sought to investigate long-term outcomes after early or delayed angiography in patients with non-ST-segment elevation acute coronary syndrome (nSTE-ACS) undergoing a routine invasive management. Background The optimal timing of angiography in patients with nSTE-ACS is currently a topic for debate.. Methods: Long-term follow-up after early (within 2 days) angiography versus delayed (within 3 to 5 days) angiography was investigated in the FRISC-II (Fragmin and Fast Revascularization During Instability in Coronary Artery Disease), ICTUS (Invasive Versus Conservative Treatment in Unstable Coronary Syndromes), and RITA-3 (Intervention Versus Conservative Treatment Strategy in Patients With Unstable Angina or Non-ST Elevation Myocardial Infarction) (FIR) nSTE-ACS patient-pooled database. The main outcome was cardiovascular death or myocardial infarction up to 5-year follow-up. Hazard ratios (HR) were calculated with Cox regression models. Adjustments were made for the FIR risk ...
This study demonstrates that UA/NSTEMI patients who would have been excluded from the randomized enoxaparin trials can be safely treated with a weight-adjusted regimen of subcutaneous enoxaparin, as long as particular attention is paid to age and renal function to further adjust the dosing regimen. The EP population represents a high-risk group of patients who had a fourfold increase in death or MI at 30 days. Hypertension and the use of GP IIb/IIIa inhibitors were the only predictors of bleeding found in our study population.. There is strong evidence that antithrombin therapy is beneficial in UA/NSTEMI patients and that subcutaneous enoxaparin is superior to UH in this setting (1-3). However, this demonstration has been obtained in selected populations, and it is not known whether these results can be applied to all comers who present with UA/NSTEMI, including those who would have been excluded from these randomized trials. Furthermore, the safety of enoxaparin in a population at a high risk ...
Background: In patients with acute non-ST elevation myocardial infarction (NSTEMI) coronary arteriography is usually recommended however visual interpretation of the coronary angiogram is subjective. A complementary diagnostic approach involves measuring the pressure drop across a coronary stenosis (fractional flow reserve, FFR) with a pressure-sensitive guidewire.. Hypothesis: Routine FFR measurement is feasible in NSTEMI patients and has additive diagnostic, clinical and health economic utility, as compared to angiography-guided standard care.. Design: A prospective multi-center randomized controlled trial in 350 NSTEMI patients with ≥1 coronary stenosis ≥30% severity (threshold for FFR measurement). Patients will be randomized immediately after coronary angiography to the FFR-guided group or angiography-guided group (FFR measured, not disclosed). All patients will then undergo FFR measurement in all vessels with a coronary stenosis ≥30% severity. FFR will be measured in culprit and ...
The paradoxical use of cardiac catheterization in patients with non-ST-elevation acute coronary syndromes: lessons from the Can Rapid Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the ACC /AHA Guidelines (CRUSADE) Quality Improvement Initiative.
Most patients with a non-ST elevation acute coronary syndrome (unstable angina and non-ST elevation myocardial infarction) undergo coronary angiography and revascularization during the index hospitalization. This topic will summarize the evidence sup
Our finding that mean platelet component is lower in acute myocardial infarction than in unstable angina, reflecting greater platelet activation, confirms the central role of thrombogenicity in the pathogenesis of acute coronary syndromes. Indeed, platelet activation was an independent predictor of the mode of presentation and, even in the subgroup of patients with unstable angina at high risk of future events, platelet activation was significantly lower than in those with myocardial infarction.. Some studies have not found a difference in platelet activation between unstable angina and myocardial infarction. However, Garlichs and colleagues2 found greater expression of the CD40 ligand in unstable angina than in myocardial infarction. This appears counterintuitive but may reflect greater hydrolysis and release of the ligand in myocardial infarction. Mathur and colleagues3 found a greater expression of P selectin in myocardial infarction than in unstable angina but also found that mean platelet ...
