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3281. Adjunctive thrombolytic therapy during angioplasty for ischemic rest angina. Results of the TAUSA Trial. TAUSA Investigators. Thrombolysis and Angioplasty in Unstable Angina trial.
作者: J A Ambrose.;O D Almeida.;S K Sharma.;S R Torre.;J D Marmur.;D H Israel.;D E Ratner.;M B Weiss.;C E Hjemdahl-Monsen.;R K Myler.
来源: Circulation. 1994年90卷1期69-77页
Acute closure is increased after angioplasty in unstable angina, and adjunctive intracoronary thrombolytic therapy has been used successfully to increase angiographic success. The role of prophylactic thrombolytic therapy during angioplasty in unstable angina is unknown.
3282. Triglyceride- and cholesterol-rich lipoproteins have a differential effect on mild/moderate and severe lesion progression as assessed by quantitative coronary angiography in a controlled trial of lovastatin.
作者: H N Hodis.;W J Mack.;S P Azen.;P Alaupovic.;J M Pogoda.;L LaBree.;L C Hemphill.;D M Kramsch.;D H Blankenhorn.
来源: Circulation. 1994年90卷1期42-9页
The Monitored Atherosclerosis Regression Study, a randomized, double-blind, placebo-controlled, 2-year trial of lovastatin monotherapy, found that coronary lesions < 50% diameter stenosis (%S) and coronary lesions > or = 50% S at baseline had different responses to therapy. We now report on clinical, lipid, and nonlipid risk factors of treatment response in these lesion subsets.
3284. Effect of intense angiotensin II suppression on the diuretic response to furosemide during chronic ACE inhibition.
作者: J M Good.;A J Brady.;F H Noormohamed.;C M Oakley.;J G Cleland.
来源: Circulation. 1994年90卷1期220-4页
Contrary to expectation, most studies have demonstrated that initiation of an angiotensin-converting enzyme (ACE) inhibitor in conventional doses in patients with heart failure reduces the diuretic efficacy of furosemide. Recently, it has been suggested that single low doses (1 mg) but not high doses (25 mg) of captopril enhance furosemide-induced diuresis. It is not known whether the interaction between diuretics and ACE inhibitors are altered during long-term dosing.
3285. Intravenous Fluosol in the treatment of acute myocardial infarction. Results of the Thrombolysis and Angioplasty in Myocardial Infarction 9 Trial. TAMI 9 Research Group.
作者: T C Wall.;R M Califf.;J Blankenship.;J D Talley.;M Tannenbaum.;M Schwaiger.;G Gacioch.;M D Cohen.;M Sanz.;J D Leimberger.
来源: Circulation. 1994年90卷1期114-20页
This study was performed to determine the safety and potential efficacy of an intravenous perfluorochemical emulsion (Fluosol) as an adjunct reperfusion therapy aimed at preventing reperfusion injury for patients with acute myocardial infarction.
3286. Effects of converting enzyme inhibition on heart period variability in patients with acute myocardial infarction.
作者: D Bonaduce.;F Marciano.;M Petretta.;M L Migaux.;G Morgano.;V Bianchi.;L Salemme.;G Valva.;M Condorelli.
来源: Circulation. 1994年90卷1期108-13页
Heart period variability provides useful prognostic information on autonomic cardiac control, and a strong association has been demonstrated after myocardial infarction (MI) between cardiac mortality, sudden death, and reduced total power, ultralow-frequency (ULF) power, and very-low-frequency (VLF) power. Converting enzyme inhibitors are widely used in MI patients, but their influence on heart period variability remains to be defined.
3287. Ventricular arrhythmias in the acute and chronic phases after acute myocardial infarction. Effect of intervention with captopril.
Ventricular arrhythmias (VAs) are independent predictors of mortality in survivors of myocardial infarction (MI), and they are more likely to be induced in dilated hearts with increased wall stress. Angiotensin-converting enzyme (ACE) inhibitors have been shown to prevent progressive dilation of the left ventricle after MI.
3288. Efficacy of a single-lead unipolar transvenous defibrillator compared with a system employing an additional coronary sinus electrode. A prospective, randomized study.
