Coronary artery disease
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Coronary artery disease · Nov 1994
Clinical TrialWeak allergenicity of recombinant hirudin CGP 39393 (REVASC) in immunocompetent volunteers. The European Hirudin in Thrombosis Group (HIT Group).
As a result of their polypeptidic nature, hirudins could theoretically elicit an immunologic response in humans. ⋯ Recombinant hirudin CGP 39393 appears to be a weak allergen. Repeated exposures are safe in fully immunocompetent subjects, including those with a history of previous allergies and high levels of total IgE. Type I allergic reactions are rare (i.e. less than 1%) after a second exposure and are limited to the skin. Routine skin tests are not needed to identify patients at risk of developing type I allergic reactions. Hirudin-specific IgE antibodies are rarely seen and then at very low titres.
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Coronary artery disease · Oct 1994
Safety aspects of spinal cord stimulation in severe angina pectoris.
Spinal cord stimulation has been used over the past decade for the treatment of patients suffering from intractable angina pectoris, despite having received optimal medical therapy, and who are unsuitable for further surgical intervention. The clinical results are promising and several studies have shown that the antianginal effect of the treatment is associated with a reduction in myocardial ischemia. It has been suggested, however, that spinal cord stimulation may only attenuate the transmission of pain from the heart, without influencing myocardial ischemia. This is a major safety concern when applying this treatment strategy. ⋯ The results of this study do not indicate any unfavourable effects of spinal cord stimulation in severe angina pectoris in terms of an increase in the frequency or severity of myocardial ischemia during treatment with spinal cord stimulation.
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Coronary artery disease · Sep 1994
Apparently coronary heart disease-free patients in the coronary care unit: characteristics, medical care, and 1-year outcome.
Coronary care units (CCUs) have contributed significantly to the improved survival rates among patients with acute myocardial infarction. Many patients admitted to CCUs are certified to be free of coronary heart disease (CHD) at discharge. There is little literature on the hospital course and prognosis of such patients. ⋯ Patients certified to be CHD-free after admission to a CCU with suspected acute myocardial infarction have a lower 1-year mortality rate than patients experiencing acute myocardial infarction or chronic CHD. Their mortality rate, however, is substantially higher than expected, probably because of a high prevalence of cigarette smoking and hypertension.
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Coronary artery disease · Jul 1994
Comparative StudyRegulation of tissue-type plasminogen activator-mediated fibrinolysis by plasminogen activator inhibitor type-1 in patients with ischaemic heart disease: possible unfavourable effect of diuretics.
Impaired endogenous tissue-type plasminogen activator (t-PA)-mediated fibrinolysis may be involved in the evolution of myocardial infarction. t-PA-mediated fibrinolysis is believed to depend on the amount of active t-PA present in the circulation. Accordingly, we investigated the possible mechanisms responsible for impaired t-PA-mediated fibrinolysis in patients with ischaemic heart disease. ⋯ Our study strongly suggests that a high plasma level of PAI-1, the main inhibitor of t-PA, is responsible for impaired t-PA-mediated fibrinolysis in patients with ischaemic heart disease, and that treatment with diuretics may be associated with an unfavourable effect on the fibrinolytic system.
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Coronary artery disease · Jun 1994
Comparative StudyOn-line computerized vectorcardiography monitoring of myocardial ischemia during coronary angioplasty: comparison with 12-lead electrocardiography.
With new interventions minimizing ischemic myocardial injury, accurate and reliable techniques for the detection and continuous monitoring of myocardial ischemia are essential. We compared two techniques used for the detection of myocardial ischemia during coronary angioplasty: on-line computerized vectorcardiographic (cVCG) monitoring and the standard electrocardiography (ECG) leads or the complete 12-lead ECG. ⋯ Compared with 12-lead ECG, on-line cVCG is a more sensitive method of detecting myocardial ischemia during coronary angioplasty and the reading is easier and faster. Our results support STC-VM > or = 0.050 mV as the criterion for ischemia during angioplasty; ST-VM should be applied together with STC-VM.