TY - JOUR. T1 - Issues in antithrombin therapy for UA/NSTEMI. AU - Alpert, Joseph S.. AU - Budaj, A. J.. AU - Gurfinkel, E. P.. AU - Henry, T. D.. PY - 2001/8/27. Y1 - 2001/8/27. N2 - In September 2000, participants at the 4th Annual Experts Meeting of the International Cardiology Forum convened to discuss guidelines for the management of unstable angina/non-ST-elevation MI, recently published by North American and European task forces. Discussion of new recommendations for antithrombin therapy focused on the role of low-molecular-weight heparin (LMWH). Although most participants found the new guidelines largely consistent with existing data, and sufficiently adaptable to most clinical settings, there was concern that neither task force specified LMWH as the antithrombin of choice for the medical management of these patients. The new guidelines continue to endorse the use of unfractionated heparin, particularly for high-risk patients, despite the evidence for the efficacy of LMWH in this ...
Objective: To analyse intensity of treatment of high-risk patients with non-ST elevation acute coronary syndromes (NSTEACS) included in the DESCARTES (Descripción del Estado de los Sindromes Coronarios Agudos en un Registro Temporal Español) registry.. Patients and setting: Patients with NSTEACS (n = 1877) admitted to 45 randomly selected Spanish hospitals in April and May 2002 were studied.. Design: Patients with ST segment depression and troponin rise were considered high risk (n = 478) and were compared with non-high risk patients (n = 1399).. Results: 46.9% of high-risk patients versus 39.5% of non-high-risk patients underwent angiography (p = 0.005), 23.2% versus 18.8% (p = 0.038) underwent percutaneous revascularisation, and 24.9% versus 7.4% (p , 0.001) were given glycoprotein IIb/IIIa inhibitor. In-hospital and six-month mortality were 7.5% versus 1.1% and 17% versus 4.6% (p , 0.001), respectively. A treatment score (⩾ 4, 2-3 and , 2) was defined according to the number of class I ...
Preoperative use is suggested for high-risk patients such as those with unstable angina with stenosis greater than 70% of main ... Unstable angina pectoris benefits from counterpulsation. Post cardiothoracic surgery-most common and useful is counterpulsation ...
Clinical guideline cg94: Unstable angina and NSTEMI. London, 2010. "UOTW #36 - Ultrasound of the Week". Ultrasound of the Week ... Unlike other causes of acute coronary syndromes, such as unstable angina, a myocardial infarction occurs when there is cell ... Plaques can become unstable, rupture, and additionally promote the formation of a blood clot that blocks the artery; this can ... Spasm of coronary arteries, such as Prinzmetal's angina may cause blockage. If impaired blood flow to the heart lasts long ...
Unstable cardiovascular status (angina, recent myocardial infarction, etc.). *Thoracic, abdominal, or cerebral aneurysms ...
... and unstable angina. Relief of the pain of angina is of paramount importance, not only for humane reasons but because the pain ... Unstable angina and non-ST elevation myocardial infarction". In Bonow RO; Mann DL; Zipes DP; Libby P. Braunwald's heart disease ... The principal symptom is typically chest pain, known as angina pectoris; people who present with angina must prompt evaluation ... the latter includes unstable angina and non-ST elevation myocardial infarction (NSTEMI). Treatment is generally more aggressive ...
His team discovered the presence of small, partially occlusive blood clots in patients with unstable angina (now called acute ... Cohen M, Fuster V (1990). "Insights into the pathogenetic mechanisms of unstable angina". Haemostasis. 20 (Suppl 1): 102-12. " ...
They are not used in the treatment of unstable angina . In vitro, they dilate the coronary and peripheral arteries and have ... An antianginal is any drug used in the treatment of angina pectoris, a symptom of ischaemic heart disease. Drugs used are ... Nifedipine is more a potent vasodilator and more effective in angina. It is in the class of dihydropyridines and does not ... Short-acting nitrates are used to abort angina attacks that have occurred, while longer-acting nitrates are used in the ...
Unstable angina. *Refractory ventricular tachycardia. *Assessment of respiratory distress *Cardiogenic vs non-cardiogenic ...
