Course Of Angina Pectoris Research Articles

Wobenzyme: correction of coronary disease yhearts and possiblemechanisms of action

The effect of Wobenzym on hemostasis, rheological properties of blood, and the clinical course of the disease when included in the complex therapy of angina pectoris was studied. It has been established that Wobenzym improves the rheologicalproperties of blood by reducing the aggregation ability of erythrocytes and platelets andincreasing the deform- ability of erythrocyte membranes. Wobenzym helps optimize the activity of the fibrinolytic and coagulation systems of the blood, improves the clinical course of angina pectoris and the quality of life of patients. The use of Wobenzym as part of complex therapy for patients with angina pectoris of functional class II is clinically justified, effective and safe.

The effectiveness of cytoprotection in the treatment of stable angina in patients with arterial hypertension and hyperuricemia, taking into account the peculiarities of the course of coronary artery disease in wartime

The aim of the study is to establish the effectiveness of treatment of severe angina pectoris in patients with hyperuricemia, taking into consideration the peculiarities of the course of coronary artery disease (CAD) in wartime, using ranolazine – a selective inhibitor of the late sodium flow in combined pharmacotherapy.
 Materials and methods. We studied the anti-anginal effect of ranolazine in 14 patients with CAD, stable angina pectoris III-IV functional class (FC), hyperuricemia and arterial hypertension (AH) during 6 months of the 2022 year. The effectiveness of the study drug on the clinical course of angina pectoris was assessed by questionnaire and clinical examination after three months of treatment.
 The results. At the end of the second week of ranolazine use, angina attacks at rest, which were registered before the start of the observation, stopped in all patients with angina pectoris III FC and 50 % with angina pectoris IV FC. In 78.6 %, the number of angina attacks and the use of nitrates decreased by more than 2 times; 21.4 % no longer had angina attacks.
 At the end of the first month, anginal attacks were not observed in all patients with angina pectoris III FC and 50 % with angina pectoris FC IV. In 2 patients with angina pectoris IV FC (50 %), anginal attacks continued to be registered during physical exertion and emotional stress, but no more than once a week. At the same time, there were no angina attacks at rest. The same results were obtained during the survey of patients at the end of three months of observation.
 Conclusions. Ranolazine is an effective component of anti-anginal therapy, significantly affecting the patient's quality of life. Therefore, we can recommend ranolazine for patients with hyperuricemia in angina attacks that persist with insufficient effectiveness of zasic therapy with first-line drugs, especially during military conflicts

Применение кверцетина в липосомальной форме для оптимизации метаболической терапии ишемической болезни сердца

The study of the clinical efficacy and safety of the dietary supplement L-Quercet as part of the complex therapy of patients with coronary artery disease with stable angina of II functional class, taking into account their effect on the clinical course of the disease, exercise tolerance and functional state of the endothelium. It has been shown that the inclusion of L-Quercet in the complex therapy in patients with stable angina leads to an improvement in the clinical course of angina pectoris, allows to significantly increase exercise tolerance and the quality of life of patients. The use of L-Quercet improves the indicators of endothelial function according to the results of the cuff test, which is one of the main factors in the prevention of the development and progression of atherosclerosis and coronary artery disease, and also causes an increase in the effectiveness of antianginal pharmacotherapy

Remote results of myocardial endovascular revascularization in patients with low ejection fraction

Despite the present-day level of the development of cardiac surgery, a low left ventricular ejection fraction (LLVEF) is an important independent predictor of high complication rates and increased in-hospital mortality related to open surgical interventions. The method of myocardial endovascular revascularization is associated with the lowest rates of both intraoperative and early postoperative complications. However, percutaneous coronary intervention (PCI) does not always make it possible to perform anatomically complete myocardial revascularization. Comparisons of the remote results of anatomically complete and incomplete revascularization of the myocardium in the world literature seem to be extremely scarce and ambiguous, with a low ejection fraction in the majority of cases being an exclusion criterion. In order to elucidate these problems we carried out a prospective, single-centre study, including a total of 151 patients suffering from ischaemic heart disease with a left ventricular ejection fraction of less than 35%, who were subjected to myocardial endovascular revascularization. The patients were divided into 2 groups: those with complete (n=87) and incomplete (n=64) revascularization, followed by comparing the alterations in the echocardiographic parameters, assessing the incidence of repeat myocardial revascularization due to a relapse of the clinical course of angina pectoris, and the survival rate in the remote period. The obtained findings were suggestive of efficacy of both complete and incomplete endovascular revascularization of the myocardium in patients with a low left ventricular ejection fraction (LLVEF), with no statistically significant differences between the patients of both groups in the examined parameters revealed.

