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)

Calcium-channel blockers may well be the drugs of choice for treating angina, hypertension, and supraventricular arrhythmia in the elderly. They are effective, have no serious side effects, and when wisely matched to the patient, are very well tolerated. Most calcium-channel blockers can be administered once or twice daily. A choice of four is available; only verapamil and diltiazem hydrochloride are useful for supraventricular arrhythmia. All four, however, are effective for the treatment of hypertension and angina. Expanding uses of calcium-channel blockers include peripheral vascular disease and migraine. There may be a theoretical advantage in humans from the point of view of the anti-atherosclerosis demonstrated in animals.
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PMID:Calcium-channel blockers and the elderly. 237 3

Hypertension has a high prevalence in most countries, so it is to be expected that hypertension will be found together with other common diseases in many patients. The association between the hypertension and the concomitant disease may be causal or casual. The presence of some other disease in the hypertensive patient often places severe restraints on the choice of antihypertensive therapy. Indoramin, an alpha adrenoreceptor antagonist may be used without ill-effect in the therapy of hypertension in patients who also have chronic obstructive airways disease, congestive heart failure, mild renal failure, peripheral vascular disease, angina pectoris, and diabetes mellitus. In at least some of these patients, the use of beta adrenoreceptor blocking drugs or thiazide diuretics would be contraindicated. We do not know whether these advantages of indoramin are unique or whether they are a general property of all alpha-adrenoreceptor antagonists.
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PMID:Indoramin in the hypertensive patient with concomitant disease: clinical experience. 242 8

Since beta-adrenoceptor blocking drugs were originally discovered and shown to be important therapeutic agents in the management of both angina pectoris and hypertension, many other similar drugs have become available. These share the common property of beta-adrenoceptor antagonism, though they may vary in terms of potency. However, they differ from one another in terms of their additional pharmacological properties--cardioselectivity, partial agonist activity, and membrane stabilizing activity. Cardioselectivity refers to the ability of some drugs, notably atenolol and metoprolol, to block beta 1 receptors without blocking beta 2 receptors. This has been considered to be of potential importance in patients with obstructive airways disease, patients with peripheral vascular disease, and patients with insulin-dependent diabetes during hypoglycemic crisis. Partial agonist activity is the intrinsic activity that some drugs have to stimulate the beta adrenoceptor while they are competitively antagonizing catecholamines. In consequence, they may have less effect on resting heart rate, cardiac output, peripheral vascular blood flow, and resting respiratory function. However, there is no good evidence that major adverse effects of beta-adrenoceptor blocking drugs such as congestive heart failure, bronchospasm, or symptoms of peripheral vascular disease are prevented by drugs with partial agonist activity: bradycardia may be improved, but its importance has probably been overemphasized. Membrane-stabilizing activity appears to be unimportant. As far as pharmacokinetic differences between drugs are concerned, lipid solubility is seen to be of increasing importance. The more water-soluble drugs have longer elimination half-lives, produce less interindividual variation in steady-state plasma concentrations, and penetrate the central nervous system less readily.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Pharmacological characteristics of beta blockers and their role in clinical practice. 243 20

The primary goals in the management of hypertension, angina pectoris, and postinfarction cases are to prevent further damage to the cardiovascular system and to reduce the risk of subsequent myocardial infarction. Of all the drugs currently available, the beta-blockers seem the most likely to achieve this aim. The search for new beta-blockers centers around the need for agents that offer the advantages of beta 1-adrenoceptor antagonism without the unwanted beta 2 effects, which may be dangerous in asthmatic patients and may make bronchitis, diabetes, and arteriopathy worse or more difficult to control. One solution is to use a selective beta 1-adrenoceptor antagonist. Another is to develop a molecule that acts as an antagonist at beta 1-adrenoceptors and as an agonist at beta 2-adrenoceptors. celiprolol is such a "third-generation" beta-blocker in that it combines both attributes, and thereby offers a clinically relevant advance. It does not seem to disrupt glucose homeostasis or exacerbate peripheral vascular disease, the lipid profile appears to be positively altered, and the risk of bronchospasm is reduced. Celiprolol is therefore both clinically and biochemically well tolerated.
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PMID:Pharmacology of third-generation beta-blockers: greater benefits, fewer risks. 248 89