"The TIMI Risk Score for Unstable Angina/Non-ST Elevation MI", JAMA, 2000 Antman, Elliott M.; Cohen, Marc; Bernink, Peter J. L. ... which assess the risk of death and ischemic events in patients experiencing unstable angina (UA) or a non-ST elevation ... "The TIMI Risk Score for Unstable Angina/Non-ST Elevation MI". JAMA. 284 (7): 835-42. doi:10.1001/jama.284.7.835. ISSN 0098-7484 ... At least 2 angina episodes within the last 24hrs ST changes of at least 0.5mm in contiguous leads Elevated serum cardiac ...
... "crescendo angina"). New-onset angina is also considered unstable angina, since it suggests a new problem in a coronary artery. ... In contrast with stable angina, unstable angina occurs suddenly, often at rest or with minimal exertion, or at lesser degrees ... Pollack CV, Sites FD, Shofer FS, Sease KL, Hollander JE (2006). "Application of the TIMI risk score for unstable angina and non ... The patient may still have suffered a "non-ST elevation MI" (NSTEMI). The accepted management of unstable angina and acute ...
This is usually repeated every 8 to 12 weeks Contraindications: unstable angina; within 6 months of myocardial infarction; ...
First described by Hein J. J. Wellens and colleagues in 1982 in a subgroup of patients with unstable angina, it does not seem ... March 1989). "Angiographic and clinical characteristics of patients with unstable angina showing an ECG pattern indicating ... coronary artery stenosis in patients with unstable angina. It is characterized by symmetrical, often deep (>2 mm), T wave ... "Anatomic and prognostic significance of new T-wave inversion in unstable angina". American Journal of Cardiology. 52 (1): 14-18 ...
Stable or unstable angina. *Myocardial infarction ("heart attack") - People usually complained of a pressure or squeezing ... Prinzmetal's angina - Chest pain is caused by coronary vasospasm. More common in women younger than 50 years. Person usually ... Cardiac chest pain is called angina pectoris. Some causes of noncardiac chest pain include gastrointestinal, musculoskeletal, ...
Angina that changes in intensity, character or frequency is termed unstable. Unstable angina may precede myocardial infarction ... Stable angina[edit]. Main article: Angina pectoris. In "stable" angina, chest pain with typical features occurring at ... refers to a group of diseases which includes stable angina, unstable angina, myocardial infarction, and sudden cardiac death.[ ... "unstable angina" is used. This process usually necessitates hospital admission and close observation on a coronary care unit ...
"Detection of silent myocardial ischemia in asymptomatic selected population and in unstable angina". Advances in cardiology. 37 ...
Angina that changes in intensity, character or frequency is termed unstable. Unstable angina may precede myocardial infarction ... refers to a group of diseases which includes stable angina, unstable angina, myocardial infarction, and sudden cardiac death. ... "unstable angina" is used. This process usually necessitates admission to hospital, and close observation on a coronary care ... "ACC/AHA guideline update for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction ...
It is also used in the treatment of heart attacks and unstable angina. It is given by injection into a vein. Other uses include ...
For example, the IP agonist iloprost is contraindicated in patients with unstable angina; decompensated cardiac failure (unless ... However, PGI2 is very unstable, spontaneously converting to a far less active derivative 6-keto-PGF1 alpha within 1 minute of ...
Variant angina - it is effective owing to its direct effects on coronary dilation. Unstable angina (preinfarction, crescendo ... The drug is indicated for angina: Stable angina (exercise-induced) - diltiazem increases coronary blood flow and decreases ... Each of these effects results in reduced oxygen consumption by the heart, reducing angina symptoms. These effects also reduce ... angina pectoris, and some types of arrhythmia. It relaxes the smooth muscles in the walls of arteries, which opens (dilates) ...
