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PubMed · 16128170

[Remarks on angina pectoris].

Sabino Scardi·Luca Perazza
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Abstract

In the first volume of the New England Journal of Medicine of 1812, J. Warren published a paper on the subject of angina pectoris, in which clearly emerge the difficulties facing the physicians of that time in trying to formulate a correct diagnosis and prescribe the right therapy. We thought it would be certainly of interest to offer our readers an Italian translation of this article, obviously with some stylistic modifications and supplemented with information coming from other historical scientific works. William Heberden in his report on " breast pain" was the first physician to use the term "angina" and the description of symptoms that he gave in 1772 is still today valid and correct.

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Angina PectorisCardiologyChest PainHistory, 18th CenturyHistory, 19th CenturyHumansLondonUnited KingdomBiographyHistorical ArticleJournal ArticlePortrait

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BibTeXRIS

Sabino Scardi, Luca Perazza. 2005. [Remarks on angina pectoris].. https://doi.org/10.4081/monaldi.2005.617

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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.

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