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At least 739 records · Page 41Linked to original sources
PubMed1985

[Early detection of diseases of the circulatory system in vocational school students with particular reference to the prevention of coronary disease and arterial hypertension].

A group of 201 boys of vocational schools living in an area of developing industry (Bełchatów) and another area of developed industry (Lódź) were examined twice: at the age of 16-17 (I examination) and 14-18 months later (II examination). Incomplete right bundle-branch block and intraventricular conduction impairment have been demonstrated mainly in the resting ECG tracings (Table I). The risk factors of coronary heart disease were increasing with age, especially in boys of Bełchatów area (Table II). Five boys with risk factors of coronary heart disease exhibited ischaemic type of postexertional ST segment changes (Table III).

Adolescent↗
PubMed1998

Improvement of reversible ischemia in severe post-transplantation coronary artery disease.

Coronary artery disease is a major cause of morbidity and mortality in patients who have undergone heart transplantation. Patients are often asymptomatic during the onset of the disease, and managing the disease is difficult. This report describes the case of a patient with post-transplantation coronary artery disease who, despite the severe, progressive appearance of the disease on angiographic examination, showed evidence of autorevascularization and collateralization.

Cardiac Catheterization↗
PubMed2005

Relations between plasma asymmetric dimethylarginine (ADMA) and risk factors for coronary disease.

BACKGROUND: Elevated plasma levels of asymmetric dimethylarginine (ADMA), an endogenous inhibitor of nitric oxide production, are reported to be associated with coronary artery disease (CAD). METHODS: We measured plasma levels of ADMA and related compounds, nitrate+nitrite (NO(x)), total homocysteine (tHCY) and assessed renal function and lipid profiles in 145 patients--75 with triple vessel coronary disease and 70 with no detectable coronary disease. RESULTS: Levels of ADMA, l-arginine, l-arginine/ADMA and plasma NO(x) were not different in the two groups but smokers with triple vessel disease had higher ADMA and lower NO(x) levels than the non-smokers, relationships also present for all smokers and non-smokers in the two groups combined. In all 145 patients ADMA, symmetric dimethylarginine (SDMA) and tHCY levels were significantly higher in patients with glomerular filtration rate (GFR) <81 mL/min/1.73 m(2) than in patients with GFR> or =81 mL/min/1.73 m(2). There was a modest positive correlation between tHCY and ADMA and both were strongly correlated with SDMA which is excreted by the kidney. ADMA, SDMA and tHCY were negatively correlated with GFR. CONCLUSIONS: We suggest that the reported ADMA increases in CAD patients are due to an associated reduction in renal function and to smoking habit.

Adult↗
PubMedDate not supplied

An open-label trial of interpersonal psychotherapy in depressed patients with coronary disease.

High rates of depression have been reported in patients with coronary artery disease, and depression has been repeatedly shown to adversely affect cardiac morbidity and mortality. Despite these findings, little work has been devoted to evaluating effective antidepressant treatments for this subpopulation. This open-label trial assessed the efficacy and acceptability of interpersonal psychotherapy in depressed patients with stable coronary artery disease. Seventeen patients with coronary artery disease who met DSM-IV criteria for major depression received 12 weekly sessions of interpersonal psychotherapy. Outcome was assessed with the 17-item Hamilton Depression Rating Scale and the Beck Depression Inventory II. Ten patients received medication during the trial, and seven patients received interpersonal psychotherapy alone. The patients showed a significant reduction in scores on both the Hamilton depression scale and the Beck Depression Inventory II from baseline, with 53% of the patients meeting criteria for remission, as defined by scores of < or =7 and < or =14 on the Hamilton depression scale and the Beck Depression Inventory II, respectively. Medicated and unmedicated patients responded similarly to interpersonal psychotherapy. These data provide support for the potential use of interpersonal psychotherapy in depressed patients with coronary artery disease. The therapy was well tolerated and accepted by patients, with a high proportion achieving remission. Future randomized clinical trials are needed to establish its efficacy.

