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)

Notwithstanding the large number of clinical trials, most of them designed and performed according to the requirements of modern clinical pharmacology, only a few firm clinical recommendations on drugs affecting platelet function in the prevention of arterial or venous thrombosis can be made at present. There is no good evidence for the clinical effectiveness of aspirin or any other drug affecting platelet function in patients with peripheral arterial occlusion or after vascular grafting. In cerebrovascular disease there is reasonable evidence that the administration of sulfinpyrazone can significantly reduce cerebral ischemia or mortality, but similar trials performed with aspirin, dipyridamole or clofibrate failed to reveal a significant difference in favor of the experimental treatment. Patients with angina only were shown to benefit from treatment with clofibrate, but prospective trials with dipyridamole or aspirin in the primary or secondary prevention of myocardial infarction did not reveal a significant reduction in morbidity or mortality in the experimental group. Use of a combination of the latter two drugs did, however, reveal a reduction in morbidity and mortality. In patients with prosthetic heart valves, there is firm evidence that dipyridamole and sulfinpyrazone therapy can normalize decreased platelet survival, an effect which has been shown to correlate well with the incidence of thromboembolism. Provided further trials lead to confirmatory conclusions, drugs inhibiting platelet function associated or not with oral anticoagulants may constitute an ideal prophylaxis in patients with a substitute valve. There is still much uncertainty as to whether dipyridamole, given in addition to conventional treatment, benefits patients with membranous or mesangiocapillary glomerulonephritis. The same holds for drugs inhibiting platelet function after kidney or heart transplantation in man. Only scanty reports are available on the usefulness of drugs affecting platelet function in thrombotic thrombocytopenic purpura and the hemolytic uremic syndrome. Three different types of antiplatelet drugs are available for the prevention of postoperative deep vein thrombosis: dextran, oral drugs also affecting platelet function and heparin administered subcutaneously in small doses. In orthopedic surgery dextran 70 administered before and every second day after surgery was the drug showing the most convincing reduction in the incidence of phlebographically proved deep vein thrombosis. Major orthopedic surgery is precisely the type of surgery in which the effectiveness of small dose heparin is much in doubt and in which the effectiveness of aspirin and dipyridamole is still to be confirmed. In general surgery, use of a combination of 1 g aspirin and 0.225 g dipyridamole daily was shown to offer approximately the same level of protection as small doses of heparin, land these two forms of prevention seem to offer a greater degree of protection than dextran...
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PMID:Are agents affecting platelet functions clinically useful? 79 99

Total starvation is effective for acute weight reduction in obesity. However, in 200 patients, most of whom also had internal diseases, 8% exhibited sometimes severe complications, i.e. reversible cerebral ischemia in 3 hypertensive patients when the blood pressure was lowered to the normal range by natriuresis of fasting; breakdown of water and electrolyte homeostasis with circulatory collapse, vomiting and vertigo; acute crises of paroxysmal nocturnal hemoglobinuria and porphyria respectively and increase of transaminases up to 200 mu/ml, or cardiac arrhythmias. Relative (?) contraindications for total fasting appear to be clinical sings of arteriosclerosis such as vascular bruits, angina pectoris and intermittent claudication. In case of doubt, the method should only be used in hospital.
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PMID:[Complications in null-diet]. 91 86

CK-isoenzymes were measured in 31 patients hospitalised for suspected myocardial infarctions who had an increase in serum creatine kinase (CK) above 50 U/l. Of 26 patients with definite evidence of myocardial infarction, MB-isoenzyme--specific for myocardial necrosis--was demonstrated in 24. MB-isoenzyme was no longer detectable in two patients hospitalised 48 hours after the onset of symptoms. In the remaining five patients only MM-isoenzyme was found, the elevated CK activity in three patients having been due to an intramuscular injection, and in two others due to pulmonary embolism. Measurement of CK isoenzymes proved of great diagnostic value in three patients with sudden circulatory arrest of, at first, unknown cause after successful resuscitation. Acute myocardial infarction was proven by the presence of MB-isoenzyme. In one of these patients an additional BB-isoenzyme was seen, possibly due to concomitant cerebral ischaemia. In all other patients (with angina, after cardioversion, or after major surgical operations) only MM-isoenzyme was detected. MB-CK-isoenzyme was found to be a highly specific, as well as sensitive, indicator of myocardial necrosis. This being a rather difficult method, its use is not justified in the routine diagnosis, but in doubtful instances its value can hardly be overestimated.
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PMID:[The diagnostic value of CK-isoenzymes in suspected acute myocardial infarction (author's transl)]. 124 17

