We investigated, in a prospective study of 1,007 patients who underwent coronary angiography for suspected coronary artery disease (CAD), the association of obstructive CAD with severe or moderate decrease in glomerular filtration rate (GFR) calculated from the Modification of Diet in Renal Disease equation. Baseline characteristics were similar in patients ...

Preoperative identification of significant coronary artery disease (CAD) in patients prior to valve surgery requires systematic invasive coronary angiography. The purpose of this current prospective study was to evaluate whether exclusion of CAD by multi-detector CT (MDCT) might potentially avoid systematic cardiac catheterization in these patients. Eighty-two patients (53 males, ...

BACKGROUND: As an endogenous inhibitor of nitric oxide production, asymmetric dimethylarginine (ADMA) is reported to be associated with coronary artery disease (CAD). METHODS: We measured plasma levels of ADMA, nitrate + nitrite (NOx), total homocysteine (tHCY), and renal function in 106 people with angiographic evidence of coronary artery disease (CAD), ...

AIMS: We sought to evaluate the effects of trimetazidine on ischemia induced by dobutamine-atropine stress echocardiography in patients with class I or class II angina. METHODS: In a randomized, double-blind, placebo-controlled study, 66 patients with proved coronary disease were subjected to dobutamine-atropine stress echocardiography. Ischemia was proved in 56 patients ...

OBJECTIVE: In this study we aimed to examine the angiographic findings, traditional risk factors and natural history of Turkish patients <40 and >or=40 years old with coronary heart disease (CHD). METHODS: The records of 491 patients with stable angina pectoris or acute coronary syndrome (ACS), who had undergone coronary angiography ...

OBJECTIVE: Thrombosis caused by disrupted yellow plaque is regarded as a cause of acute myocardial infarction (MI). However, it has not been clarified if young patients have the same pathophysiology as older ones. Therefore, we elucidated clinical and angioscopic characteristics of young patients. METHODS: Among a series of patients (n ...

BACKGROUND: According to most current guidelines, stable angina pectoris patients with a high probability of having coronary artery disease can be reliably identified clinically. OBJECTIVES: To examine the reliability of clinical evaluation with or without an at-rest electrocardiogram (ECG) in patients with a high probability of coronary artery disease. PATIENTS ...

We assessed heart rate variability (HRV) and high-sensitivity C-reactive protein (CRP) serum levels in 77 patients with chronic stable angina (CSA), 47 of whom had obstructive coronary artery disease (CAD) and 30 normal or near-normal coronary arteries (NCA). The effect of percutaneous coronary interventions (PCI) and bypass surgery (CABG) on ...

OBJECTIVES: The purpose of this study was to investigate the possible correlation between morphologic and functional characteristics of culprit lesions (CL) in patients with acute coronary syndromes (ACS) and chronic stable angina (CSA). BACKGROUND: Intravascular ultrasound (IVUS) provides morphologic assessment and intracoronary thermography (ICT) evaluates the local inflammatory activation of ...

We examined body mass index (BMI) in kilograms divided by height in meters squared in 842 patients who underwent coronary angiography for suspected coronary artery disease (CAD) in a 2-month period in 2000 at Baylor University Medical Center. Comparison of the BMI in the 624 patients in whom > or ...

BACKGROUND: Higher rates of clinical and angiographic restenosis have been reported after coronary stenting in patients with significant chronic kidney disease (CKD). Whether drug-eluting stents (DES) can reduce long-term clinical events in CKD patients compared with bare metal stents (BMS) has not been established. METHODS: The study enrolled 104 consecutive ...

AIMS: Information on the clinical outcome of patients with diabetes with silent myocardial ischaemia is limited. We compared the clinical and angiographic characteristics, and the clinical outcomes of diabetic patients with asymptomatic or symptomatic coronary artery disease (CAD). METHODS: Three hundred and ten consecutive diabetic patients with CAD were divided ...