Adult↗
PubMed2004

Effect of gemfibrozil on change in renal function in men with moderate chronic renal insufficiency and coronary disease.

BACKGROUND: Limited data suggest that low levels of serum high-density lipoprotein cholesterol (HDL-C) and high levels of triglyceride-rich lipoproteins may be associated with more rapid rates of kidney function loss in individuals with chronic renal insufficiency (CRI). Although fibric acid derivatives increase serum HDL-C levels and decrease triglyceride levels, their effects on renal function are largely unknown. We conducted this study to determine whether gemfibrozil reduced rates of renal function loss in people with moderate CRI. METHODS: This was a post hoc subgroup analysis in the Veterans Affairs High-Density Lipoprotein Intervention Trial, a randomized double-blind trial of gemfibrozil versus placebo in 2,531 men with coronary disease, HDL-C levels of 40 mg/dL or less (< or =1.0 mmol/L), low-density lipoprotein cholesterol levels of 140 mg/dL or less (< or =3.6 mmol/L), and a range of triglyceride values. Moderate CRI is defined as estimated glomerular filtration rate (GFR) of 30 to 59.9 mL/min/1.73 m2 at baseline. Multivariate regression was used to calculate rates of decline in estimated GFR for individuals administered gemfibrozil or placebo, controlling for prospectively determined potential confounders. RESULTS: Change in renal function could be calculated in 1,981 individuals, of whom 399 individuals (20.2%) were eligible for inclusion. Among 399 study subjects, the rate of change in renal function in the gemfibrozil group during a median of 61 months was not significantly different from that in the placebo group (0.49 mL/min/1.73 m2/y faster; 95% confidence interval, 0.09 slower to 1.09 faster; P = 0.10). No clinically relevant effect of gemfibrozil on renal function was observed in groups defined by baseline lipid levels, kidney function, diabetic status, or other components of the metabolic syndrome. The incidence of transient (10% versus 4%; P = 0.01), but not sustained (9% versus 4%; P = 0.07), increases in serum creatinine levels of 0.5 mg/dL or greater (> or =44 micromol/L) was significantly greater in the gemfibrozil group. However, in 5 subjects with acute increases in serum creatinine levels, serum creatine kinase levels were significantly elevated as well, suggesting that myocyte toxicity may have been responsible. Even when these individuals were excluded, no clinically significant effect of gemfibrozil on kidney function was observed. CONCLUSION: Gemfibrozil does not appear to exert a clinically relevant effect on rates of kidney function loss in individuals with moderate CRI, low HDL-C levels, and concomitant coronary disease.

Aged↗
PubMed1981

[Clamping of the thoracic aorta in a hypertensive patient with coronary disease. An indication of sodium nitroprusside (author's transl)].

In patients with cardiac failure, coronary disease or arterial hypertension, clamping of the aorta results in increased filling pressure of the left ventricle which may produce or increase subendocardial ischaemia with consequent aggravation of the ventricular insufficiency. And the higher the clamping the greater the risk. This vicious circle can be broken by sodium nitroprusside, which has potent and reversible vasodilator properties. The drug is indicated whenever the left ventricular filling pressure rises above 5 mmHg. These considerations are illustrated by the descriptions of a case where sodium nitroprusside ensured blood circulation in the lower limbs and intra-abdominal organs after clamping of the aorta above the coeliac artery in a high risk cardiac patient.

Aorta, Thoracic↗
PubMed1993

[Effect of treatment with indobufen on blood viscosity indices and exercise tolerance in patients with coronary disease].

The study included 20 patients aged from 50 to 65 years with stable coronary disease. In all patients exercise ECG test in Quinton moving track was performed before the treatment, and after one, three, and eight weeks of therapy. Besides that, before the treatment, and after each exercise, platelet aggregation, viscosity of whole blood and plasma, and filtration time of 1 ml of whole blood were evaluated. It was found that already after one week of treatment indobufen caused a decrease of platelet aggregation, reduction of viscosity of whole blood and plasma, and improvement of erythrocyte compliance which favourable effects increased with the continuation of the therapy up to eight weeks. At the same time as a result of eight weeks of treatment a significant improvement was achieved of exercise tolerance in the treated patients.