These units typically serve patients who require cardiac telemetry, such as those with unstable angina. Coronary care units ... As arrhythmias are relatively common in this group, patients with myocardial infarction or unstable angina are routinely ... unstable angina, cardiac dysrhythmia and (in practice) various other cardiac conditions that require continuous monitoring and ...
"Plasma N terminal pro-brain natriuretic peptide and cardiotrophin 1 are raised in unstable angina". Heart. 84 (4): 421-4. doi: ...
A rapid rise in blood levels can be seen in myocardial infarction and unstable angina. Other enzymes related to glycogen ...
"Elevated levels of C-reactive protein at discharge in patients with unstable angina predict recurrent instability". Institute ...
... arterial endothelial function in patients with unstable angina". The Indian journal of medical research. 129 (3): 279-84. PMID ...
Absolute contraindications to cardiac stress test include: Acute myocardial infarction within 48 hours Unstable angina not yet ... responsible for recurrent symptoms of angina. Unstable atheroma produces "vulnerable plaques" hidden within the walls of ... Limitation in blood flow to the left ventricle can lead to recurrent angina pectoris. Cardiac steal syndrome Harvard step test ...
"2011 ACCF/AHA focused update of the guidelines for the management of patients with unstable angina/non-ST-elevation myocardial ... "2012 ACCF/AHA focused update of the guideline for the management of patients with unstable angina/non-ST-elevation myocardial ... "ACC/AHA 2007 guidelines for the management of patients with unstable angina/non ST-elevation myocardial infarction: a report of ... Critical issues in the evaluation and management of patients with acute myocardial infarction or unstable angina". Annals of ...
... although abdominal drains may be placed in very unstable infants as a temporizing measure. Surgery may require a colostomy, ...
Unstable angina is a condition in which your heart doesnt get enough blood flow and oxygen. It may lead to a heart attack. ... New-onset angina; Angina - unstable; Progressive angina; CAD - unstable angina; Coronary artery disease - unstable angina; ... Unstable angina is chest pain that is sudden and often gets worse over a short period of time. You may be developing unstable ... Unstable angina is a warning sign that a heart attack may happen soon and needs to be treated right away. See your health care ...
Unstable angina belongs to the spectrum of clinical presentations referred to collectively as acute coronary syndromes (ACSs), ... encoded search term (Unstable%20Angina) and Unstable Angina What to Read Next on Medscape. Medscape Consult. ... Unstable Angina Differential Diagnoses. Updated: Dec 26, 2017 * Author: Walter Tan, MD, MS; Chief Editor: Eric H Yang, MD more ... Be aware that unstable angina can infrequently coexist or concurrently present with the following:. * Aortic dissection with ...
Unstable angina?. My chest pains started up again about 2 months ago after 9 months without. I had one really bad attack, but ...
The pathophysiology of unstable angina is controversial. Until recently, unstable angina was assumed to be angina pectoris ... "unstable angina" at Dorlands Medical Dictionary Wiviott, S. D.; Braunwald, E (2004). "Unstable Angina and Non-ST-Segment ... the concept of unstable angina is being questioned with some calling for retiring the term altogether. Unstable angina is ... Unstable angina (UA) is a type of angina pectoris that is irregular. It is also classified as a type of acute coronary syndrome ...
Unstable angina belongs to the spectrum of clinical presentations referred to collectively as acute coronary syndromes (ACSs), ... Unstable angina and NSTEMI: the early management of unstable angina and non-ST-segment-elevation myocardial infarction. London ... and death in unstable angina varies because of the broad clinical spectrum that is covered by the term unstable angina. The ... nearly 1 million hospitalized patients have a primary diagnosis of unstable angina. A similar number of unstable angina ...
unstable angina Unstable angina or sometimes referred to as acute coronary syndrome causes unexpected chest pain, and usually ...
The exact cause of her ongoing unstable angina was uncertain but may have reflected either ... A 55-year-old woman developed unstable angina following an episode of severe anaphylaxis which was treated with 0.5 mg ... Angina, Unstable / etiology*. Coronary Vasospasm / etiology. Epinephrine / administration & dosage*. Female. Food ... A 55-year-old woman developed unstable angina following an episode of severe anaphylaxis which was treated with 0.5 mg ...
