ACC/AHA/ACP–ASIM Guidelines for the Management of Patients With Chronic Stable Angina: Executive Summary and Recommendations

Gibbons, Raymond J.; Chatterjee, Kanu; Daley, Jennifer; Douglas, J. S.; Fihn, Stephan D.; Gardin, Julius M.; Grunwald, Mark; Levy, Daniel; Lytle, Bruce W.; O’Rourke, Robert A.; Schafer, W. P.; Williams, Sankey V.; Ritchie, James L.; Eagle, Kim A.; Gardner, T. J.; Garson, Arthur; Russell, Richard O.; Ryan, Thomas J.; Smith, Stuart

doi:10.1161/01.cir.99.21.2829

Cited by 351 publications

(168 citation statements)

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“…Canadian Class Society (CCS) functional class and risk stratification were evaluated prospectively in patients with stable angina. 11,12 The EuroSCORE and TIMI risk score were calculated from the available variables. 13,14 The survey on coronary revascularization was conducted between November 2001 and March 2002.…”

Section: Methodsmentioning

confidence: 99%

Management and Outcome of Patients With Established Coronary Artery Disease: The Euro Heart Survey on Coronary Revascularization

Lenzen¹,

Boersma²,

Bertrand³

2005

ACC Current Journal Review

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Section: Methodsmentioning

confidence: 99%

Management and Outcome of Patients With Established Coronary Artery Disease: The Euro Heart Survey on Coronary Revascularization

Lenzen¹,

Boersma²,

Bertrand³

2005

ACC Current Journal Review

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“…In that study, plasma Met-enkephalin increased during SCS, indicating an involvement of opioids in the regulation and improvement of the microcirculation by SCS (Fontana et al, 2004). However, clinically there is little or no evidence that opioids are involved in the SCS effects Meyerson and Linderoth, 2000) 2.2 Effects of SCS on cardiovascular system 2.2.1 Background-Refractory angina pectoris is one of the most common results of heart diseases, and is clinically characterized by discomfort in the chest, jaw, shoulder, back, or arm, which is typically aggravated by exertion or emotional stress (Gibbons et al, 1999). Vasospasm and vessel occlusion are two common mechanisms resulting in the decrease in blood supply to the heart.…”

Section: 15mentioning

confidence: 99%

Putative mechanisms behind effects of spinal cord stimulation on vascular diseases: A review of experimental studies

Linderoth

Foreman

2008

Autonomic Neuroscience

155

106

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Spinal cord stimulation (SCS) is a widely used clinical technique to treat ischemic pain in peripheral, cardiac and cerebral vascular diseases. The use of this treatment advanced rapidly during the late 80's and 90's, particularly in Europe. Although the clinical benefits of SCS are clear and the success rate remains high, the mechanisms are not yet completely understood. SCS at lumbar spinal segments (L2-L3) produces vasodilation in the lower limbs and feet which is mediated by antidromic activation of sensory fibers and decreased sympathetic outflow. SCS at thoracic spinal segments (T1-T2) induces several benefits including pain relief, reduction in both frequency and severity of angina attacks, and reduced short-acting nitrate intake. The benefits to the heart are not likely due to an increase, or redistribution of local blood flow, rather, they are associated with SCS-induced myocardial protection and normalization of the intrinsic cardiac nervous system. At somewhat lower cervical levels (C3-C6), SCS induces increased blood flow in the upper extremities. SCS at the upper cervical spinal segments (C1-C2) increased cerebral blood flow, which is associated with a decrease in sympathetic activity, an increase in vasomotor center activity and a release of neurohumoral factors. This review will summarize the basic science studies that have contributed to our understanding about mechanisms through which SCS produces beneficial effects when used in the treatment of vascular diseases. Furthermore, this review will particularly focus on the antidromic mechanisms of SCS-induced vasodilation in the lower limbs and feet.

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“…Although the number of women was low, the results of the analysis in this specific subgroup is particularly intriguing since results of exercise stress testing are often unclear in women, as it is less sensitive and less specific compared with those in men. 28 The atherosclerot-581 Abbreviations: LV = left ventricular, OR = odds ratio, CI = confidence interval. …”

Section: Discussionmentioning

confidence: 99%

Association of aortic valve sclerosis and coronary artery disease in patients with severe nonischemic mitral regurgitation

Rossi

Bertagnolli

Cicoira

et al. 2003

Clinical Cardiology

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Background: The presence of aortic valve sclerosis accounts for a higher rate of ischemic events and increased cardiovascular mortality. It may reflect coronary artery disease (CAD) because of a shared pathologic background. Hypothesis: We aimed to analyze whether the presence of aortic valve sclerosis might help in identifying patients with coronary atherosclerosis among those with severe nonischemic mitral regurgitation (MR), who undergo coronary angiography before surgery for screening, and not because of suspected ischemic heart disease. Methods: In all, 84 patients (mean age 64 ± 9 years; 71% men) with mitral valve prolapse and severe regurgitation underwent echocardiography and coronary angiography. Aortic valve sclerosis was defined as focal areas of increased echogenicity and thickening of the leaflets without restriction of leaflet motion on echocardiography. Coronary artery disease was defined by the presence/absence of atherosclerotic plaques, independent of the degree of stenosis. Results: Coronary artery disease was diagnosed in 47.6% of patients with and 15.8% of those without aortic valve sclerosis (p = 0.008). On logistic regression analysis, the presence of aortic valve sclerosis predicted CAD (odds ratio 3.3,95% confidence interval 1.03‐10.5; p = 0.04) independent of age. In female patients, the risk ratio for CAD in the presence of aortic valve sclerosis was 9. Conclusions: Coronary artery atherosclerosis and aortic valve sclerosis are closely associated in patients with severe nonischemic MR.

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ACC/AHA/ACP–ASIM Guidelines for the Management of Patients With Chronic Stable Angina: Executive Summary and Recommendations

Cited by 351 publications

References 0 publications

Management and Outcome of Patients With Established Coronary Artery Disease: The Euro Heart Survey on Coronary Revascularization

Management and Outcome of Patients With Established Coronary Artery Disease: The Euro Heart Survey on Coronary Revascularization

Putative mechanisms behind effects of spinal cord stimulation on vascular diseases: A review of experimental studies

Association of aortic valve sclerosis and coronary artery disease in patients with severe nonischemic mitral regurgitation

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