Adult↗
PubMed1991

Cholesterol and coronary disease--outstanding questions.

Established facts include the role of raised blood cholesterol in causing coronary atheroma and that a high dietary intake of saturated fat is a leading cause of coronary disease. It is also clear that reduction of hypercholesterolaemia in middle-aged males reduces CHD incidence, mostly that of non-fatal myocardial infarction. But there are many unresolved questions which should lead to a selective and moderate approach to the management of hypercholesterolaemia. These include lack of the exact knowledge of how raised cholesterol levels lead to atheroma; equivocal evidence of whether reduction of hypercholesterolaemia causes regression of atheroma; uncertainty about how far cholesterol levels can safely be reduced and whether the cost-benefit always justifies action; the fact that reduction of hypercholesterolaemia does not reduce total mortality and may increase non-cardiac mortality; and insufficient evidence as to whether the same policies for middle-aged men should be adopted for woman, the elderly and adolescents.

Adolescent↗
PubMed1995

Dental management of patients with coronary artery disease.

Coronary artery disease is common in the general population. Dentists must be prepared to treat patients with coronary artery disease in the safest possible manner. This article reviews the dental management of such patients. Specific attention is devoted to medical history, treatment planning, treatment modifications and appropriate measures to be taken in the event of an emergency.

Adult↗
PubMed1987

Evaluation of diseased coronary arterial branches by polar representations of thallium-201 rotational myocardial imaging.

The perfusion territories in polar representations of stress Tl-201 rotational myocardial imaging in patients with angina pectoris who had one diseased coronary segment were analyzed. The lesions proximal or distal to the first major septal perforator in left anterior descending arteries were detected by the presence or absence of defects at the base of the anterior septum. Right coronary artery lesions were detected by the presence of defects at the basal posterior septum, in contrast to the preservation of myocardial uptake at this portion in lesions of the left circumflex artery. The specific defect patterns were detected in cases with lesions at the first diagonal, obtuse marginal, and posterolateral branches. Recognition of these defects in the polar maps allows detailed detection of diseased coronary arterial branches.

Adult↗
PubMed1999

Coronary heart disease is a multifactorial disease.

Coronary heart disease (CHD) is the leading cause of death in the Western World. For effective treatment and prevention strategies to be put in place, the major risk factors associated with this disease must be identified. Data show that almost 300 variables are statistically associated with CHD. However, evidence suggests that the vast majority of coronary events can be explained on the basis of blood pressure, lipids, smoking, and diabetes. Laboratory, experimental, and epidemiologic data identify dyslipidemia as a pivotal CHD risk factor, in the absence of which other risk factors cease to produce any important increase in absolute risk of events. For example, in populations with relatively low levels of low-density lipoprotein cholesterol, such as China and Japan, the incidence of CHD remains low even when smoking and hypertension are highly prevalent. Observational data have clearly established that CHD risk factors tend to cluster in individuals. The impact of coexisting risk factors is greater than additive, and indeed is usually multiplicative. The implications of such an interactive effect are that relatively normal levels of two or more risk factors in coexistence may have a profound impact on risk. Despite these findings, in the past most treatment algorithms have viewed risk factors separately and have recommended discrete treatment targets. More recent guidelines have taken a broader view and provide simple, yet accurate, methods of evaluating absolute risk based on the consideration of several risk factors. Coronary heart disease is clearly a multifactorial disease with risk factors that tend to cluster and interact in an individual to determine the level of coronary risk. The current trend towards a more holistic approach in CHD risk evaluation and preventive management appears logical based on evidence from animal-experimental, observational, and clinical trial evidence.

Animals↗
PubMed1989

Failure of dipyridamole-thallium myocardial imaging to detect severe coronary disease.

