Unstable angina pectoris

Thromboxane A-2 has been implicated in a number of disorders of the circulatory system including coronary artery spasms, unstable angina pectoris, traumatic and endotoxic shock, and heart attacks. It is formed normally very near its receptors and is rapidly deactivated by metabolizing enzymes so circulating levels are quite low. Furthermore, it is opposed in its actions by the prostacyclins. When these controls are defective, pathology results and drugs can be the resort in attempts to restore the normal healthy balance. For one example, furegrelate (6) is a throm-... 

Unstable angina pectoris As above Antithrombotic effects... 

Coronary artery disease Due to the vasodilatory effect of dipyridamole, use with caution in patients with severe coronary artery disease (eg, unstable angina, recently sustained Ml). Chest pain may be aggravated in patients with underlying coronary artery disease who are receiving dipyridamole. For stroke or transient ischemic attack patients for whom aspirin is indicated to prevent recurrent Ml or angina pectoris, the aspirin in this product may not provide adequate treatment for the cardiac indications. 

To reduce the risk of death or nonfatal myocardial infarction (Ml) in patients with previous infarction or unstable angina pectoris. 

Mechanism of Action An anticoagulant that specifically and reversibly inhibits thrombin by binding to its receptor sites. Therapeutic Effect Decreases acute ischemic complications in patients with unstable angina pectoris. 

Angina pectoris, hypertension, congestive heart failure, acute myocardial ischaemia, acute pulmonary oedema, unstable coronary syndromes especially when associated with elevated filling pressures. Nitrate therapy may exaggerate outflow obstruction in hypertrophic obstructive cardiomyopathy. 

Its properties resemble those of the preceding substance. One molecule of nitric acid is readily lost by the compound, which is then transformed into triethanolamine trinitrate. The latter is also unstable and inclined to undergo decomposition. Diphosphoric salt of the trinitric ester was claimed to be an effective remedy against angina pectoris, instead of nitroglycerine. 

The contraindications to the use of 6-blockers are asthma and other bronchospastic conditions, severe bradycardia, atrioventricular blockade, bradycardia-tachycardia syndrome, and severe unstable left ventricular failure. Potential complications include fatigue, impaired exercise tolerance, insomnia, unpleasant dreams, worsening of claudication, and erectile dysfunction. Katzung PHARMACOLOGY, 9e > Section III. Cardiovascular-Renal Drugs > Chapter 12. Vasodilators the Treatment of Angina Pectoris > ... 

Garrido IP, Roy D, Calvino R, et al. Comparison of ischemia-modified albumin levels in patients undergoing percutaneous coronary intervention for unstable angina pectoris with versus without coronary collaterals. Am J Cardiol 2004 93 88-90. 

Collet JP Montalescot G, Lison L, et al. Percutaneous coronary intervention after subcutaneous enoxaparin pretreatment in patients with unstable angina pectoris. Circulation 2001 103 658-663. 

I 6 Hafner G, Rupprecht HJ, Luz M, et al. Recombinant hirudin as a periprocedural antithrombotic in coronary angioplasty for unstable angina pectoris. Eur Heart J 1996 17 1207-1215,... 

Nesto RW, Waxman S, Mittleman MA, et al. Angioscopy of culprit coronary lesions in unstable angina pectoris and correlation of clinical presentation with plaque morphology. Am J Cardiol 1998 81 225-228. 

I 6 Theroux R Latour JG, Leger-Gautier C, et al, Fibrinopeptide A plasma levels and platelet factor 4 levels in unstable angina pectoris. Circulation 1987 75 156-162. 

Kraegel AH, Reddy SC, Willes H, et al. Morphometric analysis of the composition of coronary arterial plaques in isolated unstable angina pectoris with pain at rest. Am J Cardiol 1990 66 562—567. 

One hundred and seventy-three patients (134 males and 39 females), symptomatic patients with stable angina pectoris (Canadian Cardiovascular Society I, 2, 3, or 4) or unstable angina pectoris with documented ischaemia (Braunwald Class IB-C, IIB-C, or IIIB-C) or documented ischemia with a single de novo lesion in a coronary artery suitable for treatment with a single BiodivYsio DD OC-coated coronary stent preloaded with Batimastat of I 1, 15, 18, 22, or 28 mm length by 3.0, 3.5, or4.0-mm diameter were included in the study, providing they met the selection criteria. 

Organic nitrates (and nitrites) are simple nitric and nitrous acid esters of alcohols. They differ in their volatility for example, isosorbide dinitrate is solid at room temperature, nitroglycerin is only moderately volatile, whereas amyl nitrate is extremely volatile. These compounds cause a rapid reduction in myocardial oxygen demand followed by rapid relief of symptoms. They are effective in stable and unstable angina, as well as Prinzmetal s or variant angina pectoris. 

Garabedian HD, Gold HK, Newell JB, Collen D, Hagstrom JN, Bovill EG (1994) Accelerated thrombin generation during anticoagulation in patients with unstable angina pectoris. Blood 83 1155... 

Patients with persistent angina pectoris who lack an elevated ST segment in the ECG but show an elevated blood level of troponin may have a non-STEMI ("NSTEMI ). The most frequent cause is thrombi that have moved from the larger coronary arteries into smaller branches to produce a blockage there. If neither ST segment elevation nor biochemical MI markers can be ascertained, unstable angina pectoris is present, which is initially treated with antiplatelet drugs. 

Caution after acute myocardial infarction (within 4 weeks), congestive heart failure, peripheral edema, hypotension, unstable angina pectoris... 

If patient has unstable medical condition (e.g., acute myocardial infarction, unstable angina pectoris, severe hypotension and/or bradycardia, sick sinus syndrome, recent heart surgery) (intramuscular formulation)... 

Diodati J, Theroux P, Latour JG et d (1990) Effects of nitroglycerin at therapeutic doses on platdet aggregation in unstable angina pectoris and acute myocardial infarction. Am J Cardiol 66 683-688. 

Isosorbide dinitrate (Cedocard) (t20 min) is used for prophylaxis of angina pectoris and for congestive heart failure (tabs sublingual, and to swallow). An i.v. formulation 500 micrograms/ml (Isoket) is available for use in left ventricular failure and unstable angina. 

In 202 patients with unstable angina pectoris, roxithromycin prevented death and re-infarction for at least 6 months after initial treatment (11). However, these findings could not be confirmed in another study in 302 patients with coronary heart disease and a seropositive reaction to Chlamydia pneumoniae who were treated with azithromycin. While global tests of markers of... 

M. E. Ritchie, Nuclear factor-xB is selectively and markedly activated in humans with unstable angina pectoris, Circulation 98, 1707-1713 (1998). 

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