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Query: UMLS:C0042373 (vascular disease)
 17,070 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A pilot project with medical, physical and psychosocial evaluation and a physical and psychosocial rehabilitation program included 59 men, under age 60, inactive for less than one year and who underwent aortocoronary bypass surgery between november 1978 and march 1980. A control group of 60 comparable patients was studied by questionnaire one year after the operation. The percentage of return-to-work was not significatively different: respectively 92 p. 100 and 89 p. 100. A previous study on a similar population determined 9 predictive sociodemographic and medical factors: age, angina class, duration of symptoms, associated vascular disease, non cardiovascular illness, education, physical workload, length of preoperative unemployment, annual income. The evaluations of this study showed the importance of the psychosocial factors and alcoholism. In comparison with our previous studies, the increased percentage of return-to-work (from 69 p. 100 to 89 p. 100) is mostly due to a shorter preoperative period of inactivity; the percentage of patients operated on within three months of inactivity increased from 44 p. 100 to 74 p. 100 in the last ten years. In the group of patients with a good or excellent preoperative prognosis, 94 p. 100 were working after one year. We conclude that a strategy for improving return-to-work after surgery is to decrease the period of preoperative inactivity. By using nine objective predictive factors and a psychosocial evaluation, it is possible to screen patients with a poor return-to-work prognosis and to submit them to an individualized rehabilitation program.
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PMID:[Rehabilitation and return to work of patients after aortocoronary bypass]. 641 97

A prospective study was made of the morbidity and mortality from ischemic heart disease in 390 patients with focal TIA caused by atherosclerotic vascular disease. The 5-year cumulative rate of myocardial infarction or sudden death in these patients was 21.0%, a rate only slightly less than that of fatal or nonfatal cerebral infarction (22.7%). Risk factors including diabetes, angina, and ECG abnormalities were associated with an increase in morbidity and mortality from ischemic heart disease. A major factor associated with these cardiac events was the presence of atherosclerotic obstructive or ulcerative lesions in the carotid arteries. These observations indicate that focal TIA caused by carotid atherosclerosis is a predictor not only of cerebral infarction, but also of serious cardiac disease and death.
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PMID:Risk of ischemic heart disease in patients with TIA. 653 54

Three groups of patients were analyzed to ascertain the risk of combined carotid/coronary operations and the risk factors for perioperative stroke following coronary artery bypass (CAB). Group 1 (N = 132) had simultaneous carotid endarterectomy and CAB, Group 2 (N = 51) were patients having perioperative stroke following elective CAB, and Group 3 (N = 169) had CAB alone but had prior history of either asymptomatic cervical bruit, stroke/transient cerebral ischemic attack (TIA), or carotid endarterectomy. Hospital mortality and perioperative stroke rate in the combined carotid/coronary group were 3.0% (4/132) and 1.6% (2/126), respectively. These rates were not significantly different from those of a control group having CAB alone. Overall incidence of postoperative stroke in 5,676 patients having CAB alone was 0.9% (51 patients). The incidence of perioperative stroke in patients with asymptomatic bruit or prior history of stroke or TIA undergoing CAB alone was 3.3% (2/60) and 8.6% (6/70), respectively. The majority of strokes following CAB appear to be embolic in origin. Indications for simultaneous carotid/coronary operations are bilateral carotid disease and symptomatic carotid vascular disease associated with unstable angina, left main obstruction, or diffuse multivessel disease. Staged procedures are recommended for patients with stable angina and symptomatic carotid lesions and for difficult carotid revascularization procedures. CAB alone may be performed for most patients with asymptomatic cervical bruit, moderate or mild carotid artery obstruction, and unstable angina associated with prior stroke, although in the third situation postoperative risk of neurological injury may be increased.
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PMID:Combined carotid and coronary operations: when are they necessary? 660 38

