Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Platelets may contribute to the pathogenesis of atherosclerosis and to the complications of coronary atherosclerosis, acute myocardial infarction, unstable angina, and sudden cardiac death. In addition, platelets may contribute to saphenous vein aortocoronary graft occlusion. Of 104 men with coronary artery disease, platelet survival (SURV) (chromium51 labeling) was shortened in 68% (3.1+/-0.03 days [average+/-SEM]; normal, 3.7+/-0.03 days; P greater than .001). Three platelet-suppressant drugs, sulfinpyrazone, clofibrate, and dipyridamole increased SURV. Saphenous vein graft occlusion was associated with shortened SURV. Of 36 men with occlusion of at least one graft, SURV was shortened in 35 (2.5+/-0.08 days), whereas in 19 with all grafts open, SURV was shortened in six (3.5+/-0.10 days; P less than .01). These drugs increased SURV (2.3 +/- 0.08 to 2.7 +/- 0.11 days; P less than 0.1) and were associated with improved graft patency (four of 32 grafts after initial bypass vs 30 of 34 grafts open after second operation).
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PMID:Platelet-suppressant therapy in patients with coronary artery disease. 30 69

A 32-year-old male with the clinical syndrome of unstable angina is presented. During cardiac catheterization and coronary cineangiography, the coronary arteries were found to be free of atherosclerosis, but segmental spasm of the right coronary artery was observed. Spasm was reproduced, but to a milder degree, upon the administration of ergonovine maleate intravenously. The patient was discharged on a regimen of oral nylidrin HCL, with symptomatic improvement.
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PMID:Coronary artery spasm in a patient with unstable angina pectoris. 66 5

1. 46 cases of Prinzmetal's angina have been studied: there were 36 males and 10 females, with an average age of 54.6 years. 19 patients (group A) were treated medically, and 12 of these were followed up for more than 6 months (average follow-up period 45.1 months). 27 patients (group B) underwent a coronary by-pass procedure: 22 of these were followed up for more than 6 months after surgery (average postoperative follow-up period 21.6 months). 2. One patient from group A and two patients from group B died, one of them from postoperative renal failure. None of the three deaths could be attributed directly to the coronary artery disease. 2 patients from group A and 5 patients from group B had a myocardial infarction without fatal outcome. 5 of the 12 patients in group A and 16 of the 22 patients in group B were asymptomatic after more than 6 months of follow-up. 3. The treatment policy should take account: - of the prognosis of Prinzmetal's angina, which is on the whole better than that of an unstable angina pectoris of the common type; - of an assessment of the risks in each individual case; these are increased when there is a combination of risk factors for atherosclerosis, and/or severe arrhythmia with syncope, and/or persistant electrical changes in the territory of the anterior descending artery, and/or coronary artery lesions involving two or three major vessels. 4. Surgery is used if there is a failure of treatment with beta-blockers, which are used under cover of a pacemaker when there is a paroxysmal block. If medical treatment is successful, surgery is indicated in high-risk cases.
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PMID:[Discussion on therapeutic attitude in Prinzmetal's angina. Apropos of 6 cases]. 81 80

We compared patients with variant angina (ST-segment elevation during pain) who had normal or near normal coronary arteriograms (Group 1) with 20 in whom variant angina occurred in the presence of obstructive coronary lesions (Group 2). A long history of nonexertional angina without angina of effort or previous infarction was the rule in Group 1, whereas recent-onset unstable angina preceded by effort angina and infarction predominated in Group 2 (P less than 0.001). Normal electrocardiograms at rest, with ischemic ST-segment elevation in the inferior leads, and ischemia-induced heart block and bradycardia, characterized Group 1, whereas abnormal electrocardiograms, ischemic involvement or fibrillation were more common in Group 2 (P less than 0.001). Variant angina with normal coronary arteriogram generally has a benign course and is probably unrelated to atherosclerosis.
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PMID:Clinical syndrome of variant angina with normal coronary arteriogram. 98 80

