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PubMed · 15182025

[Angina].

Abstract

The medical history is the cornerstone of the diagnosis of chest pain. In presence of angina like symptoms, the diagnosis of coronary artery disease must be assertained by rest and exercise ECG, eventually coupled with a stress echo or scintigraphy. Coronary angiography remains the ultimate diagnostic procedure despite recent advances in CT scan or MRI technologies. Beside symptomatic treatment aiming to reduce metabolic demand by medication or to improve revascularisation by surgery or percutaneous intervention, the actual therapeutic approach involves therapies aiming to stop atherosclerosis such as strict correction of coronary risk factors, use of statines, ACE inhibitors and antiplatelet agents.

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BibTeXRIS

V Legrand. 2004. [Angina].. https://pubmed.ncbi.nlm.nih.gov/15182025/

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Effect of a hypoglycemic agent on ischemic preconditioning in patients with type 2 diabetes and stable angina pectoris.

OBJECTIVE: Ischemic preconditioning is an increased tolerance to myocardial ischemia during the second of two consecutive exercise tests. ATP-sensitive K(+) channel blockers, such as glinides and sulfonylurea drugs, can induce loss of ischemic preconditioning. This study aimed to investigate the effects of repaglinide, a hypoglycemic agent with an affinity for myocardial ATP-sensitive K (+)channels, on the results of consecutive exercise tests in patients with diabetes and multivessel coronary artery disease. METHODS: Forty-two patients with type 2 diabetes and chronic stable angina pectoris, and two-vessel or three-vessel disease participated in this study. The patients underwent two consecutive treadmill exercise tests (phase 1). On the day after these exercise tests, 2 mg of oral repaglinide was given to the patients. One week later, two exercise tests were repeated consecutively (phase 2). RESULTS: All patients achieved 1.0-mm ST-segment depression during the four exercise tests (T1, T2, T3, and T4). In phase 2, seven patients improved in time to onset of 1.0-mm ST-segment depression. The worsening of the time to onset of 1.0-mm ST-segment depression in phase 2 demonstrated ischemic preconditioning block in 83.3% of patients (P=0.0001). Even the postexercise electrocardiographic parameters (ST-segment depression morphology and magnitude and arrhythmias) were significantly different between the groups with and without pharmacologic ischemic preconditioning block (P=0.031). CONCLUSIONS: Repaglinide, an oral hypoglycemic agent with ATP-sensitive K(+) channel-blocker activity, eliminated the myocardial ischemic preconditioning in patients with coronary disease and diabetes.

Angina Pectoris↗