angina

摘要： Chronic stable angina(CSA)is the main symptom of myocardial ischemia,which is associated with an increased risk of major cardiovascular events and sudden cardiac death[1].In China,patients with CSA are mainly treated with anti-angina drugs,and some patients are also treated with percutaneous coronary intervention[2].Acupuncture has a long history as adjunctive therapy for CSA,especially in relieving symptoms of myocardial ischemia,improving cardiac function,and preventing recurrence[3].There have also been randomized controlled studies reported,but the effectiveness and safety of acupuncture as adjuvant therapy in the treatment of CSA still lack of strong evidence support due to insufficient sample size and low quality of the research[4].

摘要： Giant coronary artery aneurysm(CAA)is a rare condition,reportedly seen in 0.02-0.2%of patients undergoing coronary angiography.Asymptomatic in most cases,patients may present with angina pectoris,myocardial infarction,cardiac tamponade or sudden death.Given that the natural history of the CAA is still not predictable,the optimal treatment remains still debatable.In this case report,we present a male patient with a sudden non-exertional dyspnea and angina in a context of obesity,multiple large and medium vessels aneurysms and chronic kidney disease(CKD).A contrast CT detected a giant left anterior descending artery(LAD)CAA measuring 73 mm×47 mm,apparently compressing the circumflex(CX)and the pulmonary artery(PA).After undergoing a full(etiologic and aneurysm extension)panel of exams,the patient underwent a surgical exclusion of the giant CAA and a coronary artery bypass grafting(CABG)by using the left thoracic mammary artery(LITA).The hospitalization was uneventful,and the patient left the hospital completely asymptomatic.In conclusion,even in cases of giant coronary aneurysms,the treatment is surgical by excluding the aneurismatic sac and performing a surgical revascularization.

摘要： 急性冠脉综合征(acute coronary syndromes,ACS)是指冠状动脉内不稳定的粥样硬化斑块破裂或糜烂继发新鲜血栓形成所导致的心脏急性缺血综合征,包括急性ST段抬高型心肌梗死(ST elevation myocardial infarction,STEMI)、急性非ST段抬高型心肌梗死(non ST elevation myocardial infarction,NSTEMI)和不稳定性心绞痛(unstable angina,UA),其中NSTEMI与UA合称非ST段抬高型急性冠脉综合征(NSTE-ACS)。

摘要： 心绞痛(angina pectoris)具体是指冠状动脉供血不足、心肌急剧的暂时缺血与缺氧所引起的以发作性胸痛或胸部不适为主要表现的临床综合征。具体反映在人体当中可以出现一些其他状况,如心脏疼痛、胸骨后部疼痛,放射在心前区以及左上肢。一般情况下,心绞痛患者的在劳动或者是情绪过于激动时都会出现心绞痛的相关症状,患者的每次发病大约持续在3-5分钟左右,根据患者病情的不同,有的患者可能数日才发作一次,而有的患者在一日则可能发作数次,在用药或者是休息之后消失。心绞痛这类病症主要发作人群多为男性,年龄在40岁以上,心绞痛发作的主要诱因则为劳累、饱食、急性循环衰竭、阴雨天气、情绪激动、受寒等。并且,心绞痛的发展也是有着一定的周期性的,在不同的周期也会产生不同的状况,今天,我们便针对这个问题进行深入分析。

摘要： Objective:To investigate the clinical efficacy of metoprolol succinate sustained-release tablets combined with trimetazidine in the treatment of gastrointestinal tumors with angina pectoris.Methods:We enrolled the 58 patients with digestive tract tumor merger angina in November 2017-October 2019 and analysis the hospital clinical data by retrospective method.We included patients with routine treatment in control group(n=31 cases)and the subjects treated with increased dose of succinic acid metoprololzyban joint with trimetazidineinobservation group(n=27 cases)according to the different treatment group.Results:The effective rate of angina pectoris treatment in the observation group was higher than that in the control group.Furthermore,the incidence of adverse reactions was lower than that in the control group and the difference was statistically significant(P<0.05).Conclusion:Metoprolol succinic acid sustained release tablets combined with trimetazidine in the treatment of gastrointestinal tumors with angina pectoris can improve the efficacy of angina pectoris.The drug use is safe and worthy of clinical use.