Since the seventies, and in particular the eighties of this century, findings on pathogenetic mechanisms of ischaemic heart disease are expanding markedly and are becoming more accurate. This makes it possible to know and understand better factors which influence the genesis and development of myocardial ischaemia including the most serious clinical forms (unstable angina pectoris, acute myocardial infarction and sudden cardiac death). Diminution of the cardiac flow and/or increased oxygen demands of the heart muscle are not the only determinants of myocardial ischaemia which is influenced markedly also by neurohumoral, metabolic, prothrombotic (proaggregation and procoagulation) factors as well as antithrombotic and haemodynamic factors. Acute coronary syndromes have as a rule, in particular in patients with out severe atherosclerotic stenosis of the coronary arteries, a common pathophysiological mechanism of fissuration of the atherosclerotic plaque followed by different grades of dynamic coronary occlusion depending on vasoconstriction--spasm of the coronary arteries and thrombus formation. The coronary arteries, usually affected with atherosclerosis, may be due to the comprehensive action of various factors temporarily, intermittently or permanently occluded. In case of the development of acute coronary syndromes thrombosis plays a key role. Better knowledge of pathogenetic mechanism of IHD markedly changes views on treatment and management of patients with IHD in particular patients with acute coronary syndromes. The authors emphasize strategies focused (also preventively) on preventing progression of the disease with the aim to improve survival and the short-term and long-term prognosis.
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PMID:[Pathogenesis of myocardial ischemia and acute coronary syndromes]. 129 43

Heparins are a heterogenous group of naturally occurring glycosaminoglycans characterized by anticoagulant activity and a wide range of molecular weights (low molecular weight or fractionated heparins evolving within the past two decades). Cofactors for endogenous inhibitors of coagulation (antithrombin III and heparin cofactor II), heparin administration results in a hypocoagulable state. Various platelet activities, including inhibition of activity induced by platelet-derived growth factors on vascular smooth muscle, also have been noted. Divorced of anticoagulant nature, novel applications may include a role in atherosclerosis prevention, acceleration of collateral coronary as well as peripheral circulation (i.e., angiogenesis), and continued (chronic) post-myocardial infarction therapy. Established indications include treatment of various thrombotic diseases, unstable angina, and thrombosis chemoprophylaxis in medical/surgical patients. The antithrombotic potential of the heparins is used also in thrombosis management related to extracorporeal circulatory assistance or dialysis devices. Heparin's therapeutic potential in the postphlebitic syndrome as well as in acute treatment of myocardial infarction (primarily and adjunctively with various thrombolytic agents) continues to undergo evaluation; however, early data review shows favorable trends for its inclusion in situations that favor thrombus generation (e.g., anterior myocardial infarction). Although associated with thrombocytopenia or hypertransaminasemia, the heparins are relatively well tolerated. In a small subset of patients, a severe thrombocytopenia may ensue, which generally resolves on medication withdrawal. As this class of glycosaminoglycans becomes better characterized, new indications may emerge for both native and the newer fractionated heparins.
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PMID:Pharmacodynamics, clinical indications, and adverse effects of heparin. 132 34