BACKGROUND: We aimed at investigating serum adiponectin in patients with the metabolic syndrome (MetS), in patients with angiographically diagnosed coronary artery disease (CAD), and in patients who had both, the MetS and CAD. METHODS: We enrolled 687 consecutive patients undergoing coronary angiography for the evaluation of CAD. RESULTS: From our ...

Several matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) have been implicated in the development and outcome of coronary artery disease (CAD). We investigated whether MMP-12 and TIMP-1 levels were associated with risk, severity, and outcome of CAD. Plasma MMP-12 and TIMP-1 levels are measured in 50 and 44 ...

OBJECTIVE: To compare clinical outcomes and glycoprotein IIb-IIIa inhibitor use in patients undergoing percutaneous coronary intervention (PCI) who received bivalirudin or unfractionated heparin (UFH) in a real-world setting. DESIGN: Retrospective cohort analysis. SETTING: University-affiliated medical center. PATIENTS: One thousand seventy-five adult patients who underwent PCI and received either bivalirudin (539 ...

AIM: This study was designed to determine whether therapy with a diuretic has antianginal effects in patients with stable angina who are already treated with a traditional antianginal regimen. METHODS AND RESULTS: Forty patients with chronic stable angina and normal left ventricular function were randomized in a double-blind, placebo-controlled study. ...

AIMS: The aim of this retrospective study was to assess the feasibility of catheter-based interventions in two different vascular beds performed in a single stage in patients with vascular multimorbidity. METHODS AND RESULTS: Fifty patients, 28 males, mean age 68.6 (+/- 9.2) years and 22 females, mean ages 72.2 (+/- ...

BACKGROUND: Reduced left ventricular ejection fraction (LVEF) is a risk factor for poor outcomes in patients with coronary artery disease (CAD). Mental stress-induced myocardial ischemia (MSIMI) also identifies a subset of CAD patients at increased risk for future cardiovascular events. Susceptibility to MSIMI in patients with CAD and reduced LVEF ...

INTRODUCTION: Recently it has been demonstrated that enhanced external counterpulsation (EECP) could improve erectile dysfunction (ED) in patients with refractory ischemic heart disease (IHD). AIM: To assess the effect of risk factors on the efficacy and the satisfaction rate of EECP in patients with coronary artery disease (CAD)-associated ED. MAIN ...

AIM: The aim of this study is to evaluate the influence of coronary artery bypass graft (CABG) on physical activity (PA) one year postoperative and the influence of the preoperative level of PA on the postoperative PA level. METHODS: In 428 patients, mean age 64.1+/-9.2 (30-84), undergoing an isolated CABG ...

The development of dynamic left ventricular outflow tract (LVOT) obstruction (DLVOTO) during effort in patients without hypertrophic cardiomyopathy has been described only a few times and its clinical significance has not been established. This study was undertaken to determine DLVOTO during exercise in patients with angina and normal coronary arteries, ...

BACKGROUND: The effectiveness of stress single photon emission computed tomography (SPECT) as a gatekeeper for coronary angiography has not been extensively investigated. The characteristics of patients referred for early angiography after a normal stress SPECT study have not been described. METHODS AND RESULTS: Over a 10-year period, 14,273 patients without ...

BACKGROUND: Inflammation is one of the key mechanism in the development and progression of coronary artery disease. Myocardial bridging (MB) increases the tendency for development of atherosclerosis. The role of inflammation on the development of atherosclerosis in the MB is not clear. In this study, we investigated the existence of ...

BACKGROUND: Despite their proven beneficial effects and inclusion in the guidelines, glycoprotein (GP) IIb/IIIA blockers are underused in daily practice in patients with non ST-segment elevation acute coronary syndrome (NSTE ACS). This study combines the data from two randomized controlled trials, comparing routine upstream versus selective down stream use of ...

The level of circulating stromal progenitor cells carrying osteonectin (ON), a marker of osteogenic differentiation, was evaluated by flow cytometry in blood of patients with coronary artery disease (CAD). Ninety-nine patients with CAD were included into the study. Coronary angiography of all patients showed critical stenosis of at least 2 ...