Two hundred and thirteen patients underwent surgical treatment for coronary artery disease from 1968, May to 1983, Feb. at our Department. Clinical diagnosis was stable angina in 55 patients, unstable angina in 47, angina with complication in 9, myocardial infarction in 54, and post-infarction complication in 48. Two hundred consecutive postoperative patients were evaluated. There were 11 late deaths occurred including 4 cardiac deaths in origin. Causes of late cardiac deaths were sudden death in 2 patients and cardiac decompensation in 2 patients. Reinfarction was seen in 1 out of 2 sudden deaths. This case underwent only left ventricular aneurysmectomy without A-C bypass grafting. Preoperatively, 49.2% of the patients were in NYHA 2, 34.8% in NYHA 3, and 15.9% in NYHA 4, but postoperatively 86.3% in NYHA 1 and 13.7% in NYHA 2. Reoperative surgical indications were native coronary progression in 1 patient, graft obstruction in 1, and ascending aortic aneurysm in 1. Surgical treatment of coronary arterial disease has still many problems to be solved, especially in patient with cardiogenic shock, multi-vessel disease, cerebral vascular disease, abdominal aortic aneurysm and patient of old age. But, we believe the surgical treatment will make much progress with development of myocardial preservation, assisted circulation, membrane oxygenator and simultaneous operative techniques including complete revascularization.
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PMID:[Survival and late results following surgical treatment of coronary artery disease]. 661 96

The work status following aortocoronary bypass surgery was evaluated by questionnaire in 268 male patients aged 44 years or less, after a mean follow-up of 38 months. During follow-up, 87% resumed work; when analyzed on a yearly basis, the rate of patients at work peaked at 2 years (80%) and then declined to 70% at 4 years. Multivariate analyses showed that the two most important preoperative variables predictive of work status after surgery were (1) the length of the period of not working, and (2) the educational level. Other influential factors were the presence of an associated vascular disease and the type of work, annual income and functional class. The postoperative health status, as described by the patient, was also closely correlated with return to work. Recurrence of angina after surgery impaired work resumption. A majority of patients who were never gainfully employed after surgery attributed the reason to their physician, while 93% of them stated that they received financial aid from the government.
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PMID:Employment following aortocoronary bypass surgery in young patients. 697 65

The association of coronary artery disease and peripheral vascular disease was studied to determine the influence of coronary artery disease on early and late mortality rates after surgical reconstruction for peripheral occlusive vascular disease and abdominal aortic aneurysm. Between January 1976 and December 1978, 161 consecutive patients underwent surgery for peripheral occlusive vascular disease or abdominal aortic aneurysm. The patients were 35-86 years old (mean 63.3 years). Thirty patients (18.6%) had abdominal aortic aneurysmectomies, 59 (36.7%) had aortoiliac reconstruction with or without femoropopliteal bypass and 72 (44.7%) had procedures for femoropopliteal disease. The 30-day hospital mortality rate was 6.7% for abdominal aortic aneurysm (n = 2), 3.4% for aortoiliac reconstruction (n = 2) and 1.4% for femoropopliteal procedures (n = 1). Myocardial infarction was the cause of 40% (n = 2) of the early postoperative deaths. The early mortality rate of patients with a history of angina or myocardial infarction was 5.4% (two of 37), while the early mortality rate among patients without such a history was 2.4% (three of 124). The mortality rate from myocardial infarction during the late observation period was 65% (15 of 23). The freedom from myocardial infarction was 90% at 30 months and 75% at 60 months. The overall survival rate was 87% at 30 months and 71% at 60 months. The late mortality rate was assessed with respect to various risk factors: coronary artery disease (n = 31), previous vascular surgery (n = 19) and diabetes mellitus (n = 7). Among the 63 patients who had one or more of the risk factors, the late cardiac mortality rate was 20.6% (n = 13). The late cardiac mortality rate for for the 78 patients with no risk factors was 3.8% (n = 3). An additional 10 patients with previous coronary artery bypass (n = 9) or angiography (n = 1) experienced no early or late mortality. The freedom from late cardiac death at 60 months was 71% for the high-risk group (63% patients) and 96% for the low-risk group. The study shows that coronary artery disease is a major determinant of both early and late mortality after arterial reconstruction. The status of the myocardium should be assessed before peripheral vascular surgery, as selective myocardial revascularization may improve survival in these patients.
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PMID:Influence of ischemic heart disease on early and late mortality after surgery for peripheral occlusive vascular disease. 708 52