Elevated levels of lipoprotein(a) [Lp(a)] have been associated with an increased risk of ischemic heart disease (IHD), and higher levels of Lp(a) are associated with lesions of significantly greater severity. We have examined Lp(a), total cholesterol (TC) and high density lipoprotein-cholesterol (HDL-C) levels in patients with IHD including those with normal coronary arteries with vasospastic angina. The study population consisted of 206 patients (166 males and 40 females) who underwent diagnostic coronary angiography for known IHD. Twenty-eight patients had effort angina, 36 rest angina, 8 unstable angina and 134 old myocardial infarction. IHD patients were categorized as zero vessel disease (0VD), single vessel disease (SVD) and multi-vessel disease (MVD). To investigate the relationship between atherosclerosis and IHD, these patients were further divided into 3 groups based on angiographic findings. Eighteen patients had entirely normal coronary arteries (normal group), 24 discretely diseased coronary arteries (discrete group) and 80 diffusely diseased coronaries (diffuse group). The results were compared with those obtained from 50 healthy individuals. Lp(a) levels for IHD patients (12.4 mg/dl) were significantly higher than those of controls (7.1 mg/dl, p < 0.05). However, there were no statistical differences between 0VD (13.1 mg/dl) and MVD (12.8 mg/dl). Similarly, no statistical differences of Lp(a) values were found among the normal group (13.3 mg/dl), discrete group (12.0 mg/dl) and diffuse group (12.9 mg/dl). Mean levels of HDL-C in 0VD (51.3 +/- 13.5 mg/dl) were significantly higher than those of SVD (42.9 +/- 11.5 mg/dl, p < 0.05). However, no significant differences were observed between controls (59.5 +/- 15.3 mg/dl) and 0VD (51.3 +/- 13.5 mg/dl).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Importance of lipoprotein(a) in patients with ischemic heart disease]. 133 90

Patients with extensive atherosclerosis are at increased risk of developing embolic complications during cardiac catheterization. We describe a 51-year-old man with unstable angina and bilateral leg claudication who developed fever and right upper abdominal pain shortly after cardiac catheterization. Liver-spleen scintigraphy demonstrated a wedge-shaped filling defect compatible with splenic infarction, and serial scans performed over a period of five months showed resolution of this finding. Splenic infarction tends to be under-diagnosed, and physicians should be aware of this potentially serious complication of cardiac catheterization.
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PMID:Splenic infarction: a complication of cardiac catheterization. 139 6

The clinical value of IgG and IgM cardiolipin antibodies (CLa) was examined in 22 patients with myocardial infarction and 9 patients with unstable angina (UA). Higher IgG levels were observed in 41% of MI patients and 55% of UA patients. There was a significant correlation between the detection of IgG CLa in patients with a history of myocardial infarction and the presence of left ventricular intracavitary thrombosis. The levels of IgG CLa were increased in 78% of patients with history of MI and in 32% without MI history. In addition, those of IgG CLa was higher in 80% of IM patients with signs of intracavitary thrombosis and in 38% with cavitary thrombosis. The findings suggest that antibodies to cardiolipin (of IgG in particular) make contribution to the development of thrombotic events in patients with coronary atherosclerosis in the absence of autoimmune pathology.
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PMID:[Cardiolipin antibodies in patients with myocardial infarction and unstable angina pectoris]. 140 56

Between April 1988 and September 1991, 16 among 23 patients over 70 years of age underwent coronary bypass grafting (CABG) with at least one arterial graft. The age ranged from 70 to 77 years (mean, 72.1 years) and involved coronary lesions were two vessels in two patients and three vessels in 14 patients. Seven patients with unstable angina received emergency CABG. The number of distal anastomosis with arterial graft was mean of 1.3 per patient and left internal thoracic artery (ITA) was used as a pedicled graft in all patients. Sequential grafting with left ITA arterial graft was performed in two and right gastroepiploic artery was concomitantly used in three patients. No atherosclerosis was seen in left ITA, however, poor quality saphenous vein graft (SVG) was in five and atherosclerosis of ascending aorta was in five patients. After operation deep vein thrombosis of leg after harvesting SVG occurred in one patient. The angiogram performed within one month of operation in nine patients showed that the patency rate of arterial graft was 100% and that of SVG was 94.4%. The longest follow-up period was 42 months and New York Heart Association Functional Class improved to Class I or II in all patients. The use of pedicled ITA in elderly patient showed advantage for diseased ascending aorta and it seemed to prevent the postoperative complication due to the use of SVG.
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PMID:[Advantage of internal thoracic artery for coronary arterial bypass surgery in patients over 70 years of age]. 143 55


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