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EuroIntervention : Journal of EuroPCR... Apr 2021
Topics: Angina Pectoris; Humans
PubMed: 33792542
DOI: 10.4244/EIJV16I18A265 -
Complementary Therapies in Medicine Aug 2014A series of case-control studies have been conducted to investigate the association between blood lipid and phlegm turbidity syndrome of angina pectoris, but produced... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
A series of case-control studies have been conducted to investigate the association between blood lipid and phlegm turbidity syndrome of angina pectoris, but produced inconsistent results.
OBJECTIVE
We performed a meta-analysis to determine the association between blood lipid and phlegm turbidity syndrome of angina pectoris more precisely.
METHODS
Manual screening as well as screening of the China National Knowledge Infrastructure (CNKI), Chinese Journal full-text database (VIP), Wanfang database (WF), ScienceDirect, Pubmed, the Cochrane Library, and Embase were carried out for relevant literature. The formula was translated to calculate the pooled mean value and standard deviation value. The "Newcastle-Ottawa Quality Assessment Scale: Case-Control Studies" (NOS) was taken to assess the quality of the included studies. The Revman 5.2.6 software provided by "The Cochrane Collaboration" was used to analyze the collected data. The subgroup analysis was established according to the sample size proportion between the test group and the control group. Sensitivity analysis was constructed by using two different effect models. Besides, a funnel plot was created to analyze potential publication bias.
RESULTS
No statistically meaningful difference existed between the test group and control group of total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C) in non-Qi and yin deficiency syndrome (QYDS) and non-Yang deficiency syndrome (YDS) subgroup, whereas the two biotic indicators in the test group were higher than the non-phlegm syndrome group in other subgroups. Triglyceride (TG) in phlegm syndrome group showed superior to non-phlegm syndrome group in the rest subgroups except for the non-CCS (Cold coagulating syndrome)-non-YDS subgroup. High-density lipoprotein-cholesterol (HDL-C) levels of the phlegm group were lower than that of the non-phlegm group in all subgroups.
CONCLUSION
When comparing with Traditional Chinese Medicine (TCM) syndromes of asthenia nature, such as YDS, QYDS, and heart qi deficiency syndrome), the levels of TG, TC, and LDL-C were higher in phlegm turbidity syndrome. However, for sthenia syndromes such as Qi stagnation syndrome (QSS), heart blood stasis syndrome (HBSS), and CCS, there was no obvious difference. Furthermore, HDL-C levels in the phlegm turbidity group were lower than those of the non-phlegm group. Nevertheless, these results should be confirmed with further studies.
Topics: Adult; Aged; Aged, 80 and over; Angina Pectoris; Cholesterol; Female; Humans; Male; Medicine, Chinese Traditional; Middle Aged; Triglycerides
PubMed: 25146084
DOI: 10.1016/j.ctim.2014.05.008 -
Deutsches Arzteblatt International Nov 2023Coronary microvascular dysfunction (CMD) comprises a variety of pathogenic mechanisms that impair the microcirculation of the heart. Clinical studies have shown that... (Review)
Review
BACKGROUND
Coronary microvascular dysfunction (CMD) comprises a variety of pathogenic mechanisms that impair the microcirculation of the heart. Clinical studies have shown that 30-50% of patients suffering from myocardial ischemia without significant coronary artery stenosis have CMD. The disease is associated with ele - vated mortality and poor quality of life. Whenever a patient presents with symptoms of angina pectoris and no underlying disease is detected by the usual methods, CMD should be considered a possible cause.
METHODS
This review is based on publications retrieved by a selective search in PubMed and on current international guidelines and recommendations of specialty societies.
RESULTS
The diagnosis of CMD is based on objective evidence of a microvascular origin of symptoms. The guidelines contain a class IIa recommendation for invasive coronary flow reserve and microvascular resistance measurements. Noninvasive tests such as positron emission tomography and cardiac magnetic resonance imaging are less accurate and are given a class IIb recommendation. No highquality therapeutic trials are available to date, and the treatment of CMD is thus based on that of chronic coronary syndrome. Lifestyle modification is performed to reduce risk factors. Patients with an abnormal coronary flow reserve or elevated microvascular resistance can be treated with an ACE inhibitor or angiotensin receptor blocker. Beta-blockers and calcium channel antagonists can relieve angina pectoris. Statins lower the LDL level and have positive pleiotropic effects. First-line treatment can be supplemented with further medications.
CONCLUSION
Approximately 25% of patients with CMD have symptoms that do not respond to intensive treatment with the currently available modalities. New treatments, including interventional therapies, are being studied. Their long-term benefit remains to be assessed and compared to that of the existing methods.
Topics: Humans; Coronary Circulation; Microcirculation; Quality of Life; Coronary Artery Disease; Angina Pectoris; Myocardial Ischemia
PubMed: 37721132
DOI: 10.3238/arztebl.m2023.0205 -
Journal of the American College of... Feb 1991
Topics: Angina Pectoris; Coronary Angiography; Coronary Circulation; Coronary Vessels; Humans; Syndrome; Vascular Resistance
PubMed: 1991910
DOI: 10.1016/s0735-1097(10)80123-8 -
Clinical Cardiology Mar 2010Once it is determined that the patient's symptoms are thought to be due to chronic stable myocardial ischemia, the symptoms are then graded as 1 to 4 using the Canadian...
Once it is determined that the patient's symptoms are thought to be due to chronic stable myocardial ischemia, the symptoms are then graded as 1 to 4 using the Canadian Cardiovascular Society classification (CCVS). Class 1-angina with strenuous exertion, Class ll-angina with moderate exertion, Class lll-angina with mild exertion, Class lV-angina with any level of physical exertion. Copyright (c) 2010 Wiley Periodicals, Inc.
