Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0002962 (angina)
 21,142 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In the course of 5 years, 9509 healthy adult subjects had an average annual incidence of 3.6 unrecognized infarcts per 1000 persons and 5.3 clinical ones per 1000 persons. A multivariate analysis showed that the most significant risk factors were age, left axis deviation, left ventricular hypertrophy, cigarette smoking, systolic or diastolic blood pressure, and peripheral vascular disease. Some of the known risk factors of clinical infarct, or angina pectoris or both, such as cholesterol, diabetes, anxiety, and psychosocial problems, do not play a significant role in unrecognized infarcts. Subjects whose electrocardiograms were initially interpreted by cardiologists as noninfarcts but by the computer as infarcts developed a high rate of unrecognized infarcts in the subsequent 5 years. A 7-year mortality follow-up showed a markedly higher rate among the unrecognized infarct group as compared with the noninfarct population, but significantly lower than those who developed a clinical infarct.
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PMID:Unrecognized myocardial infarction: five-year incidence, mortality, and risk factors. 13 28

Clinical and coronary arteriographic findings were evaluated in patients with angina pectoris who were considered not to have diabetes mellitus or to have chemical or clinical diabetes. Each of the three groups consisted of 100 consecutive referred patients. Neither the age of the patients nor duration of symptoms differed significantly among the groups. Hypertension, gout, and peripheral vascular disease were more frequent in the patients with clinical diabetes. There was no difference in serum cholesterol concentration among the groups, but plasma triglyceride levels and the frequency of type 4 hyperlipoproteinemia were significantly higher (p less than 0.01) in the chemical and clinical diabetic groups than in the nondiabetic patients. Coronary arteriographic observations indicated that the severity of the coronary arterial disease was greater in both diabetic groups than in nondiabetic patients. The difference in the coronary scores among the three groups of patients interacts to some extent with the triglyceride level, since a high score in the diabetic groups was noted only in the presence of an elevated tryglyceride concentration. The results indicate that the increased severity of coronary arterial disease in diabetic patients is not attributable to age, duration of symptoms, hypertension, type -4 hyperlipoproteinemia, or apparent severity of the glucose intolerance.
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PMID:Reappraisal of the role of the diabetic state in coronary artery disease. 18 Dec 12

Measurement of the sinus node recovery time has been proposed as a diagnostic tool for recognition of the sick sinus syndrome. The latter is most frequently encountered in elderly patients with hypertension, coronary heart disease, and atherosclerosis. In order to provide normal values for the sinus node recovery time in this particular population group, atrial pacing studies were carried out in 30 subjects over 50 years of age, all with peripheral vascular disease and some with angina pectoris (10), residua of infarction (6), or hypertension (7). On stimulation, 7 patients maintained a I:I atrioventricular conduction up to the rate of 180/min. Second degree atrioventricular block developed in all other cases. On six occasions, Wenckebach's periods appeared at the relatively slow pacing rate of 120/min. The maximum postoverdrive pause ranged from 680 to 1600 ms with an average of 1100 ms plus or minus 190 (10). For each pacing speed, a correlation was found between the duration of the pause and the control intrinsic cardiac rate, longer pauses being associated with longer resting PP intervals. Beyond 120/min, the duration of the pause was seen to shorten progressively as the driving rate was increased. Finally, the behavior of the sinus node pacemaker following interruption of pacing showed individual variations. After pacing at relatively slow rates, a prompt return to near control values was consistently observed, whereas, after fast rates of driving, a phase of secondary depression developed in about one-half of the studied cases.
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PMID:Sinus node recovery time in the elderly. 112 18

Platelet aggregation studies were performed in five men with coronary artery disease and angina pectoris and five men with nonspecific chest pain before and after receiving 1,000 I.U. of alpha-tocopherol acetate orally per day for 8 days. There was no significant difference in the platelet aggregation response to three concentrations of ADP and two concentrations of epinephrine between the pre- and post-vitamin E periods among the 10 patients. If tocopherol acetate (vitamin E) has any beneficial effect on the prevention of thromboemolism or in the treatment of angina pectoris and peripheral vascular disease, it is not via inhibition of platelet aggregation.
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PMID:The effect of vitamin E on platelet aggregation. 125 49

137 patients with a mean age of 77.3 years (Group A) who underwent isolated coronary artery bypass grafting (CABG) were compared to 137 patients with a mean age of 55.6 years (Group B) who also underwent isolated CABG on the same or the adjacent day as the Group A patients. Group A patients were more commonly women, and had a significantly higher incidence of unstable angina, emergency operations, extensive coronary disease, peripheral vascular disease, and multiorgan debility. However, their left-ventricular function and the extent of revascularisation was similar to Group B patients. They also had significantly more operative mortality (7.2% vs 1.45%, p < 0.001). cardiac and non-cardiac complications, and longer hospital stay (14.2 vs 8.8 days, p < 0.001) than group B patients. At a mean follow-up of 29.8 months, no significant differences were noted in Group A versus Group B patients in terms of long-term survival (95% vs 94%), freedom from angina (82% vs 81%), cardiac readmission (10% vs 12%), or in the incidence of new myocardial infarction or new CABG. Actuarial survival at 4 years was 76.9% in Group A patients and 90.1% in Group B patients. Severe angina due to extensive coronary disease commonly makes urgent surgery unavoidable in this growing population of very old patients, but the operative mortality is modest and survivors do enjoy several years of life, remaining as free of angina, etc., as similar but younger patients.
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PMID:Isolated coronary artery bypass grafting in patients 75 years of age and older: is age per se a contraindication? 129 Jan 85