Stable angina pectoris: choice of therapeutic tactics.

In everyday practice, the basic principles of diagnosis and treatment of stable ischemic heart disease, set out in the clinical recommendations, are often not observed. For successful treatment of angina, first of all, it is necessary to verify the diagnosis. The diagnosis of stable angina pectoris can be considered sufficiently justified, provided the characteristic chest pain and documentary evidence of transient myocardial ischemia by stress tests. The patient should be evaluated as a whole, taking into account all existing diseases, since concomitant diseases can directly or indirectly exacerbate the course of coronary heart disease, and sometimes be the main cause of angina. In such cases, treatment of concomitant diseases has a pronounced positive effect on the course of angina pectoris. It is advisable to assess the magnitude of the coronary reserve, the severity and prevalence of transient myocardial ischemia, its impact on hemodynamics and, based on the analysis of these indicators, to identify patients with high or low risk of myocardial infarction. Revascularization brings a clear prognostic benefit only in subgroups at high risk.

The effect of double dose of omeprazole on the course of angina pectoris and treadmill stress test in patients with coronary artery disease — A randomised, double-blind, placebo controlled, crossover trial

Background Gastroesophageal reflux (GER) and coronary artery disease (CAD) frequently overlap, making the proper diagnosis of chest pain more difficult. GER symptoms may mistake anginal chest pain, and oesophageal acidification may induce myocardial ischaemia both in the rest and in the effort. Increase of oesophageal pH should prevent these conditions. Aim To estimate the effect of double omeprazole dose on the course of angina pectoris and treadmill stress test in patients with coronary artery disease (CAD), using double-blind, crossover randomised, placebo-controlled study design. Methods We studied 48 patients with angina pectoris symptoms and significant narrowing of coronary vessels in angiography. After baseline examination and treadmill stress test all subjects were randomised to treat either with omeprazole (20 mg b.i.d.) or placebo for 14 days, using a double-blind, crossover placebo controlled design. Results Seventeen (35%) subjects reported more than by half decrease in symptoms severity after omeprazole and 6 (12%) after placebo ( p = 0,01). Omeprazole significantly decreased the number of chest pain episodes and number of nitroglycerin doses taken in the second week of both study phases, as well as the percentage of subjects with significant decrease of ST interval during the stress test (64% vs. 73%, p < 0,05). However majority of other stress test parameters (i.e. test duration, DUKE index) have improved both after omeprazole and placebo administration (by 9–38%). Conclusion Double dose of omeprazole significantly decreased symptoms severity in 35% of patients with CAD, as well as frequency of some electrocardiographic signs of myocardial ischaemia during stress test.

Course of angina pectoris after an acute coronary event.

The course of postcoronary angina pectoris was examined in 555 men who had survived a first attack of myocardial infarction or unstable angina. Patients were aged less than 60 and were followed up yearly for up to 17 years. Only 25 (4.5%) had coronary artery bypass surgery. Most patients with angina were treated by nitrates alone. One year after infarction 24.1% of survivors (124/515) reported the presence of angina pectoris, and the proportions at five, 10, and 15 years were 29.9%, 30.4%, and 43.5% respectively. Seventeen years after the initial event 35.3% of the survivors had never reported postcoronary anginal symptoms. The patients who experienced anginal symptoms in the year after their coronary attack had a poorer long term survival than the group who were symptom free over the first year. These patients also had longer subsequent periods with angina, though in 41.7% angina resolved before death after a median of 2.9 years. Throughout follow up mortality during periods in which patients experienced angina was higher than in the symptom free periods. This long term follow up study of patients after a coronary event confirms that the presence or absence of angina may vary considerably over time in patients treated medically and that the presence of angina is associated with a poorer prognosis. These findings have important implications when assessing the effects of various treatment modalities on postcoronary angina, including coronary artery bypass surgery.