C-reactive protein (CRP) plasma levels increase in patients with acute coronary syndrome (ACS). The role and implications of increased plasma concentrations of other acute phase proteins (APPs), such as alpha-1-antitrypsin (A1AT), alpha-1 glycoprotein (A1GP), haptoglobin (HG), ceruloplasmin (CP), and C3c and C4 complement fraction, in patients with ACS are still ...

AIM: To investigate whether the increasing CD40-CD40 ligand system is related to restenosis in patients after percutaneous coronary intervention (PCI). METHODS: Twenty normal controls and 120 patients with PCI were investigated. The expression of CD40 and the CD40 ligand (CD40L) on platelets was analyzed by indirectimmunofluorescence flow cytometry. The serum ...

OBJECTIVE: To investigate the association between chronic exposure to second hand smoke (SHS) and the short-term prognosis of patients hospitalised with acute coronary syndromes. METHODS: Between 1 October 2003 and 30 September 2004, 2172 consecutive patients enrolled with acute coronary syndromes at the cardiology clinics or the emergency units of ...

Aspirin resistance may increase the risk of major adverse cardiac events (MACE) more than threefold in patients with stable coronary artery disease (CAD). This study aimed to determine the prevalence of aspirin resistance in patients with stable CAD, the role of aspirin resistance on outcome in the follow-up, and the ...

AIM: The relationships between clinical events and acetylsalicylic acid resistance (AR), as well as its frequency, have been established in stable patients with coronary artery disease (CAD). Although acute coronary syndrome (ACS) patients taking acetylsalicylic acid have been accepted as a high-risk population, the role of AR has not been ...

Complementary and alternative medicine (CAM) use is common in patients with cardiovascular disease. Although numerous efforts have sought to understand CAM types and the prevalence of CAM, whether patients preferentially use CAM instead of evidence-based therapies is unknown. Self-reported use of CAM and evidence-based therapies in a prospective registry of ...

BACKGROUND: Among patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI), those with multivessel disease have worse prognosis, mainly due to a higher frequency of cardiogenic shock (CS) at admission. The aim of this study was to identify clinical and angiographic characteristics of patients with ...

The usefulness of 64-slice multidetector coronary computed tomography (MDCT) in a diagnostic triage of 100 consecutive patients (age 55.8+/-11.6 years; 57% men) with chest pain suspected to be ischemic in origin and a negative or nondiagnostic exercise treadmill test (ETT) result was examined. None of the patients had previously known ...

Ischemic preconditioning may provide a systemic organ protection, evident as the phenomenon known as remote preconditioning. Unstable angina may be a clinical analogue to ischemic preconditioning. Vein graft harvesting induces inflammation of the graft wall. We hypothesized that preoperative unstable angina preconditions vein grafts and reduces the inflammatory response to ...

BACKGROUND: Several reports have suggested a possible link between bronchial asthma and coronary spasm, but the possibility of a relationship in coronary spastic angina (CSA) has not been clarified. METHODS AND RESULTS: Airway responsiveness to methacholine and coronary spasticity to acetylcholine were examined in 42 patients with CSA and 36 ...

Angiography of patients with typical chest pain reveals normal epicardial coronary arteries in about 20%. Coronary flow reserve (CFR) determination is an elaborate, but helpful, task, as only the evidence of microvascular disease enables appropriate therapy. We prospectively evaluated the incidence of a dysfunctional microcirculation and searched for predictive parameters ...

Negative T waves in precordial leads are often seen in patients with acute coronary syndrome (ACS), but also occur in those with acute pulmonary embolism (APE). However, little attention has been given to differences in negative T waves between patients with these 2 diseases. The present study examines the value ...

BACKGROUND: Mechanisms of instability in patients affected by unstable angina and who exhibit low levels of C-reactive protein (CRP) on admission are unclear. We compared levels of markers of thrombin generation [thrombin-antithrombin complexes (TAT), of fibrinolysis [plasmin-antiplasmin complexes (PAP)], and angiographic severity and extent of coronary atherosclerosis in patients with ...

