-
Cardiology Journal 2022Chronic ischemic heart disease (IHD) is a multifactorial disease with different underlying pathogenetic mechanisms. Percutaneous coronary intervention (PCI) is widely... (Review)
Review
Chronic ischemic heart disease (IHD) is a multifactorial disease with different underlying pathogenetic mechanisms. Percutaneous coronary intervention (PCI) is widely used in patients with IHD in order to reduce angina recurrence. However, after complete or incomplete revascularization procedures, patients may still present anginal symptoms, with a detrimental impact on quality of life and prognosis. This review summarizes the pathogenic mechanisms and the main challenges encountered in the diagnosis and management of post-PCI angina.
Topics: Angina Pectoris; Humans; Myocardial Ischemia; Percutaneous Coronary Intervention; Quality of Life; Treatment Outcome
PubMed: 33843042
DOI: 10.5603/CJ.a2021.0042 -
Clinical Cardiology Nov 1989
Topics: Angina Pectoris; Angina, Unstable; Humans
PubMed: 2582653
DOI: 10.1002/clc.4960121102 -
Circulation Journal : Official Journal... Aug 2019Japanese Circulation Society (JCS) guidelines do not include adolescents with coronary artery spasm.Methods and Results:We recruited 18 adolescents less than 20... (Review)
Review
BACKGROUND
Japanese Circulation Society (JCS) guidelines do not include adolescents with coronary artery spasm.Methods and Results:We recruited 18 adolescents less than 20 years old with vasospastic angina (VSA): 11 were Japanese and 3 had chest symptoms for >12 months before admission. ST-segment elevation was observed in 11 patients and none of the 18 patients had a fixed stenosis. Spasm provocation tests were performed in 9 patients and two-thirds had multiple spasms; 6 suffered from acute myocardial infarction and ventricular fibrillation occurred in 2 patients; 1 patient died and the remaining 17 patents survived.
CONCLUSIONS
Clinical status of adolescents with VSA was as severe as in adults with refractory VSA. Cardiologists should cooperate with pediatricians to diagnose and treat adolescents with VSA. There is a need to establish the additional issues for adolescents with coronary spasm in the JCS guidelines.
Topics: Adolescent; Age of Onset; Angina Pectoris; Angina Pectoris, Variant; Child; Coronary Vasospasm; Coronary Vessels; Female; Humans; Male; Myocardial Infarction; Prognosis; Risk Factors; Vasoconstriction; Vasodilator Agents; Ventricular Fibrillation
PubMed: 31378771
DOI: 10.1253/circj.CJ-19-0433 -
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 -
Clinical Cardiology Feb 2007Between 10 to 30% of patients with coronary disease still suffer from symptoms of angina pectoris in contemporary clinical practice. This article summarizes analytic... (Review)
Review
Between 10 to 30% of patients with coronary disease still suffer from symptoms of angina pectoris in contemporary clinical practice. This article summarizes analytic tools for measuring angina, as well as, its prevalence based on community based surveys, registries and in randomized controlled trials. Additionally, the impact of angina symptoms on patients' survival rates, functional status, quality of life and health-related costs is reviewed. The effectiveness of treatment, revascularization and medical therapies, on reducing angina symptoms is also reviewed.
Topics: Acute Coronary Syndrome; Angina Pectoris; Cost of Illness; Humans; Prevalence; Prognosis; Psychometrics; Quality of Life; Surveys and Questionnaires; United States
PubMed: 18373325
DOI: 10.1002/clc.20047 -
Heart (British Cardiac Society) Oct 2019Around 40% of all patients undergoing angiography are found to have normal coronary arteries or non-obstructive coronary artery disease (NOCAD). Despite the high... (Review)
Review
Around 40% of all patients undergoing angiography are found to have normal coronary arteries or non-obstructive coronary artery disease (NOCAD). Despite the high prevalence, this is a group who rarely receive a definitive diagnosis, are frequently labelled and managed inappropriately and by and large, continue to remain symptomatic. Half of this group will have coronary microvascular dysfunction (CMD), associated with a higher rate of major adverse cardiovascular events; identifying CMD represents a therapeutic target of unmet need. As the pressure wire has revolutionised our ability to interrogate epicardial coronary disease during the time of angiography, measuring flow can similarly classify NOCAD during a single procedure. Assessment of flow is a function that is already integral to some pressure wires and furthermore, the familiarity and usage of the combined Doppler and pressure wire is rapidly increasing-these are techniques that readily lend themselves to the skillset of a practising interventional cardiologist. We present a structured algorithm designed for cardiologists who frequently encounter NOCAD in the catheter laboratory, identifying specific disease phenotypes within this heterogeneous population with linked therapy. This review paper clearly explains the rationale for this algorithm and outlines its applicability to routine clinical practice and also, the importance of phenotyping for future research. Ultimately, personalised therapy could improve outcomes for both patients and healthcare providers; while these approaches in turn will need robust evaluation to ensure that they improve both clinical outcomes and health economic benefits, this proposal will provide a framework for future trials and evaluations.
Topics: Algorithms; Angina Pectoris; Coronary Angiography; Coronary Artery Disease; Coronary Vessels; Humans; Microvessels
PubMed: 31366574
DOI: 10.1136/heartjnl-2019-315042 -
Journal of the American College of... Feb 1989
Topics: Administration, Cutaneous; Angina Pectoris; Drug Tolerance; Humans; Nitroglycerin
PubMed: 2492323
DOI: 10.1016/0735-1097(89)90522-6 -
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 (Clinical... Jun 1981
Topics: Angina Pectoris; Humans; Hypothyroidism; Thyroxine
PubMed: 6786632
DOI: No ID Found -
Acta Medica Portuguesa Apr 1997One of the most difficult problems related to coronary artery disease is the detection and eventual treatment of silent myocardial ischemia (SMI). After defining the... (Review)
Review
One of the most difficult problems related to coronary artery disease is the detection and eventual treatment of silent myocardial ischemia (SMI). After defining the concept of SMI and total ischemia burden, the author approaches the pathophysiology of myocardial ischemia and focuses on the ischemic cascade. Concerning the detection of SMI the importance of exercise testing and Holter ECG is stressed. Following the classification of SMI proposed by P. F. Cohn, the author analyzes SMI type III with particular interest. He refers the prevalence of SMI in patients suffering from chronic stable angina, and focuses on the prognostic importance of SMI. Afterwards, the problem of treatment and prognostic implications is approached. The paper ends with mention of the results of the most important clinical trials in this field: CASIS, CAPE, TIBBS, ASIST, ACIP, TIBET.
Topics: Angina Pectoris; Cardiovascular Agents; Clinical Trials as Topic; Humans; Myocardial Ischemia; Prevalence; Prognosis
PubMed: 9341023
DOI: No ID Found