A complete and vast study about platelet antiaggregants, alone or associated to other drugs, is presented. Studying firstly these drugs, and afterwards its clinical use: cerebral ischemia, myocardium acute infarct, angor pectoris, revascularization coronary surgery, coronary percutaneous transluminal angioplasty, valvular prosthesis, valvulopathies, vascular prosthetic grafts, and others.
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PMID:[Platelet antiaggregants in the treatment of vasculopathies]. 218 92

Ventricular arrhythmias detected in the late-hospital phase of myocardial infarction have been identified as a risk factor for sudden death, being their prognostic value independent of ventricular function. However, relations between both factors are not clarified. In order to study hypothetic associations between ventricular arrhythmias and some clinical, hemodynamic and angiographic variables, 60 patients (52 males, 8 females) underwent 24-hour Holter recordings and cardiac catheterization with left ventricular and coronary angiographies, 3-5 weeks after hospital admission. Past history data, acute phase complications and hemodynamic and angiographic results were compared between patients with and without significant ventricular arrhythmias during Holter monitoring (10 or more PVC's/hour and/or repetitive forms). No significant differences were found between both groups neither in mean age nor in the incidence of previous angina or infarction, cerebral ischemia, diabetes, lipid disorders or subjective feeling of being under psychological stress. Prior history of arterial hypertension was, however, significantly more frequent in patients with ventricular arrhythmias (53.3% vs 17.8%; p = 0.0183). No differences were observed in the localization of the infarct or in the complications during the acute phase (CPK peak, Killip's score, angina after 24 hours of evolution, intraventricular or A-V conduction disorders and supraventricular and ventricular arrhythmias). Among hemodynamic data, only left ventricular and aortic systolic pressures were different in both groups, being significantly higher in patients with ventricular arrhythmias. There were not differences in left ventricular segmentary contraction and in number of coronary vessels involved. To conclude, significant ventricular arrhythmias were recorded in 25% of patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Anatomo-functional substrate of high risk arrhythmia after myocardial infarct]. 239 9

Nicardipine, a calcium antagonist of the 1:4 dihydropyridine type, has been used to treat angina and hypertension and is currently being examined as an agent for treating ischemia of cerebral and myocardial tissue. Nicardipine shows high affinity for the dihydropyridine binding site (pKi = 9.7) and inhibits the L-type calcium ion channel as demonstrated by its ability to decrease the calcium ion-dependent action potential dose-dependently in ventricular papillary muscle (pIC50 = 7.15). Nicardipine shows greater potency in inhibiting the response of vascular smooth muscle (pIC50 = 8.20) than that of cardiac muscle (pIC50 = 7.15). The nicardipine selectivity for vascular smooth muscle is greater than that shown by other dihydropyridine calcium antagonists such as nifedipine and accounts for the efficacy of nicardipine in the treatment of angina and hypertension. Various mechanisms have been proposed to account for the beneficial action of nicardipine in treating animal models of cerebral ischemia and myocardial infarction. For example, it has been suggested that (1) nicardipine has a specific membrane-stabilizing effect on cell membranes, (2) the compound blocks certain sodium channels, (3) it may become concentrated in ischemic cells, or (4) it may stimulate calcium ion efflux from mitochondria, and these actions may account for the inhibition by nicardipine of veratrine-induced contraction of myocytes. In this study, some of these effects of nicardipine were examined. However, the suggestion that nicardipine concentrates in ischemic cells owing to the tertiary amine structure could not be conclusively demonstrated.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Cellular action of nicardipine. 280 73

Tetramethylpyrazine, a drug originally isolated from the rhizome of Ligusticum walliichi, has been used routinely in China for the treatment of stroke and angina pectoris. We evaluated this drug by testing its effectiveness in increasing the survival rate in a stroke model using Mongolian gerbils. Our results indicate that tetramethylpyrazine can increase survival rate only if it is administered before the induction of cerebral ischemia. Since we administered the drug intraperitoneally, it is possible that pretreatment was necessary to increase its effective concentration in the blood. Receptor binding studies indicated that tetramethylpyrazine was inactive against a variety of pharmacologically active receptors.
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PMID:Tetramethylpyrazine for treatment of experimentally induced stroke in Mongolian gerbils. 291 41