Explains MI and angina differences. Offers prevention tips. Covers diagnostic tests and treatment with medicines and surgery. ... and unstable angina. Discusses symptoms like chest pain or pressure. ...
... or unstable angina.. Angioscopic studies have revealed that the thrombus responsible for unstable angina is more commonly white ... secondary unstable angina. Most frequently, unstable angina is caused by coronary plaques that have undergone repeated phases ... correlate with the clinical severity of unstable angina.7 The plaque morphology in patients with higher grades of unstable ... "24 in unstable angina may therefore reflect the presence of an unstable plaque containing platelet-rich thrombus in the ...
Effect of stopping smoking after unstable angina and myocardial infarction Br Med J (Clin Res Ed) 1984; 288 :146 ... Effect of stopping smoking after unstable angina and myocardial infarction. Br Med J (Clin Res Ed) 1984; 288 doi: https://doi. ...
Also known as: Angina Pectoris, Unstable / Unstable Angina Pectoris / Unstable Angina (UA) / Angina, Unstable / Unstable Angina ... Accelerated angina / Intermediate coronary syndrome / Angina pectoris unstable / Angina at rest / Crescendo angina / Angina ... in the management of unstable angina (UA) and non-ST segment elevation myocardial infarction (NSTEMI); and in the management of ...
... and unstable angina. Discusses symptoms like chest pain or pressure. Explains MI and angina differences. Offers prevention tips ... Unstable angina. Unstable angina symptoms are similar to a heart attack. Call 911 or other emergency services immediately if ... What is angina, and why is unstable angina a concern?. Angina (say "ANN-juh-nuh" or "ann-JY-nuh") is a symptom of coronary ... Unstable angina means that your symptoms have changed from your typical pattern of stable angina. Your symptoms do not happen ...
Unstable angina and NSTEMI: early management [CG94]. Measuring the use of this guidance. Recommendation: 1.5.1. Offer coronary ... Perform angiography as soon as possible for patients who are clinically unstable or at high ischaemic risk. ...
... unstable angina patient,/b, and gave me medicines to be used for 6 months, which I am using continuously, but I am feeling ... after doing angiography my doctor diagnosed that I am an unstable angina patient and gave me medicines to be used for 6 months ... Home » Frequently asked Questions on Health » Unstable angina. Unstable angina. Answered by: Dr U Kaul , Director,. Director of ...
The recurrence of angina soon after myocardial infarction is not uncommon and represents areas of viable myocardium at risk ... Angina Pectoris / therapy*. Angina, Unstable / physiopathology, therapy*. Angioplasty, Balloon. Anticoagulants / therapeutic ... The recurrence of angina soon after myocardial infarction is not uncommon and represents areas of viable myocardium at risk ...
Drug-Eluting Balloon in Stable and Unstable Angina (DEBUT). The safety and scientific validity of this study is the ... Angina, Unstable. Heart Diseases. Cardiovascular Diseases. Arteriosclerosis. Arterial Occlusive Diseases. Vascular Diseases. ... Drug-Eluting Balloon in Stable and Unstable Angina: a Randomized Controlled Non-inferiority Trial. ... Stable angina or dyspnea and a coronary narrowing causing myocardial ischemia detected in the angiogram. Ischemia is documented ...
People want answers to the question what is angina... ... Many sufferers of chest pain have asked what is angina and the ... There are two common types of angina, stable or unstable angina. Whether you experience stable or unstable angina the overall ... Unstable angina pain usually signals a possible heart attack. If you suspect stable or unstable angina it is best to have the ... Normally stable angina disappears when the person lies down and rests for a period of time. Unstable angina, however, is ...
Unstable angina. Unstable angina is a change in your usual pattern of stable angina. Your symptoms do not happen at a ... Unstable angina happens when blood flow to the heart is suddenly slowed by narrowed vessels or small blood clots that form in ... Unstable angina is an emergency. It may mean that you are having a heart attack. ... For example, you may feel angina when you are resting. Your symptoms may be more frequent, severe, or longer-lasting than your ...
