Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:4.1.1.6 (CAD)
 4,420 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We studied 42 consecutive patients with coronary artery spasm (CS) who where treated with the Ca2+ entry blocker diltiazem for a mean period of 11 months (range 2-29 months). Patient population consisted of 26 females (age X = 52.1) and 16 males (age X = 59.1). ALl patients had diagnosis of CS confirmed by coronary arteriography (CA) with no patient having 70 per cent CAD. CS was equally distributed between LAD and RCA. 81 per cent of patients were cigarette smokers, 55 per cent had Raynaud's phenomenon, and 9 per cent had a history of migraine, 2 patients had previous MI, 2 previous bypass surgery (CABS), 1 previous angioplasty, 3 syncope with heartblock requiring pacemaker, and 2 with sudden death (VF-resuscitated). All patients were placed on diltiazem 240 or 360 mg/day to achieve pain free state. During follow-up there was no mortality. 2 patients hd uncomplicated inferior MI's. 1 patient had CABS for progressive 90 per cent LAD lesion, and 2 required hospitalization for dose adjustment due to frequent chest pain. No patient has drug-related side effects. Thus, long-term follow-up of patients with CS treated with diltiazem revealed no mortality, low morbidity (12 per cent) and no adverse drug side effects.
Arch Mal Coeur Vaiss 1983 Feb
PMID:The short and long-term efficacy of diltiazem for the treatment of variant angina pectoris. 640 38

AABPI, calculated as the ratio of systolic ankle/systolic arm blood pressure, has been recently found to be a strong predictor of cardiovascular and overall mortality in hemodialysis patients. The aim of our study was to confirm the role of this test in dialysis patients, a population with high prevalence of vascular diseases. Two hundred and twenty-six patients were studied, of which the AABPI could be measured in 217. There were 134 males (61%) and 83 females (39%) with a mean age of 61.3 +/- 17.4 years. The mean AABPI for the studied patients was 1.02 +/- 0.26; a past history of coronary artery (CAD), and/or cerebrovascular (CVD), and/or peripheral vascular disease (PVD) was present in 97 (45%) of these patients. This latter group had a mean AABPI less than controls with any vascular diseases (0.9 vs 1.1 p < 0.0001). For patients with or without CAD and PVD, the AABPI was respectively 0.84 +/- 0.3 vs 1.06 +/- 0.23 (p < 0.001) and 0.91 +/- 0.28 vs 1.08 +/- 0.22 (p < 0.001). In the group of patients with CAD, CAV, and PVD the positive and negative predictive value of AABPI was respectively of 66 and 74%. Diabetes was associated with a significantly lower AABPI (p < 0.02), gender did not influence AABPI. Significant positive correlation was found between AABPI and age (r2 = 0.46; p < 0.01). For patients with CAD, CVD and/or PVD no differences were found in serum lipid parameters (triglycerides, cholesterol, HDL-cholesterol, and lipoprotein a). Cumulative survival curves showed a lower mortality in patients with AABPI. 0.9 (Logrank test p < 0.001). We confirm that AABPI is a powerful non-invasive marker for the presence of systemic atherosclerotic disease in hemodialysis patients.
Arch Mal Coeur Vaiss 1998 Aug
PMID:[Ankle-arm blood pressure index (AABPI) in hemodialysis patients]. 974 45

Coronary artery disease is a common and serious condition in diabetes and the prognosis of the diabetic without a history of cardiovascular disease is either the same or nearly as serious as that of a non-diabetic patient with a history of coronary disease. This is particularly true in women. The prognosis is even worse in the presence of silent myocardial ischaemia. Conversely, anti-ischaemic and anti-thrombotic therapy and myocardial revascularisation of most severely affected patients are effective. This justifies the recent recommendations (as those of the working group of the French Society of Cardiology and the ALFEDIAM) for the diagnosis of coronary artery disease in diabetes, even in asymptomatic patients. This is a two stage process: --First, the identification of patients who should be screened for ischaemia, diabetics with a priori an intermediate or high risk of the presence of CAD, with respect to the presence of markers easily identified on initial examination, like the presence of clinical macroangiopathy (femoral, carotid), of renal disease or ECG changes or the presence of several classical risk factors; --The second stage is the demonstration of myocardial ischaemia in patients identified to be at risk. This article reviews the advantages and limits of the tests available: ECG stress test, myocardial perfusion imaging on effort or under dipyridamole, stress echocardiography. Coronary angiography in asymptomatic patients is only recommended in the presence of significant ischaemia or with a poor prognosis (affecting over 20% of the myocardium or several myocardial territories). This should precede a myocardial revascularisation procedure. The prescription of coronary angiography may be more direct in some symptomatic patients.
Arch Mal Coeur Vaiss 2004 Dec
PMID:[Strategy of investigation of coronary artery disease in diabetes: from screening to suspicion of acute coronary syndromes]. 1566 81

