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PubMed · 2691949

[Late post-infarction angina].

K Csapó·L Voith·F Medgyesi·I Hegedüs·L Mihóczy
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Abstract

The authors survey the clinical features and therapeutic results of 88 patients suffering from late postinfarctional angina. The results of the bicycle ergometer ECG tests were negative only in the case of 8 patients. Exercise-induced silent myocardial ischaemia was registered in 45.4%. Coronary angiography revealed that 54 (61%) of the patients suffered from multivessel disease. Coronary bypass surgery was carried out in 56.8% and the rate of peripheral anastomoses was 3.1/patient. The authors consider it to be essential to detect the ischaemia in the infarct survivors with chest pain. Taking into consideration the clinical feature and the results of exercise tests, the authors propose cardiac catheterization. Myocardial revascularization is recommended if the medical therapy is not successful or the patients suffered from left main, triple-vessels disease and the myocardium is jeopardized to a large extend.

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Angina PectorisAngiocardiographyCoronary DiseaseElectrocardiographyExercise TestHumansMyocardial InfarctionEnglish AbstractJournal ArticleReview

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BibTeXRIS

K Csapó, L Voith, F Medgyesi, I Hegedüs, L Mihóczy. 1989-12-24. [Late post-infarction angina].. https://pubmed.ncbi.nlm.nih.gov/2691949/

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PubMed2007

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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