Three patients referred for peripheral vascular surgery who died of coronary artery disease complications despite normal dipyridamole-thallium scans are discussed. Although recent literature has shown enthusiasm for this test in this clinical setting, the dipyridamole-thallium scans are not absolute and patients remain at risk for major coronary artery events. Careful clinical screening and awareness of the signs of left main coronary disease on thallium images are important in the evaluation of these patients.

Adult↗
PubMed1986

Angiotensin-converting enzyme and coronary haemodynamics in coronary artery disease.

Coronary sinus pacing was performed in 12 patients with and 12 patients without significant coronary artery disease as verified by angiography in order to elucidate a possible link between cardiac exchange of angiotensin-converting enzyme and the coronary circulation. The coronary sinus and arterial blood enzyme activity remained unchanged and were similar in the two groups, both at rest and during pacing, and the activity was not related to pacing-induced changes in oxygen consumption or coronary vascular resistance. Therefore it does not seem that global cardiac formation or depletion of angiotensin-converting enzyme is of regulatory importance in the coronary vascular bed in patients with and without coronary artery disease under these circumstances.

Adult↗
PubMed2004

Microvascular dysfunction in angiographically normal or mildly diseased coronary arteries predicts adverse cardiovascular long-term outcome.

OBJECTIVE: To study the role of coronary flow reserve for the prediction of long-term cardiovascular event rate. DESIGN: Observational, longitudinal. SETTING: Single-center, coronary vasomotor testing at university hospital. PARTICIPANTS: One hundred and twenty patients with angiographically normal or minimally diseased coronary vessel. METHODS: Coronary flow reserve was assessed by intracoronary Doppler and quantitative coronary angiography. Cardiovascular events during follow-up (6.5+/-3 years, range 14-125 months) were defined as sudden death, myocardial infarction, unstable angina, ischemic stroke or the need for revascularization by percutaneous transluminal coronary angioplasty or coronary as well as peripheral bypass surgery. RESULTS: Reduced coronary flow reserve was significantly associated with a poor long-term outcome: cardiovascular events occurred in seven (18%) patients in the lowest tertile of coronary flow reserve compared with four patients in the middle tertile (10%) and two patients in the upper tertile (5%) (P=0.019 by Kaplan-Meier analysis). The multivariate Cox proportional hazard model revealed coronary flow reserve as an independent predictor of prognosis (P=0.017) in addition to angiographic evidence of atherosclerosis (P=0.047) and arterial hypertension (P=0.013). CONCLUSIONS: Coronary flow reserve in normal to mildly diseased arteries is an independent predictor of long-term prognosis of atherosclerosis within the next decade.

Adult↗
PubMed1994

Impact of intensive lipid modulation on angiographically defined coronary disease: clinical implications.

We reviewed all randomized, controlled angiographic trials to assess the impact of intensive lipid modulation on the progression or regression of angiographically defined coronary disease. Five of seven trials satisfied selection criteria: Cholesterol-Lowering Atherosclerosis Study, Program on the Surgical Control of the Hyperlipidemias, Familial Atherosclerosis Treatment Study, Regression of Coronary Atherosclerosis During Treatment of Familial Hypercholesterolemia, and St. Thomas' Atherosclerosis Regression Study. We compared patient selection, baseline and on-trial lipid values, changes in angiographic disease scores, and clinical outcomes. In all five trials, treatment reduced levels of low-density lipoprotein (LDL) cholesterol substantially (range -32% to -46%). Treatment reduced risk of angiographic progression by almost 50% compared to controls. Furthermore, nearly one third of drug-treated patients showed angiographic regression of disease. Regression correlated well with reduction in LDL cholesterol. Although overall improvement in stenosis was modest, reduction in clinical events was impressive. Intensive lipid modulation may "stabilize" existing lesions, making them less "active" (ie, less prone to rupture or thrombosis), thereby reducing risk of acute coronary syndromes. These studies clearly support intensive lipid modulation in patients with established coronary disease.

Angiography↗