Topics: Angina Pectoris; Chronic Disease; Decision Making; Exercise Test; Humans; Myocardial Ischemia
PubMed: 20235212
DOI: 10.1002/clc.20766 -
Journal of Cardiology Oct 2023
Topics: Humans; Coronary Vasospasm; Muscle Spasticity; Angina Pectoris; Myocardial Ischemia
PubMed: 37597878
DOI: 10.1016/j.jjcc.2023.06.009 -
European Heart Journal Aug 2019Persistence or recurrence of angina after a percutaneous coronary intervention (PCI) may affect about 20-40% of patients during short-medium-term follow-up. This appears... (Review)
Review
Persistence or recurrence of angina after a percutaneous coronary intervention (PCI) may affect about 20-40% of patients during short-medium-term follow-up. This appears to be true even when PCI is 'optimized' using physiology-guided approaches and drug-eluting stents. Importantly, persistent or recurrent angina post-PCI is associated with a significant economic burden. Healthcare costs may be almost two-fold higher among patients with persistent or recurrent angina post-PCI vs. those who become symptom-free. However, practice guideline recommendations regarding the management of patients with angina post-PCI are unclear. Gaps in evidence into the mechanisms of post-PCI angina are relevant, and more research seems warranted. The purpose of this document is to review potential mechanisms for the persistence or recurrence of angina post-PCI, propose a practical diagnostic algorithm, and summarize current knowledge gaps.
Topics: Algorithms; Angina Pectoris; Humans; Percutaneous Coronary Intervention; Recurrence
PubMed: 30608528
DOI: 10.1093/eurheartj/ehy857 -
Journal of the American College of... Jun 1985Angina is an important though relatively insensitive and nonspecific predictor of the presence of significant coronary occlusive disease. If angina is present, there is... (Review)
Review
Angina is an important though relatively insensitive and nonspecific predictor of the presence of significant coronary occlusive disease. If angina is present, there is a high probability of significant coronary atherosclerosis. However, the lack of angina, even with vigorous exertion, does not imply absence of severe and potentially lethal amounts of coronary stenosis because a high percent of patients who have had sudden cardiac arrest or myocardial infarction have not had prior angina pectoris. In many studies that carefully and specifically examined the prognostic importance of angina in relation to other variables, neither the presence of angina nor its severity was of prognostic significance, although a few studies suggested that the unstable form of angina may have unfavorable prognostic significance independent of the state of left ventricular function or the severity of coronary atherosclerosis. Thus, it would not appear to be wise to base individual or national decisions aimed at reducing the likelihood of death from coronary disease primarily on the presence or absence of angina pectoris.
Topics: Adult; Aged; Analysis of Variance; Angina Pectoris; Arteriosclerosis; Coronary Disease; Death, Sudden; Europe; Follow-Up Studies; Humans; Male; Middle Aged; New Zealand; Random Allocation; Risk; United States
PubMed: 3889108
DOI: 10.1016/s0735-1097(85)80551-9 -
Clinical Cardiology Jun 2011The objective of this meta-analysis was to evaluate the efficacy of the metabolic agent trimetazidine (TMZ) as monotherapy in the treatment of stable angina pectoris,... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The objective of this meta-analysis was to evaluate the efficacy of the metabolic agent trimetazidine (TMZ) as monotherapy in the treatment of stable angina pectoris, from echocardiography and radionuclide angiography data.
HYPOTHESIS
Treatment with TMZ proved to be as effective as other first-line antianginal agents for coronary patients, and it provided additional efficacy in combination with hemodynamic agents.
METHODS
A search of the literature published between 1965 and 2008 was performed on the MEDLINE and EMBASE databases. Only randomized, controlled trials were included in this meta-analysis. Patients had to be treated for at least 2 weeks with data on the following 4 parameters at baseline and at the end of the treatment period: left ventricular ejection fraction (LVEF), LV end-diastolic volume (LVEDV), LV end-systolic volume (LVESV), and wall motion score index (WMSI). The quality of the trials was assessed by the Jadad score.
RESULTS
Eleven clinical studies meeting our criteria were analyzed. Results showed that TMZ significantly improved LVEF, with a mean increase of 6.88% (95% confidence interval [CI]: 5.50-8.25), and significantly reduced LVESV by 11.58 mL (95% CI: 5.79-17.37) and WMSI by 0.23 (95% CI: 0.07-0.38). Changes in LVEDV were variable. In both the long term and the short term, TMZ can improve LV function. The efficacy was unchanged in patients with diabetes mellitus.
CONCLUSIONS
This meta-analysis confirmed the efficacy of TMZ monotherapy in improving LV function compared with placebo.
Topics: Aged; Angina Pectoris; Drug Therapy, Combination; Echocardiography; Evidence-Based Medicine; Female; Humans; Male; Middle Aged; Predictive Value of Tests; Radionuclide Angiography; Randomized Controlled Trials as Topic; Stroke Volume; Time Factors; Treatment Outcome; Trimetazidine; Vasodilator Agents; Ventricular Function, Left
PubMed: 21538382
DOI: 10.1002/clc.20888 -
British Medical Journal Mar 1971
Topics: Adult; Aged; Angina Pectoris; Arrhythmias, Cardiac; Cholesterol; Cholestyramine Resin; Clofibrate; Diet; Female; Heart Failure; Humans; Hyperlipidemias; Hyperthyroidism; Male; Middle Aged; Myocardium; Oxygen Consumption; Pacemaker, Artificial; Propranolol; Warfarin
PubMed: 5547579
DOI: No ID Found