This study investigated the feasibility of high-risk percutaneous coronary intervention (PCI) in hemodynamically unstable patients supported by modified cardiopulmonary bypass (extracorporeal life support [ELS]). Over a 38-month period, 15 patients (10 men, 5 women, mean age 72 +/- 9 years, mean ejection fraction 34 +/- 15%, angina pectoris New York ...

The authors sought to investigate whether an increase or decrease of hemoglobin (Hgb) and hematocrit (Hct) levels were a predictor of occurrence of acute coronary syndrome. This retrospective case-control study included 594 myocardial infarction (MI) patients, 596 unstable angina patients, and 590 controls who were hospitalized from 1994 to 2005. ...

OBJECTIVE: Coronary artery disease (CAD) is prevalent in patients with type 2 diabetes mellitus (T2DM) and because it is often asymptomatic and extensive in comparison with CAD in subjects without diabetes, it represents a diagnostic challenge. The objective of the study was to investigate the prevalence of CAD in asymptomatic ...

OBJECTIVE: Macrophage migration inhibitory factor (MIF), a protein secreted by immune cells and the pituitary gland, may be associated with coronary artery disease (CAD) and the mental state of coronary patients. The first origin of MIF suggests positive, the second negative associations. The aim of this study was to explore ...

BACKGROUND: Atherosclerotic plaques prone to cause thrombotic complications and plaque rupture account for the majority of fatal myocardial infarctions (MI), which may be complicated by ventricular fibrillation (VF). Matrix-degrading metalloproteinases (MMPs) and their inhibitors (TIMPs) are expressed in atherosclerotic lesions and contribute to plaque vulnerability. Interleukin-8 (IL-8) is one of ...

AIM: To study the relation between myocardial ischemia assessed with different techniques in patients with peripheral arterial disease (PAD) in comparison with a matched control group. METHODS: Ninety-nine male patients with PAD and 94 age- and sex-matched control subjects without PAD or ischaemic heart disease performed a exercise treadmill test, ...

Previous studies have demonstrated seasonal variation in the incidence of acute myocardial infarction (AMI) with an increase in cases during the winter months. However, they did not assess whether ST-elevation MI (STEMI) and non-ST-elevation MI (NSTEMI) exhibit similar changes. The object of this study was to compare the seasonal variation ...

BACKGROUND: Electron beam computed tomography (EBCT) is a method for measuring coronary calcification and has been promoted as a possible non-invasive screening/diagnostic tool for coronary artery disease (CAD). Our objective was to carry out a systematic review and meta-analysis of EBCT for the screening of asymptomatic patients and the diagnosis ...

BACKGROUND: Noninvasive angiography using multislice computed tomography (MSCT) is superior to magnetic resonance imaging (MRI) for detection of coronary stenoses. We compared patient acceptance of these two noninvasive diagnostic tests and invasive conventional coronary angiography (Angio). METHODS AND FINDINGS: A total of 111 consecutive patients with suspected coronary artery disease ...

BACKGROUND: The worse prognosis in patients without ST-elevation (non-STEMI) as compared to ST-elevation myocardial infarction (STEMI), may be due to treatment differences. We aimed to evaluate the differences in characteristics, treatment and outcome in patients with non-STEMI versus STEMI in an unselected patient population. METHODS: Individual patient data from all ...

BACKGROUND: Patients testing positive for myocardial ischemia but without significant coronary artery (CA) stenosis in coronary angiography (CXA) are characterized as having "small vessel disease" (SVD). The aim of our study was to identify these patients by stress perfusion cardiac magnetic resonance (CMR). METHODS: 317 patients with suspected myocardial ischemia ...

The aim of this study was to analyze the diagnostic accuracy of edema on T2-weighted (T2w) cardiac magnetic resonance imaging (CMR), presence of microvascular obstruction (MO) on first-pass enhancement (FPE) or on delayed enhancement (DE) CMR, and wall thinning on cine CMR to differentiate between acute (AMI) and chronic myocardial ...