Clinical course and symptomatology of angina pectoris in a population study.

The clinical course of angina pectoris was studied in a follow-up study of 427 patients with angina from a general population sample. The subjects were men aged 56-65 years at the time of follow-up. After a mean follow-up time of 5.8 years, 55% were still suffering from angina pectoris, 15% had died and a further 19% were either free from chest pain or had chest pain considered to be of different origin. In the group with definite angina pectoris at follow-up (n = 236), 29% had sustained a myocardial infarction, 23% had symptoms of intermittent claudication, 36% were treated for hypertension and 15% had diabetes. Many of the angina patients suffered from other chest conditions in addition to anginal symptoms. Most of the patients (56%) had infrequent attacks (a few times per month or less often) and were not severely incapacitated by their symptoms. Only one fifth worked full time compared with more than half of those in the same age groups in the general population. Only 16 of those interviewed had undergone bypass surgery and a further 16 had disabling angina but, for various reasons, they had not been operated on. The implications are that most angina patients do well on pharmacological treatment alone even though they are limited socially as well as physically. Precipitating factors other than physical activity were also investigated and associations were found between susceptibility to cold, early morning angina, angina at rest and attacks of long duration, possibly indicating a mechanism of vasospasm superimposed on a fixed stenosis.

Studies on Clinical Prediction of Myocardial Infarction

Myocardial infarction frequently occurs suddenly, and the prediction of its onset is said to be difficult. However, concept of coronary risk factors have drawn attention through epidemiological studies on ischemic heart disease. Since anginal pain is frequently experienced prior to the attack of myocardial infarction, pursuit of coronary risk factors and angina pectoris makes prediction of myocardial infarction possible to Results and Discussion some extent. Materials and Methods In 11, 188 cases of ambulant and hospitalized patients and subjects admitted for examination, follow-up studies by questionaires and direct examination were carried out. Prognosis was established in 3, 851 cases. 2621 cases of these after exclusion of young subjests below the age of 30 and insufficiently examined subjects, and 110 cases observed from pre-attack period in other institutions, a total of 2, 731 cases, were employed in this study. They were subdivided in following three groups: group of 265 cases of myocardial infarction (MI) (208 males and 57 females), group of 215 cases of angina pectoris (AP) (132 males and 83 females) and group of 2, 251 cases of control subjects (CS) (1 .253 males and 998 females). In MI group, 165 cases (132 males and 33 females) had experienced anginal attack prior to (MIA), AP group consisted of the patients of angina pectoris without subsequent development of myocardial infarction for at least one year of follow-up period. Coronary risk factors were compared among MI group, AP group and CS group. Moreover, these factors and clinical course of angina pectoris were also compared between AP group and MIA group. There were little difference in average age among these groups.

Stimulation of inter-arterial coronary anastomoses by experimental acute coronary occlusion.

"Hence it sometimes happens that, when the lumen of some artery has been too long obstructed or ligated, the blood busies itself in opening a wider channel for its passage in this vessel, must drive and buffet all the more into the next ones, until it has considerably dilated them to give itself room." The development of interarterial coronary anastomoses may exert a profound influence on the clinical course of angina pectoris, coronary failure, and acute myocardial infarction. Earlier studies have shown that marked narrowing of a coronary artery produces rich intercoronary anastomotic communications. The present study is designed to determine whether acute occlusion of a coronary artery in a previously normal heart also leads to the development of a collateral circulation and what length of time is necessary to establish such a collateral circulation.

An evaluation of the effect of choline and inositol on the clinical course and serum lipids in patients with angina pectoris.

