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Query: UMLS:C0151744 (myocardial ischemia)
 31,282 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Essential antioxidants were determined in plasma of middle-aged men representing 16 European study populations, which differed sixfold in age-specific mortality from ischemic heart disease (IHD). In 12 populations with "common" plasma cholesterol (5.7-6.2 mmol/L) and blood pressure, both classical risk factors lacked significant correlations to IHD mortality, whereas absolute levels of vitamin E (alpha-tocopherol) showed a strong inverse correlation (r2 = 0.63, P = 0.002). Evaluating all populations, cholesterol and diastolic blood pressure were moderately associated, but their correlation was inferior to that of vitamin E. In stepwise regression and multiple regression analysis, mortality was predictable to 62% by lipid-standardized vitamin E, to 79% by vitamin E and cholesterol, to 83% after inclusion of lipid-standardized vitamin A (retinol), and to 87% by all the above parameters plus blood pressure. Thus, in the present study the cross-cultural differences of IDH mortality are primarily attributable to plasma status of vitamin E, which might have protective functions.
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PMID:Inverse correlation between plasma vitamin E and mortality from ischemic heart disease in cross-cultural epidemiology. 198 6

A group of 2,065 gold miners surveyed between 1968 and 1970 was followed to 31 December 1986, at which date 859 were known to be dead. The relationship between airways obstruction and mucus hypersecretion to causes of mortality was analyzed. Airways obstruction was strongly related to mortality from chronic obstructive pulmonary disease (COPD), lung cancer, coronary heart disease and other causes. After standardization for airways obstruction, mucus hypersecretion was not related to mortality from COPD but remained related to mortality from ischaemic heart disease (IDH) and other causes, even after adjustment for tobacco smoking and dust exposure. Mucus hypersecretion was not related to mortality from lung cancer when standardized for airways obstruction.
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PMID:Relevance of airflow obstruction and mucus hypersecretion to mortality. 201 56

1) Patients with ischaemic heart disease have a substantial increased risk to develop perioperative myocardial infarction (reinfarction). 2) The incidence of cardiac complications increases when surgery is performed on the great vessels and in the intrathoracic and upper abdominal region. 3) The choice of the anaesthetic is of minor importance. However, isoflurane may be particularly susceptible to produce a coronary steal phenomenon and therefore should be used with caution in patients with IHD. 4) Experience and skill of the anaesthetist is of greater importance to avoid ischaemia. Invasive monitoring and aggressive treatment of haemodynamic disorders may reduce the risk of ischaemia. 5) During recovery patients with IDH must be controlled carefully at a recovery ward or ICU. 6) Preoperative evaluation of the individual risk and specific treatment of haemodynamic and metabolic disorders are mandatory. Psychologic guidance of the patients throughout the preoperative period is important.
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PMID:[Special problems of coronary patient: viewpoint of the anesthesiologist]. 343 Dec 39

The authors summarize their experience with intraaortic balloon counterpulsation (IABC) at the Institute for Clinical and Experimental Medicine between 1978-1984. A total of 756 cardiac surgery procedures were performed for ischaemic heart disease (IHD), and 266 procedures for rheumatic heart disease (RHD). Of patients operated on for IDH, IABC was used in 38 (5%) and, of those undergoing surgery for RHD, in 38 cases (14%). Overall, IABC was employed in 76 patients, i.e., 7%. Ventricular assistance using IABC was successful in 55% of patients. The technique was significantly more successful in IHD (68%) than in RHD (42%) patients. IABC was less successful in IHD patients suffering myocardial infarction intraoperatively. Moreover, the success of IABC depended on its early initiation. Eleven patients (14%) developed complications associated with IABC. The data do not differ from results reported by world's leading centres.
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PMID:Intraaortic balloon counterpulsation. 343 49

Thirty patients suffering from arterial occlusive disease (stages II, III or IV of Fontaine's classification) were treated by isovolaemic haemodilution (IDH). Most of these patients received conventional medical treatment without success (negative selection). Angiography was performed on all patients prior to treatment. 500 ml of whole blood was withdrawn from each patient. 250 ml of dextran 40 mixed with 250 ml of 5% albumin solution was injected intravenously to avoid hypovolaemia. This procedure, carried out three or four times, was repeated until a haematocrit of 0.30 was reached. This haematocrit level of 0.30-0.35 was maintained for 60 days. The measurement of ankle systolic pressure, systolic index at rest, treadmill performance and lower limb thallium-201 muscular scintigraphy were used to assess laboratory efficiency. On the sixtieth day, 14 patients (46%) showed clinical improvement, nine were stable and arterial occlusive disease worsened in seven patients. Clinical improvement persisted for several months (15 months in one case). Clinically, it seemed that patients treated by IHD showed improvement of their arterial occlusive disease. However, the prediction of the chances of success of IHD, as well as the quantification of results by common laboratory examination, were difficult. Muscular scintigraphy with thallium-201 gave a good assessment as well as a quantifiable analysis of results.
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PMID:[Intentional normovolemic hemodilution in the medical treatment of lower limb arteritis]. 377 44