... Xuelan Qiu, ... Xuelan Qiu, Andrew Miles, Xuehua Jiang, Xin Sun, and Nan Yang, "Sulfotanshinone Sodium Injection for Unstable Angina Pectoris: ...
... unstable angina and non-ST elevation myocardial infarction) undergo coronary angiography and revascularization during the index ... Unstable angina (UA) and non-ST elevation myocardial infarction (NSTEMI) are part of the continuum of acute coronary syndrome ( ... In unstable angina or non-ST-segment acute coronary syndrome, should patients with multivessel coronary artery disease undergo ... Coronary angiography and revascularization for unstable angina or non-ST elevation acute myocardial infarction. Authors. ...
... Treatment Overview. Angioplasty gets blood flowing back to the heart. It ... Only small areas of the heart are at risk, and you do not have disabling angina symptoms. ... Have frequent or severe angina that is not responding to medicine and lifestyle changes. ...
Late Results Following Emergency Saphenous Vein Bypass Grafting For Unstable Angina. LAWRENCE I. BONCHEK, SHAHBUDIN H. ... Late Results Following Emergency Saphenous Vein Bypass Grafting For Unstable Angina. LAWRENCE I. BONCHEK, SHAHBUDIN H. ... Late Results Following Emergency Saphenous Vein Bypass Grafting For Unstable Angina. LAWRENCE I. BONCHEK, SHAHBUDIN H. ... after extended follow-up indicate that emergency saphenous vein bypass grafting is an effective therapy for unstable angina. ...
The long-term treatment of angina depends on the severity of the coronary artery disease, the condition of ... ... Unstable Angina Long-Term Care. The long-term treatment of angina depends on the severity of the coronary artery disease, the ... PubMed Unstable Angina References *Abrams J. Clinical practice. Chronic stable angina. N Engl J Med. 2005 Jun 16;352(24):2524- ... Continue to Unstable Angina Diet Last Updated: Nov 7, 2007 References Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D ...
Explains MI and angina differences. Offers prevention tips. Covers diagnostic tests and treatment with medicines and surgery. ... and unstable angina. Discusses symptoms like chest pain or pressure. ... Unstable angina. Unstable angina symptoms are similar to a heart attack.. Call 911 or other emergency services immediately if ... What is angina, and why is unstable angina a concern?. Angina (say "ANN-juh-nuh" or "ann-JY-nuh") is a symptom of coronary ...
Antman EM, Cohen M, Bernink PJ, McCabe CH, Horacek T, Papuchis G. The TIMI risk score for unstable angina/non-ST elevation MI: ... ACC/AHA 2007 guidelines for the management of patients with unstable angina/non ST-elevation myocardial infarction: a report of ... Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy. N Engl J Med. 1998 Aug 13. ... FDA approves Praluent (alirocumab) to prevent heart attack, stroke and unstable angina requiring hospitalization [press release ...
  • De Servi et al 7 reported that patients with recent onset or worsening angina without rest pain (class IB) had calcified lesions more frequently than did patients with angina at rest (classes IIB and IIIB), whereas the latter showed thrombus or intraplaque hemorrhage on angiography more frequently than did the former. (ahajournals.org)
  • A 55 year old man, known to have angina, presents to the Emergency Department with new-onset typical ischaemic rest pain that is not relieved by his nitrate spray at home. (bmj.com)
  • Unstable angina is a pattern of symptoms that is new in onset, changing in severity or frequency, occurring at rest, or lasting longer than 20 minutes. (vidyya.com)
  • Group 1 consisted of 10 patients who had new onset of refractory rest angina and ischemic ST-T changes, but no infarction, single-vessel coronary disease without collateralization, and normal left ventricular (LV) angiograms. (ovid.com)
  • The onset of angina symptoms is sometimes called an angina attack. (hse.ie)