Morbidity and Use of Medical Resources in Patients With Chest Pain and Normal or Near-Normal Coronary Arteries

Albertsson, Per; Emanuelsson, H; Karlsson, Thomas; Lamm, Carl; Sanden, W. Van Der; Lagerberg, Gunilla; Herlitz, Johan

doi:10.1016/s0002-9149(96)00751-5

Cited by 24 publications

(25 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Unfortunately, many such patients continue to have recurrent symptoms, are readmitted to the hospital, can become disabled, and continue to consume health care resources even with repeated coronary angiography. 566,567 It is not presently possible to define the extent of comorbidity that would, in every case, make referral for coronary angiography and revascularization inappropriate. The highrisk patient with significant comorbidities requires thoughtful discussion among the physician, patient, and family and/or patient advocate.…”

Section: Care Objectivesmentioning

confidence: 99%

See 1 more Smart Citation

2011 ACCF/AHA Focused Update Incorporated Into the ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction

Anderson¹,

Adams²,

Antman³

et al. 2011

Circulation

681

367

View full text Add to dashboard Cite

Section: Care Objectivesmentioning

confidence: 99%

“…In 1 study, after a normal coronary arteriogram, there was a reduced need for hospitalization and a reduction in the number of hospital days for cardiac reasons. 566 However, even minimal atherosclerotic disease on angiography warrants risk factor modification.…”

Section: Treatmentmentioning

confidence: 99%

2011 ACCF/AHA Focused Update Incorporated Into the ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction

Anderson¹,

Adams²,

Antman³

et al. 2011

Circulation

681

367

View full text Add to dashboard Cite

“…Unfortunately, many such patients continue to have recurrent symptoms, are readmitted to the hospital, can become disabled, and continue to consume health care resources even with repeated coronary angiography. 654,655 It is not presently possible to define the extent of comorbidity that would, in every case, make referral for coronary angiography and revascularization inappropriate. The highrisk patient with significant comorbidities requires thoughtful discussion among the physician, patient, and family and/ or patient advocate.…”

Section: Care Objectivesmentioning

confidence: 99%

“…In 1 study, after a normal coronary arteriogram, there was a reduced need for hospitalization and a reduction in the number of hospital days for cardiac reasons. 654 However, even minimal atherosclerotic disease on angiography warrants risk factor modification.…”

Section: Treatmentmentioning

confidence: 99%

2012 ACCF/AHA Focused Update Incorporated Into the ACCF/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction

Anderson¹,

Adams²,

Antman³

et al. 2013

Circulation

204

View full text Add to dashboard Cite

“…11 The overwhelming majority (50% to 94%) of these patients continue to have chest discomfort similar to that for which they underwent coronary arteriography. More than half of the patients use antianginal drugs for many years without significant benefits.…”

Section: Myocardial Perfusion In Angina With Normal Angiogramsmentioning

confidence: 99%

Angiotensin-Converting Enzyme Inhibitors and 3-Hydroxy-3-Methylglutaryl Coenzyme A Reductase in Cardiac Syndrome X

et al. 2004

View full text Add to dashboard Cite

Background— Morbidity of patients with Syndrome X (SX; chest pain and normal coronary angiograms) is high and is associated with continuing episodes of chest pain and hospitalization. Impairment of microvascular endothelial function caused by increased oxidative stress has been suggested to be a mechanism of the disease. Superoxide dismutase (SOD) is the major antioxidant enzyme system of the vascular wall. This study sought to establish whether combination treatment with ACE inhibitors and statins reduces oxidative stress and improves quality of life of patients with cardiac SX. Methods and Results— Forty-five patients with SX were randomly assigned to receive either a combination of ramipril (10 mg/d) and atorvastatin (40 mg/d) or placebo for 6 months. We determined the activity of extracellular SOD and its relation to flow-dependent endothelium-mediated dilation (FMD) and quality of life (exercise capacity and score with Seattle Angina Questionnaire [SAQ]) before and after treatment. After 6 months, patients with SX who received atorvastatin and ramipril had significantly reduced ( P =0.001) SOD levels (188.1±29.6 U/mL). No significant changes were seen on placebo (262.9±48.8 U/mL). Reduction of SOD after therapy was negatively correlated with FMD ( r =0.38; P =0.01) and positively with total cholesterol ( r =−0.56; P <0.001). At follow-up, patients taking atorvastatin and ramipril improved their quality of life both in terms of exercise duration (by 23.46%) and SAQ (by 64.1%). Conclusions— Six months of therapy with atorvastatin and ramipril improves endothelial function and quality of life of patients with SX. Reduced SOD activity may reflect low superoxide anion production. Benefits of these drugs may be related to reduction of oxidative stress.

show abstract

Morbidity and Use of Medical Resources in Patients With Chest Pain and Normal or Near-Normal Coronary Arteries

Cited by 24 publications

References 18 publications

2011 ACCF/AHA Focused Update Incorporated Into the ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction

2011 ACCF/AHA Focused Update Incorporated Into the ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction

2012 ACCF/AHA Focused Update Incorporated Into the ACCF/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction

Angiotensin-Converting Enzyme Inhibitors and 3-Hydroxy-3-Methylglutaryl Coenzyme A Reductase in Cardiac Syndrome X

Contact Info

Product

Resources

About