In a prospective study of 87 patients with TIA or minor stroke (48 men and 39 women, average age 65 years) a history of ischaemic heart disease (IHD) was present in 30 (angina in 25 and myocardial infarction (MI) in 19, 14 having both). The London School of Hygiene Questionnaire did not confirm the diagnosis of IHD in 7 patients, but did detect a further 5 patients with angina and/or MI. The Minnesota coding of the ECG revealed 5 patients with asymptomatic suspect IHD and 15 with probable IHD (a total of 23%). Cardiomegaly (cardiothoracic ratio greater than 0.5) was present in 28 patients, 9 with a history of MI and 8 with a history of angina. These findings indicate that IHD is common in patients with cerebral vascular disease. As both probable IHD on Minnesota coding of the ECG and the presence of cardiomegaly are highly predictive of a poorer outcome, the findings add further weight to the argument that, amongst patients with minor cerebral ischaemia, a sub-group at high risk of death due to IHD can be detected by using simple methods rather than by performing routine coronary angiography on all patients as has been suggested in recent times.
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PMID:Unreported symptomatic and asymptomatic ischaemic heart disease in patients presenting with TIA or minor stroke detected by the London School of Hygiene Cardiovascular Questionnaire and Minnesota coding of a routine ECG. 326 47

The impact of diabetes was prospectively studied during a 5-year period in 428 unselected and consecutive patients with acute cerebrovascular disease of whom 18% were diabetic. Cerebral infarction was more frequent in diabetics (81 vs 70%, p less than 0.02) whereas transient cerebral ischaemia was less frequent (4 vs 14%, p less than 0.01). Case fatality rate during hospitalization was higher in the diabetic than in the non-diabetic patients (28 vs 15%, p less than 0.02). Patients who died during hospitalization, diabetic as well as non-diabetic, had significantly higher blood glucose concentrations on admission compared with patients who survived. Hematocrit values were higher in the diabetic than in the non-diabetic patients (p less than 0.02). Diabetics had higher systolic blood pressure levels than the non-diabetics in the acute phase (p less than 0.005). The diabetic stroke patients more often had a history of hypertension, atrial fibrillation, heart failure and angina pectoris than non-diabetics stroke patients and diabetic control patients without stroke. Stroke patients, not known to be diabetic, had larger mean oral glucose tolerance test curve areas when compared with healthy controls but not when compared with hospitalized controls. We propose that diabetes increases the risk for stroke through other concurrent risk factors, cardiac disorders in particular.
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PMID:Clinical characteristics in diabetic stroke patients. 339 27

The major cause of death from carotid artery surgery (1.2% in 1984 in this series) is still coronary disease and myocardial infarct. A series of 50 patients were randomly selected for detailed study of post-operative cardiologic complications and the following sequelae were noted: mortality = 1 myocardial infarct; morbidity = 1 myocardial infarct, 3 documented anginal pains, 8 repolarization disorders, 4 benign ventricular arrhythmias. Analysis of these complications and a literature review demonstrated: the high frequency of combined carotid artery and coronary artery stenosis even in asymptomatic patients (25 to 40% of cases); the elevated percentage of complications in patients with symptomatic coronary disease (mortality risk multiplied by ten), hypertension or arterial disease; the low effect of age taken alone as risk factor. Pre-operative explorations to detect angina, particularly when latent and asymptomatic, should include a questionnaire, strict patient clinical examination and detailed reading of electrocardiogram tracings. An effort test should be performed as a function of results and patients' medical history and when positive should lead to coronarography in patients under 70 in good general condition, and when doubt persists after the effort tests. The indication for surgical treatment is dependent on results of these explorations: Carotid artery surgery (stenosis with high cerebral risk) should be performed under pre- and post-operative myocardial protection in patients with coronary artery disease who are too old or inoperable for cardiac reasons. Simultaneous myocardial and cerebral revascularization in the presence of severe lesions and at equivalent risk of progression. First intention carotid artery surgery for bilateral stable lesions with subsequent simultaneous myocardial and cerebral revascularization. First intention carotid artery surgery in case of cerebral ischemia with coronary artery shunt surgery at a later stage. Improved exploration of patients and close cooperation between cardiologists, anaesthetists and surgeons should allow patients at high risk to be operated upon under improved conditions of safety.
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PMID:[Exploratory hierarchy and surgical indications for carotid surgery in patients with coronary disease]. 355 11


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