Both dipyridamole and exercise-201Tl imaging are sensitive, specific and of prognostic value in patients with suspected coronary artery disease, following myocardial infarction, and undergoing major noncardiac surgery. Though reported sensitivities and specificities vary widely from 60% to 100%, the consensus is that both are between 80% and 90% for both dipyridamole and exercise studies (23). Moreover, when compared directly in the same study populations, the two have equal sensitivities and specificities (9,11,13,23). Transient thallium perfusion abnormalities are the most consistent predictors of adverse cardiac events and have more predictive power than clinical and angiographic parameters. Thallium reversibility may be a better predictor of adverse cardiac events than angiography since it represents more of a physiologic rather than a purely anatomic evaluation of the heart. It is difficult to make an exact comparison of some of the studies in the literature because they use different patient populations, sometimes define coronary stenosis in different ways, may have different cardiac endpoints and may not differentiate between reversible and fixed thallium perfusion defects. Exercise has the advantage of a graded examination and more experience historically and is of importance in a detailed study of cardiopulmonary hemodynamics, as in cardiac transplantation. Dipyridamole is more useful in patients who cannot achieve symptom-limited, submaximal exercise. It may also be more useful for patients who are bedridden or have peripheral vascular disease. Angina occurs less frequently with dipyridamole.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Predictive value of dipyridamole thallium imaging in a patient with myocardial bridging but without fixed obstructive coronary artery disease. 140 64

21 studies reporting on at least 100 elderly patients were reviewed to assess the influence of patient age on outcome of isolated coronary artery bypass surgery. Elderly patients were variously defined as being older than 64, 69 or 74 years of age. They had significantly higher incidences of female sex, unstable angina, urgent surgery, extensive coronary disease, peripheral vascular disease and other risk factors, but left ventricular function was similar to younger patients. The number of grafts inserted and operation times were also similar. Operative mortality and multiorgan morbidity were significantly higher with advancing age. Late survival and relief of angina were generally good.
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PMID:Coronary artery bypass grafting in the elderly--a review of studies on patients older than 64, 69 or 74 years. 151 68

The Progetto Lombardo Atero-Trombosi (PLAT) Study was a prospective, multicenter, multidisciplinary study of the association among hemostatic variables, conventional risk factors, and atherothrombotic events in four groups of patients with preexisting vascular ischemic disease (335 myocardial infarction survivors, 123 patients with stable angina pectoris, 160 with transient ischemic attacks, and 335 with peripheral vascular disease). In the myocardial infarction group, univariate analysis showed that atherothrombotic events were associated with high fibrinogen (p = 0.001), factor VIII:C (p less than 0.001), and von Willebrand factor antigen (vWF:Ag) (p = 0.004) levels and with low high density lipoprotein cholesterol (p = 0.043), factor VII (p = 0.019), and protein C (p = 0.044) levels; multivariate analysis produced associations with high fibrinogen and factor VIII:C levels and low protein C levels. By both univariate and multivariate analysis, events in the angina pectoris group were associated with high vWF:Ag (p = 0.026) and leukocyte (p = 0.033) levels and the presence of carotid arterial stenosis (p = 0.063); associations with high leukocyte (p = 0.037) and factor VIII:C (p = 0.186) levels, family history (p = 0.031), and diabetes (p = 0.061) were also found in the group with transient ischemic attacks. In those with peripheral vascular disease, events were associated with Fontaine stage greater than or equal to IIB (p = 0.024), high factor VIII:C levels (p = 0.073), and low protein C (p = 0.028), fibrinogen (p = 0.030), antithrombin III (p = 0.054), and factor VII (p = 0.057) levels by univariate analysis and with Fontaine stage and low fibrinogen levels by multivariate analysis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The PLAT Study: hemostatic function in relation to atherothrombotic ischemic events in vascular disease patients. Principal results. PLAT Study Group. Progetto Lombardo Atero-Trombosi (PLAT) Study Group. 152 21

Angiotensin-converting enzyme (ACE) inhibitors and calcium antagonists are important classes of antihypertensive agents. Within their respective classes, ACE inhibitors and calcium antagonists share common pharmacokinetic properties, but in contrast to ACE inhibitors, some calcium antagonists may cause a significant increase in plasma digoxin concentrations. Clinically, both classes of agents have been shown to be safe and effective in large-scale, long-term clinical trials. ACE inhibitors appear to be very well tolerated and may be associated with fewer adverse effects than some calcium antagonists. ACE inhibitors appear to blunt diuretic-induced hypokalemia, hypercholesterolemia, hyperuricemia, and hyperglycemia. Both classes of agents can be used safely in patients with renal disease, diabetes mellitus, peripheral vascular disease, and chronic obstructive pulmonary disease. They may also be used in the elderly. While ACE inhibitors are particularly useful in hypertension accompanied by congestive heart failure, calcium antagonists can be very useful when angina pectoris is present in the hypertensive patient.
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PMID:Comparative pharmacokinetic and clinical profiles of angiotensin-converting enzyme inhibitors and calcium antagonists in systemic hypertension. 154 35

Therapeutic stimulation of the autonomic nervous system has been limited by lack of qualitative or quantitative evaluation of autonomic mechanisms. This article provides an historical review of knowledge about autonomic pathways and critical evaluation of available tests of autonomic function. Recent developments in evaluation of autonomic dysfunction and improvement in techniques of neurostimulation have facilitated the development of a number of clinically useful treatments for bladder control, sexual problems, peripheral vascular disease, angina pectoris, and seizure disorders. Future therapeutic measures may allow specific control of hypertension, pain, cardiac arrhythmias, trophic disorders and balance.
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PMID:Autonomic stimulation. 170 37


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