Article1 March 1955AN EVALUATION OF THE EFFECT OF CHOLINE AND INOSITOL ON THE CLINICAL COURSE AND SERUM LIPIDS IN PATIENTS WITH ANGINA PECTORISRAYMOND S. JACKSON, M.D., CHAS. F. WILKINSON JR., M.D., F.A.C.P., LAWRENCE MEYERS, M.D., F.A.C.P., MICHAEL S. BRUNO, M.D., MARTIN R. BENJAMIN, M.D.RAYMOND S. JACKSON, M.D.Search for more papers by this author, CHAS. F. WILKINSON JR., M.D., F.A.C.P.Search for more papers by this author, LAWRENCE MEYERS, M.D., F.A.C.P.Search for more papers by this author, MICHAEL S. BRUNO, M.D.Search for more papers by this author, MARTIN R. BENJAMIN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-42-3-583 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe question of whether lipotropic agents might have an effect upon atherosclerosis has been the basis for a number of studies in animals and in man. Clinical investigations have followed along two general lines. Attempts at direct therapeutic evaluation have depended upon the administration of a test substance to patients who have recovered from a myocardial infarction, comparing their course with that of an untreated group of coronary survivors. Strict comparability of methods of managing the basic disease and all concomitant diseases in both the treated and control groups is a necessary part of such a clinical test.The alternate,...Bibliography1. Davidson JD: Diet and lipotropic agents in arteriosclerosis, Am. J. Med. 11: 736, 1951. CrossrefMedlineGoogle Scholar2. ZollWesslerBlumgart PMSHL: Angina pectoris. A clinical and pathologic correlation, Am. J. Med. 11: 331, 1951. CrossrefMedlineGoogle Scholar3. GreinerGoldMcKeenTravellBakstRinzlerBenjaminWarshawBobbKwittModellRothendlerMesseloffKramer THKJHSHZHLJALNIWHHCRML: A method for the evaluation of the effects of drugs on cardiac pain in patients with angina of effort, Am. J. Med. 9: 143, 1950. CrossrefMedlineGoogle Scholar4. Sperry WM: The Schoenheimer-Sperry method for determination of cholesterol, Rev. Ed., 1945, Department of Biochemistry, Psychiatric Institute, New York. Google Scholar5. SimonsenWertmanWestoverMehl DGMLMJW: The determination of serum phosphate by the molybdivanadate method, J. Biol. Chem. 166: 747, 1946. CrossrefMedlineGoogle Scholar6. JacksonWilkinson RSCF: The ratio between phospholipid and the cholesterols in plasma as an index of human atherosclerosis, Ann. Int. Med. 37: 1162, 1952. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: *Presented as a Morning Lecture at the Thirty-fifth Annual Session of the American College of Physicians, Chicago, Illinois, April 8, 1954.From the Department of Medicine, Post Graduate Medical School, New York University, and the Fourth Medical (N.Y.U.) Division, Bellevue Hospital, New York.Funds for this study were furnished in part by the Wyeth Laboratories and the Lillia Babbit Hyde Foundation.†Lillia Babbit Hyde Research Fellow.The Wychol and the placebo were furnished by the Wyeth Laboratories. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited bySerum Lipids in Patients with Senile Macular Degeneration* *From the Department of Medicine, West Virginia University School of Medicine, and the Section of Ophthalmology, Yale University School of Medicine. This study was supported (in part) by grant H-6714(Cl) from the National Heart Institute. This work was performed during tenure (M. J. A.) of an established investigatorship of the American Heart Association.Research in Russia on Vitamins and AtherosclerosisStudies on the Effect of a Low Lipid Diet and Lipotropic Agents in Cerebral AtherosclerosisEFFECTS OF LIPOTROPES AND SITOSTEROL ON THE LEVEL OF BLOOD LIPIDS AND THE CLINICAL COURSE OF ANGINA PECTORIS† 1 March 1955Volume 42, Issue 3Page: 583-594KeywordsAnginaAtherosclerosisGraduate medical educationHospital medicineLipidsMyocardial infarctionPatients Issue Published: 1 March 1955 PDF downloadLoading ...