A typical patient with this uncommon premature aging syndrome was followed over a period of four and a half years until his death. He presented the characteristic clinical features, as well as the complications, of Werner's syndrome. About one hundred forty cases of this recessively inherited syndrome have been reported. Most patients become recognizable in their thirties by their short stature, typical facies, premature graying, hair loss, cataracts, atrophy of skin and subcutaneous tissue, and acral sclerosis. Advanced peripheral vascular disease occurs early; angina, skin cancer, diabetes mellitus, and internal malignancy are common. Most patients die before the age of fifty years either from complications of anteriosclerotic vascular disease or malignancy.
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PMID:Werner's syndrome. 735 90

The effects of dietary fat-induced lipemia on arterial oxygen tension and plasma lactate, cholesterol, and triglyceride levels were examined in 11 male subjects (average age 60) with a diagnosis of arteriosclerotic coronary vascular disease and angina pectoris. All subjects were alternately fed three isocaloric formula meals consisting of 100 g of cream fat, 100 g of saffola oil, and an isocaloric nonfat cornstarch control meal. Resting values of arterial blood gases and plasma lactate, triglyceride, and cholesterol were measured before (fasting) and at 3 and 5 hr postprandially. Both types of dietary fat produced significant postprandial decreases in plasma lactate, significant increases in plasma triglyceride and cholesterol levels, and no significant changes in arterial oxygen tension. The control meal had no effect upon any value except to transiently increase the plasma lactate. The role of postprandial lipemia in the atherosclerotic process is discussed and a hypothesis for the plasma cholesterol elevation due to dietary fats is presented.
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PMID:Dietary fat-induced postprandial lipemia: effect on arterial oxygen saturation and plasma lactate, triglyceride, and cholesterol levels in subjects with angina pectoris. 738 9

Four hundred forty-one subjects 34 to 69 yr of age were recruited from a random sample of the community. They answered a questionnaire and were monitored in their homes for sleep-disordered breathing (SDB). This report concerns the association between observed SDB and arterial hypertension and vascular disease. Hypertension was defined as self-report of a diagnosis of hypertension made by a physician, current treatment for hypertension, or a systolic pressure greater than 150 mm Hg or a diastolic pressure greater than 90 mm Hg. Coronary artery disease was defined by self-report of angina or myocardial infarction of "heart attack." There were few cases of stroke or claudication, and a category of "occlusive vascular disease" was defined by self-report of coronary artery disease or of "blocked arteries" or stroke. Subjects were classified as snorers (n = 289) or nonsnorers (n = 73) by self-report of regular snoring, and as having SDB (n = 79) if more than 15 abnormal respiratory events were recorded per hour of recording. There were significant increases in the prevalence of hypertension, coronary artery disease, and occlusive vascular disease from nonsnorers (26, 7, and 10%, respectively) through snorers (39, 12, and 17%) to subjects with SDB (57, 20, and 28%). The crude odds ratio for SDB versus nonsnorers was 3.8 (95% CI, 1.9 to 7.5) for hypertension, 3.5 (1.2 to 10.0) for coronary artery disease, and 3.7 (1.5 to 9.1) for occlusive vascular disease.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:A community study of snoring and sleep-disordered breathing. Health outcomes. 763 32

Each year in the United Kingdom about 250,000 people die from acute myocardial infarction, other ischaemic heart disease or stroke. Many will already have evidence of established vascular disease that predisposes to such an event--such as angina, peripheral vascular disease, atrial fibrillation, transient ischaemic attacks or a previous myocardial infarction or stroke. Others will have risk factors such as hypertension, diabetes mellitus or hyperlipidaemia, but the stroke or heart attack is the first evidence of established vascular disease. Aspirin was first discovered to have antiplatelet properties 30 years ago and since then many randomised clinical trials have sought to determine whether it (or other antiplatelet agents) can protect patients from heart attack or stroke. In this article we review the evidence and update our earlier conclusions on stroke, myocardial infarction, and unstable angina, arguing that aspirin should be widely used to reduce cardiovascular morbidity and mortality in certain high-risk patients.
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PMID:Aspirin to prevent heart attack or stroke. 763 3


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