摘要： 我国科学家在针灸治疗心绞痛研究方面取得重要进展2019年7月29日,成都中医药大学梁繁荣教授团队在JAMA?Internal Medicine(IF=20.786)杂志以原创性论著形式发表了题为“Acupuncture as adjunctive therapy for chronic stable angina:A randomized clinical trial”的研究文章报告,为针灸作为抗心绞痛药物的有效辅助疗法提供了高质量的临床证据。心绞痛是冠状动脉粥样硬化性心脏病(冠心病)的最常见表现,也是导致重大心血管事件和心源性死亡的重要危险因素,冠心病死亡率近年来呈总体上升态势。

摘要： Background: Due to the aging population and increased survival of the patients with coronary artery disease, there is an increasing number of patients with debilitating angina refractory to optimal medical treatment who are not candidates for revascularization. In case of low ischemic load, the treatment of stable refractory angina is aimed at symptom reduction. There are several new treatment methods targeting myocardial ischemia available, including coronary sinus flow reducer (CFR) implantation. Case Report: We report a case of a patient suffering from CCS class IV angina despite optimal medical therapy, with further revascualrization options exhausted, who was successfully treated with coronary sinus flow reducer (CFR). Besides technical skill to reach ostium of coronary sinus, the most important technical tip is precise positioning of the CFR. The reduction of angina symptoms started after epithelisation of CFR frame, usually 6 - 7 weeks after implantation. At 6-month follow-up, the patient reported a marked reduction of angina symptoms, with CCS grade improving by three classes (from IV to I). At 10-month follow-up, the sustainment of CCS grade I angina symptoms was reported by the patient. Conclusions: We conclude that CFR can be safely and successfully implanted in patients suffering from refractory angina. Considerable improvements in CCS grade may be experienced in certain cases.

摘要： BACKGROUND Previous studies have established a role of gout in predicting risk and prognosis of cardiovascular diseases. However, large-scale data on the impact of gout on inpatient outcomes of acute coronary syndrome (ACS)-related hospitalizations and post-revascularization is inadequate. AIM To evaluate the impact of gout on in-hospital outcomes of ACS hospitalizations, subsequent healthcare burden and predictors of post-revascularization inpatient mortality. METHODS We used the national inpatient sample (2010-2014) to identify the ACS and goutrelated hospitalizations, relevant comorbidities, revascularization and postrevascularization outcomes using the ICD-9 CM codes. A multivariable analysis was performed to evaluate the predictors of post-revascularization in-hospital mortality. RESULTS We identified 3144744 ACS-related hospitalizations, of which 105198 (3.35%) also had gout. The ACS-gout cohort were more often older white males with a higher prevalence of comorbidities. Coronary artery bypass grafting was required more often in the ACS-gout cohort. Post-revascularization complications including cardiac (3.2% vs 2.9%), respiratory (3.5% vs 2.9%), and hemorrhage (3.1% vs 2.7%) were higher whereas all-cause mortality was lower (2.2% vs 3.0%) in the ACSgout cohort (P < 0.001). An older age (OR 15.63, CI: 5.51-44.39), non-elective admissions (OR 2.00, CI: 1.44-2.79), lower household income (OR 1.44, CI: 1.17- 1.78), and comorbid conditions predicted higher mortality in ACS-gout cohort undergoing revascularization (P < 0.001). Odds of post-revascularization inhospital mortality were lower in Hispanics (OR 0.45, CI: 0.31-0.67) and Asians (OR 0.65, CI: 0.45-0.94) as compared to white (P < 0.001). However, postoperative complications significantly raised mortality odds. Mean length of stay, transfer to other facilities, and hospital charges were higher in the ACS-gout cohort. CONCLUSION Although gout was not independently associated with an increased risk of postrevascularization in-hospital mortality in ACS, it did increase postrevascularization complications.

摘要： Background and Objective Treatment strategy for unstable angina has underwent significant changes since the introduction of Braunwald classification of unstable angina nearly 30 years ago,yet re-evaluation of this routinely used classification system is rarely published in recent years.We aim to re-evaluate the Braunwald unstable angina(UA)classification on its predictive value of clinical characteristics,angiographic features,and occurrence of future adverse events.