Reports suggest that white blood cells are involved in the development of tissue ischaemia. No studies on leucocyte rheology in the earliest stages of ischaemia exist. In 10 peripheral vascular disease (PVD) patients, 10 stable angina pectoris (SAP) patients and two groups of 10 matched controls leucocytes were separated by density and adherence into their granulocyte, lymphocyte and monocyte subpopulations. Blood samples were taken from the PVD group and respective controls before and after treadmill exercise (5 min 2 km-1 h-1, 12% slope) and from the SAP patients and controls before and after cycle ergometer test (25 W every 3 min). All the subpopulations were filtered through five micron diameter pore filters. Compared to controls, calf pain in the PVD patients was associated with an increase in monocyte filterability (P less than 0.01). ST depression in the SAP patients was linked to impaired granulocyte filterability (P less than 0.04). Therefore leucocyte rheology appears impaired in the earliest stages of ischaemia.
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PMID:Human leucocyte rheology and tissue ischaemia. 250 15

The first population-based incident case-control study of temporal arteritis (TA) in the US was conducted using the unique data resources of the Rochester Epidemiology Project. During the period 1950-1985, 88 newly diagnosed cases of biopsy-proven TA were identified among residents of Olmsted County, Minnesota. Cases were each matched to four Olmsted County community controls on age, sex and duration of community medical record. Odds ratios (OR) were calculated for marital status, education, Quetelet index, pregnancy, age at menopause, thyroid disease, diabetes, smoking, hypertension, angina, myocardial infarction, peripheral vascular disease, and stroke. Multivariable conditional logistic regression analysis identified statistically significant adjusted OR for smoking (2.3, 95% CI = 1.3-4.1). Elevated ORs which were not statistically significant were noted for angina, myocardial infarction, and peripheral vascular disease. These data suggest that TA and arteriosclerosis may share a common causal pathway. Alternatively, histopathological misclassification of temporal artery biopsies may have resulted in the observed association. Due to the limited power of this population-based study, multicentre collaboration should be encouraged to more precisely define the epidemiology of TA.
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PMID:A population-based case-control study of temporal arteritis: evidence for an association between temporal arteritis and degenerative vascular disease? 262 Oct 19

To study the effects of age on the results of coronary artery bypass grafting (CABG), 250 patients operated on from 1986 to 1989 were divided into two groups: 1) less than 65 years of age and 2) older than 65. Pre, intra and postoperative data collected in all patients included: sex, type and class of angina, associated diseases, previous myocardial infarction, previous CABG, left ventricular aneurysm, bypass time, aortic cross-clamp time, number of grafts per patient, need for prolonged inotropic support, postoperative complications, and mortality. A large number of elderly patients had unstable angina (20.3% vs 6.2%), post-infarction angina (10.1% vs 7.8%), angina at rest (10.1% vs 3.6%), peripheral vascular disease (8.4% vs 2.6%), required prolonged inotropic support (18.6% vs 3.1%), had major neurological complications (8.4% vs 0.1%) and perioperative myocardial infarction (5.0% vs 0.5%). Overall mortality was 3.6% but mortality rates were significantly higher in elderly patients (11.8% vs 1.0%). These data suggest that elderly patients have an increased risk of cardiac and neurologic morbidity and mortality. It appear that the increased morbidity and mortality is related to an increased susceptibility of the elderly to serious postoperative complications.
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PMID:[Influence of age on the morbidity and mortality in coronary artery surgery]. 262 72

