Coronary Heart Disease Syndromes: Pathophysiology and Clinical Recognition

Willerson, James T.; Maseri, Attilio; Armstrong, Paul W.

doi:10.1007/978-1-4471-2828-1_15

Cited by 7 publications

(3 citation statements)

References 265 publications

(362 reference statements)

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“…As such, we were unable to determine whether the AP was actually caused by cardiac ischemia as opposed to other non-cardiac factors, and it may be difficult for patients to distinguish between different these types of pain. In addition to CAD, other types of heart disease (such as ventricular hypertrophy, valvar disease, and cardiomyopathy) may reduce coronary blood flow, thus causing AP symptoms [41]. The esophagus is stimulated by gastric acid, which induces cardioesophageal reflex, which in turn can cause coronary artery spasm, leading to myocardial ischemia and angina symptoms.…”

Section: Discussionmentioning

confidence: 99%

The association between psychological distress and angina pectoris: A population-based study

et al. 2019

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BackgroundPsychological distress is an undifferentiated combination of symptoms that may be related to the occurrence of angina pectoris (AP). However, few studies have investigated the relationship between psychological distress and AP, particularly in Asian populations. The purpose of this study was to examine the relationship between psychological distress and AP in Taiwanese adults.MethodsWe adopted a cross-sectional design to explore the data of the 2005–2008 Nutrition and Health Survey in Taiwan. In total, 2080 subjects (aged ≥ 19 years) responded to questionnaire interviews and underwent physical examinations. Each of the five dimensions of psychological distress (sleep disturbance, anxiety, hostility, depression, and feelings of inferiority) were scored (from 0–20) according to the Five-Item Brief Symptom Rating Scale (BSRS-5). A score ≥ 6 points indicated psychological distress. AP was evaluated using a modified Rose questionnaire.FindingsIn total, 102 subjects (3.6%) had AP, and 231 subjects (8.8%) had symptoms of psychological distress. After adjusting for the basic data, metabolism, and lifestyle covariates, the BSRS-5 total score was associated with AP (odds ratio [OR] = 1.2, 95% confidence interval [CI] = 1.13–1.26, p < 0.001). Subjects with psychological distress had a higher risk of AP (OR = 2.97, 95% CI = 1.76–4.99, p < 0.001).ConclusionsThe presence of AP is associated with psychological distress. Health care providers should therefore be aware of the impact of psychological distress on AP. Our study findings can serve as a reference for AP assessments. Large scale longitudinal studies are needed to confirm a causal relationship between psychological distress and AP.

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Section: Discussionmentioning

confidence: 99%

The association between psychological distress and angina pectoris: A population-based study

et al. 2019

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“…Coronary artery disease (CAD), or more commonly known as heart disease, is usually a result of plaque buildup in coronary arteries, a condition called atherosclerosis. [1] Cardiovascular diseases are the most common cause of death in the world and the most important cause of disability and decreased the quality of life. [2] According to statistics, about 50% of deaths (5 million out of 12 million deaths) in developed countries are caused by cardiovascular diseases.…”

Section: Introductionmentioning

confidence: 99%

Assessment of risk factors for coronary artery disease in military personnel: A study from Iran

Mirzaeipour

Seyedmazhari

Pishgooie

et al. 2019

J Family Med Prim Care

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Introduction: Cardiovascular diseases are the most significant cause of mortality. Although the risk factors of this disease are well known, the strength of these factors varies in different populations and needs to be investigated. Aim: The aim of this study is to estimate the amount of the effect of each classic risk factor on CAD (coronary artery disease) among Aja personnel. Materials and Methods: This matched case-control study was conducted on 1000 male Aja personnel admitted selecting Aja hospitals in Tehran in 2017. The samples were selected using purposive-graded sampling method. The 250 military patients hospitalized for CAD were considered as a case group. Each case was individually matched for age and service force with tree military patients without CAD. Data were gathered using standard demographic information and history of risk factors questionnaire and analyzed using SPSS 23 and statistical tests. Odds ratio measured trough Cochran–Mantel–Haenszel test and used to estimate the amount of the effect of each classic risk factors on CAD. Results: Data analysis indicated that the risk factors including diabetes, hyperlipidemia, smoking, hypertension, and positive family history of CAD enhance the probability of CAD as much as 79.2%, 77.3%, 67.7%, 64.1%, and 56.6%, respectively. Conclusion: Diabetes and other modifiable risk factors have the greatest impact on CAD among the concerned Aja personnel. Hence, the authorities can consider the independent amount of the effect of each risk factor and modify them in order to prevent the disease more effectively and purposefully among the personnel.

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“…Incident coronary heart disease (CHD) is a major health problem, and the leading cause of mortality worldwide [ 1 ]. Environmental toxicants, such as lead (Pb) and other heavy metals, are known to be associated with cardiovascular disease [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Lead-Related Genetic Loci, Cumulative Lead Exposure and Incident Coronary Heart Disease: The Normative Aging Study

et al. 2016

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BackgroundCumulative exposure to lead is associated with cardiovascular outcomes. Polymorphisms in the δ-aminolevulinic acid dehydratase (ALAD), hemochromatosis (HFE), heme oxygenase-1 (HMOX1), vitamin D receptor (VDR), glutathione S-transferase (GST) supergene family (GSTP1, GSTT1, GSTM1), apolipoprotein E (APOE),angiotensin II receptor-1 (AGTR1) and angiotensinogen (AGT) genes, are believed to alter toxicokinetics and/or toxicodynamics of lead.ObjectivesWe assessed possible effect modification by genetic polymorphisms in ALAD, HFE, HMOX1, VDR, GSTP1, GSTT1, GSTM1, APOE, AGTR1 and AGT individually and as the genetic risk score (GRS) on the association between cumulative lead exposure and incident coronary heart disease (CHD) events.MethodsWe used K-shell-X-ray fluorescence to measure bone lead levels. GRS was calculated on the basis of 22 lead-related loci. We constructed Cox proportional hazard models to compute adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for incident CHD. We applied inverse probability weighting to account for potential selection bias due to recruitment into the bone lead sub-study.ResultsSignificant effect modification was found by VDR, HMOX1, GSTP1, APOE, and AGT genetic polymorphisms when evaluated individually. Further, the bone lead-CHD associations became larger as GRS increases. After adjusting for potential confounders, a HR of CHD was 2.27 (95%CI: 1.50–3.42) with 2-fold increase in patella lead levels, among participants in the top tertile of GRS. We also detected an increasing trend in HRs across tertiles of GRS (p-trend = 0.0063).ConclusionsOur findings suggest that lead-related loci as a whole may play an important role in susceptibility to lead-related CHD risk. These findings need to be validated in a separate cohort containing bone lead, lead-related genetic loci and incident CHD data.

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Coronary Heart Disease Syndromes: Pathophysiology and Clinical Recognition

Cited by 7 publications

References 265 publications

The association between psychological distress and angina pectoris: A population-based study

The association between psychological distress and angina pectoris: A population-based study

Assessment of risk factors for coronary artery disease in military personnel: A study from Iran

Lead-Related Genetic Loci, Cumulative Lead Exposure and Incident Coronary Heart Disease: The Normative Aging Study

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