Document Detail


Effects of the repeated administration of adenosine and heparin on myocardial perfusion in patients with chronic stable angina pectoris.
MedLine Citation:
PMID:  11078227     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The mechanism by which ischemia stimulates angiogenesis is unknown. Adenosine is released during myocardial ischemia and may be a mediator of this process. Experimental data suggest that heparin may enhance this effect. The purpose of this open-labeled, placebo-controlled trial was to determine whether repeated intravenous administration of adenosine and heparin could mimic physiologic angiogenesis and reduce the amount of exercise-induced myocardial ischemia in patients with coronary artery disease. Subjects with chronic stable angina refractory to conventional medical therapy and not suitable for revascularization received either adenosine (140 microg/kg/min for 6 minutes) and heparin (10,000 U bolus), (n = 14), or placebo, (n = 7) daily for 10 days. All patients underwent baseline and follow-up exercise testing with thallium-201 single-photon emission computed tomography myocardial perfusion imaging. A semiquantitative assessment of the extent and severity of the perfusion abnormalities was calculated by 2 blinded investigators. There was no significant change in exercise duration or in the peak heart rate systolic blood pressure product associated with adenosine and heparin compared with placebo treatment. There was, however, a 9% reduction in the extent (60.6 +/- 4.0 vs 54.9 +/- 4.1, p = 0.03) and a 14% improvement in severity (41.5 +/- 3.2 vs 35.7 +/- 2.9, p = 0.01) of the myocardial perfusion abnormalities seen in patients who received adenosine and heparin compared with placebo. Thus, in this pilot study, repeated administration of adenosine and heparin reduced the amount of exercise-induced ischemia in patients with chronic stable angina refractory to conventional treatment.
Authors:
H V Barron; M G Sciammarella; K Lenihan; A D Michaels; E H Botvinick
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Publication Detail:
Type:  Clinical Trial; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  85     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2000 Jan 
Date Detail:
Created Date:  2000-11-30     Completed Date:  2000-11-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine Cardiology, University of California, San Francisco, USA.
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MeSH Terms
Descriptor/Qualifier:
Adenosine / therapeutic use*
Angina Pectoris / complications*,  drug therapy*
Anticoagulants / therapeutic use*
Blood Pressure / drug effects
Chronic Disease
Collateral Circulation / drug effects*
Drug Therapy, Combination
Exercise Test
Female
Heart Rate / drug effects
Heparin / therapeutic use*
Humans
Infusions, Intravenous
Injections, Intravenous
Male
Middle Aged
Myocardial Ischemia / classification,  diagnosis,  etiology*,  physiopathology
Neovascularization, Physiologic / drug effects*
Pilot Projects
Severity of Illness Index
Single-Blind Method
Systole
Thallium Radioisotopes / diagnostic use
Tomography, Emission-Computed, Single-Photon
Vasodilator Agents / therapeutic use*
Chemical
Reg. No./Substance:
0/Anticoagulants; 0/Thallium Radioisotopes; 0/Vasodilator Agents; 58-61-7/Adenosine; 9005-49-6/Heparin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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