Atrial pacing was performed either alone (n = 23) or in combination with thallium-201 scintigraphy (n = 113) in 136 patients referred for evaluation of chest pain. The presence of coronary artery disease (CAD) was excluded by cardiac catheterization in 12 patients and confirmed in 124. Both pacing-induced ST depression and angina had sensitivities of 48% for CAD; specificities were 75% and 83%, respectively. An abnormal thallium-201 scan (one or more reversible and/or fixed perfusion defects) was seen in 72% of patients with CAD (specificity 83%). Reversible perfusion defects were present in 47% of patients with CAD (specificity 83%), and fixed defects in 36% (specificity 100%). Pacing was associated with either ST depression or an abnormal perfusion scan in 81% of patients (specificity 67%). There were no significant differences in the results of atria pacing or thallium-201 scintigraphy in patients with or without a history of myocardial infarction, or in those with or without previous coronary artery bypass surgery. Pacing-induced ST depression, or both ST depression and a reversible perfusion defect occurred significantly less frequently in patients with peripheral vascular disease than in those without this diagnosis (p less than .05). With only one exception, there were no significant differences in the sensitivities of any indicators of ischemia (ST depression, angina, or perfusion scans), either individually or in combination, as the peak pacing rate or double product achieved increased.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Diagnostic value of atrial pacing and thallium-201 scintigraphy for the assessment of patients with chest pain. 265 82

Twelve patients with exertional angina underwent exercise treadmill testing, exercise equilibrium blood pool scintigraphy (Ex EBPS). Dipyridamole equilibrium blood pool scintigraphy (Dip EBPS) and coronary angiography by the Judkin's technique. Dipyridamole was infused through a venous cannula placed in the antecubital vein, in a dose of 0.56 mg/kg over four minutes. Four patients had single vessel disease, three double vessel disease, four triple vessel disease, and one had normal coronary arteries. Exercise equilibrium blood pool scintigraphy was found to have a sensitivity of 81%, and a positive predictive value for significant coronary artery disease of 100%. Dipyridamole EBPS had a sensitivity of 72% with a positive predictive value of 100%. The occurrence of regional wall motion abnormalities, following dipyridamole infusion, occurs up to fifteen minutes after exercise, and, therefore, serial acquisition for up to 20 minutes after the infusion is recommended. In patients with angina, who are unable to exercise because of orthopaedic disabilities or peripheral vascular disease, dipyridamole stress blood pool scintigraphy is a feasible alternative.
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PMID:Comparison of exercise and dipyridamole equilibrium blood pool scintigraphy (EBPS) in angina pectoris. 277

The value of atrial pacing and thallium-201 scintigraphy for assessing risk of subsequent cardiac events was examined in 210 patients with stable chest pain. Follow-up information was complete in 195 patients (mean age 61 years). Over an average follow-up of 19 months, cardiac events occurred in 38 patients--unstable angina in 20, nonfatal acute myocardial infarction in 6 and death from cardiac causes in 12. A history of previous myocardial infarction, diabetes mellitus, systemic hypertension or peripheral vascular disease at the time of pacing was not associated with an increased frequency of subsequent cardiac events. Six of 38 patients with later cardiac events had a history of congestive heart failure, compared with 8 of 157 without cardiac events (p less than 0.05). Neither pacing-induced angina, ST depression, nor the presence of a fixed perfusion defect was significantly more frequent in patients with cardiac events as a whole compared with patients without such events. Reversible defects and abnormal scans (reversible or fixed defects) were present, respectively, in 19 and 31 of 38 patients with cardiac events, compared with 42 and 79 patients, respectively, of the 157 patients without cardiac events (both p less than 0.01). In patients who developed unstable angina, a reversible defect was seen in 13 and an abnormal scan in 16 (both p less than 0.01 compared with patients without cardiac events). In 12 patients who died from a primary cardiac event, fixed defects were present in 8 and an abnormal scan in 11 (p less than 0.05 and p less than 0.01, respectively, compared with patients without cardiac events).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Prognostic value of atrial pacing and thallium-201 scintigraphy in patients with stable chest pain. 281 58


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