The results of a survey carried out in Marseilles between 1972 and 1979 are reported. A common protocol was used to compare results with two other surveys performed conjointly in Paris and Brussels. The protocol was designed with special emphasis on the psychological factors with respect to the risk factors for ischaemic heart disease (IHD). Seven hundred and eighty six men in a Marseilles administrative department, aged 40 to 60 years (mean age 48.5 +/- 4.5 years) were followed-up for 74 months. Apart from cardiovascular clinical examination with measurement of height, weight, blood pressure and ECG recording, the initial check-up included serum cholesterol, triglycerides and glucose determination and a study of psychological risk factors based on the Bortner's scale for the evaluation of type A profile, and on a questionnaire : the SHEPI for evaluation of the N score (neuroticism). The annual IHD incidence was 9.5% with 4.2% of major events (death or infarction), and 5.3% of minor events (angina pectoris, suggestive ECG changes). Age, tobacco consumption, average systolic blood pressure, serum cholesterol and obesity index were higher in patients who became ill than in those who remained healthy, but overall and separate analysis of major and minor events showed no significant difference apart from age. On the other hand, the study of increased risk according to the level of each of these major factors gave significantly positive results except for the serum glucose level. The correlations between incidence of IDH and the value of each risk factor were not always the same according to the clinical expression (major or minor events). Psychological factors also differed according to the clinical expression of IHD : the Bortner scale was higher in patients developing IHD than in healthy subjects, and higher in those who suffered major events than in those who suffered minor events. On the other hand, the N score was higher in patients with minor events than in those suffering major events. These differences which were not statistically significant in the Marseilles study alone, became significant in the Franco-Belgian cooperative study. The increased risk with the number of associated factors (including psychological) is significant from the association of 2 factors, but only in the fifth decade.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Physical and psychological risk factors of ischemic heart diseases. Apropos of a prospective survey in Marseilles]. 642 24

Although ventricular fibrillation (VF) out-of-hospital cardiac arrest (OHCA) occurs primarily in the setting of severe ischemic heart disease (IHD), a significant proportion of events occurs in patients who do not have severe IHD. The relative effect of IHD on survival after VF OHCA is unknown. All residents of Rochester, Minnesota, who presented with a VF OHCA from November 1990 to December 2004, treated by emergency medical services, were included in the study. During the study, emergency medical services treated 208 patients (64.1 +/- 13.6 years of age) for VF OHCA, with an average call-to-shock time of 6.3 +/- 1.8 minutes. Of these patients, 156 had IHD and 39 had non-IHD. In 13, the underlying heart disease was unknown. Eighty-seven patients (41.8%) survived to hospital discharge with neurologic recovery (66 with IDH [42%] vs 21 with non-IHD [54%], p = 0.211)]. Five-year survival was 79 +/- 6% for patients with IHD versus 100% for those with non-IHD (p = 0.047). After adjustment for other patient characteristics, IHD was not predictive of 5-year survival (hazard ratio [HR] 2.2, 95% confidence interval [CI] 0.7 to 9.8, p = 0.177). Variables associated with poor outcomes included age >65 years (HR 4.9, 95% CI 2.0 to 13.4, p = 0.0003), ejection fraction <0.35% (HR 3.0, 95% CI 1.3 to 7.3, p = 0.012), and hypertension (HR 4.9, 95% CI 1.4 to 16.3, p = 0.001). In patients with IHD, use of an implantable cardioverter-defibrillator (HR 0.32, 95% CI 0.16 to 0.88, p = 0.024) and statin therapy (HR 0.68, 95% CI 0.17 to 0.73, p = 0.001) were associated with decreased mortality. In conclusion, compared with patients with non-IHD, those with IHD had similar short- and long-term survival rates. Long-term survival in patients with IHD was primarily influenced by other co-morbid conditions. Nonetheless, in patients with IHD, use of an implantable cardioverter-defibrillator and statin therapy were associated with higher long-term survival rates.
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PMID:A comparative analysis of short- and long-term outcomes after ventricular fibrillation out-of-hospital cardiac arrest in patients with ischemic and nonischemic heart disease. 1699 62