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PubMed · 8227116

Coronary artery aneurysm.

J Eng·K K Nair
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Abstract

A 55 year old man presented with a 2 year history of angina of effort complicated by two myocardial infarctions. Coronary angiography confirmed fusiform aneurysm of the right coronary artery and disease of the left anterior descending coronary artery. The patient underwent surgery with exclusion of the right coronary artery aneurysm and reversed saphenous vein graft, and graft to the left anterior descending coronary artery, with uneventful recovery. The clinical and radiological features are reviewed, and the surgical options considered.

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Angina PectorisCoronary AneurysmCoronary AngiographyCoronary Artery BypassHumansMaleMiddle AgedCase ReportsJournal Article

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J Eng, K K Nair. 1993. Coronary artery aneurysm.. https://pubmed.ncbi.nlm.nih.gov/8227116/

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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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