Coronary arteries are the most frequent location of atherosclerosis. Coronary artery disease is the first cause of death related to atherothrombosis. In addition, patients with a prior history of acute coronary syndromes exhibit a 10% annual risk of recurrence. Although there seems to be a close correlation between the extension of CAD and the severity of atherosclerotic lesions in extra coronary arterial beds, the prevalence of these extracoronary asymptomatic lesions depends on their location. Hence, the prevalence of renal artery disease defined as stenosis > or = 50% or of peripheral artery disease defined as an ABI < 0.9 is estimated to be 20% up to 30%, whereas the prevalence of both carotid artery disease defined as stenosis > or = 70% or aortic aneurysm is estimated to be 5%. Conversely, the annual absolute risk of stroke among CAD patients is estimated at 1% while it remains unknown for vascular events related to PAD or aortic lesions. These data suggest that a systematic screening for asymptomatic extracoronary atherosclerotic lesions among CAD patients cannot be justified without a better knowledge of the prevalence of these lesions. In addition, the identification of the predicting factors for the presence and the development of these asymptomatic lesions is warranted. Finally, the potential benefit in terms of therapeutic intervention of such screening needs to be evaluated. These important issues warrant further clinical studies with appropriate design.
Arch Mal Coeur Vaiss 2005 Oct
PMID:[Prevalence of asymptomatic atherothrombotic lesions and risk of vascular events in patients with documented coronary artery disease]. 1629 57

Peripheral arterial disease (PAD) remains an under-diagnosed affection, and the ankle-brachial index (ABI), a simple diagnostic method, is poorly known and seldom used, and the vascular patient's prescription list is frequently insufficient regarding results obtained in large trials with good methodology. The French ATTEST study underlines the fact that ABI is measured in less than 1 out of 3 patients with PAD. In ATTEST study, less than 10% have the triple therapy validated in PAD : antiplatelet drugs, statins and ACE-inhibitors. The international REACH registry included more than 60 000 patients suffering from atherosclerosis, including 8 000 cases with PAD. This survey evidences that in PAD patients, the annual cardiovascular complication rate is significantly higher than in patients with coronary artery disease (18 vs 13%); again PAD appears systematically under-treated when compared to CAD. These epidemiological surveys highlight the importance of screening of atherosclerotic lesions with the aim of setting an active prevention of CV complications. The new guidelines insist on the screening of PAD in patients at risk, as well as on the importance of the global management after initiating the triple therapy, independent of the CV risk factors. In a 5-year longitudinal study from an initial cohort of 2265 subjects, Aboyans et al. studied the progression of PAD by repeated measurements of ABI at the level of ankles and toes. Factors of progression for large-vessels PAD were active smoking, the total/HDL-cholesterol ratio, Lp(a) and CRP. Importantly, diabetes was not associated to the PAD progression in large vessels, but in contrast, it was the sole factor associated to the progression of PAD in small vessels. In an Austrian study published this year in the NEJM, Schillinger et al. compared balloon angioplasty versus the use of Nitinol stent for the treatment of long stenoses of the superficial femoral artery. In case of claudication, these lesions are usually treated medically, whereas surgery is required for more severe cases. The fact that stenting these long lesions of the superficial femoral artery provides benefits in terms of restenosis opens a approach for the endovascular therapy, to be confirmed by larger trials.
Arch Mal Coeur Vaiss 2007 Jan
PMID:[The best of vascular medicine in 2006]. 1740 65