作者: P J Kudenchuk.;G H Bardy.;G L Dolack.;J E Poole.;R Mehra.;G Johnson.
来源: Circulation. 1994年89卷6期2641-4页
Recent development of a prototype single-lead unipolar transvenous defibrillator offers the possibility of device implantation with the ease of a permanent pacemaker. Lowering defibrillation energy requirements would allow for a further reduction in defibrillator generator size and enhance the feasibility of pacemaker-like placement. However, if achieving a lower defibrillation energy requires placing additional intracardiac leads, the potential advantage of a smaller generator may be offset by the disadvantages of a more complex lead system. The purpose of this study was to compare defibrillation energy requirements of a single-lead unipolar defibrillator with a three-electrode system employing an additional lead in the coronary sinus.
3289. Potentiation of isosorbide dinitrate effects with N-acetylcysteine in patients with chronic heart failure.
作者: A Mehra.;A Shotan.;E Ostrzega.;W Hsueh.;J Vasquez-Johnson.;U Elkayam.
来源: Circulation. 1994年89卷6期2595-600页
Supply of sulfhydryl groups with the administration of N-acetylcysteine (NAC) has been reported to reverse tolerance to nitroglycerin but not to isosorbide dinitrate (ISDN). Lack of interaction between NAC and ISDN was suggested as an explanation for these findings. The present study was therefore designed to further evaluate this hypothesis. For this purpose, we compared the hemodynamic and hormonal effects of ISDN when given alone and in combination with NAC.
3290. Relation between coronary artery stenosis assessed by visual, caliper, and computer methods and exercise capacity in patients with single-vessel coronary artery disease. The Veterans Affairs ACME Investigators.
作者: E D Folland.;R A Vogel.;P Hartigan.;E R Bates.;G J Beauman.;T Fortin.;C Boucher.;A F Parisi.
来源: Circulation. 1994年89卷5期2005-14页
Practitioners often assume a close relation between angiographic coronary artery stenosis and patient functional capacity. To test this unproven hypothesis, we analyzed the relation between coronary artery stenosis measured by different methods and maximal treadmill exercise tolerance in patients with single-vessel disease before and after intervention by percutaneous transluminal coronary angioplasty (PTCA).
3291. Recombinant human superoxide dismutase (h-SOD) fails to improve recovery of ventricular function in patients undergoing coronary angioplasty for acute myocardial infarction.
作者: J T Flaherty.;B Pitt.;J W Gruber.;R R Heuser.;D A Rothbaum.;L R Burwell.;B S George.;D J Kereiakes.;D Deitchman.;N Gustafson.
来源: Circulation. 1994年89卷5期1982-91页
Animal studies have demonstrated a burst of oxygen free radical generation after reperfusion of ischemic myocardium that could be blocked by administration of the free radical scavenger recombinant human superoxide dismutase (h-SOD). A multicenter, randomized, placebo-controlled clinical trial was designed to test the hypothesis that free radical-mediated reperfusion injury could be reduced by intravenous administration of h-SOD begun before percutaneous transluminal coronary angioplasty (PTCA) in patients with acute transmural myocardial infarction.
3292. N-terminal proatrial natriuretic factor. An independent predictor of long-term prognosis after myocardial infarction.
作者: C Hall.;J L Rouleau.;L Moyè.;J de Champlain.;D Bichet.;M Klein.;B Sussex.;M Packer.;J Rouleau.;M O Arnold.
来源: Circulation. 1994年89卷5期1934-42页
Atrial natriuretic factor (ANF) is a peptide hormone secreted from cardiac atria in response to increased atrial pressure. Because of a longer half-life and greater stability, the N-terminal of ANF prohormone (N-terminal proANF) may be a better integrator of atrial peptide secretion than ANF itself. After myocardial infarction, elevation of ANF and other neurohormones has been associated with a poor prognosis. However, when left ventricular ejection fraction (LVEF) and other important clinical variables are included in multivariate analysis, the independent predictive value of these neurohormones has been reduced markedly.
3293. An enantiomer-enantiomer interaction of (S)- and (R)-propafenone modifies the effect of racemic drug therapy.
作者: H K Kroemer.;M F Fromm.;K Bühl.;H Terefe.;G Blaschke.;M Eichelbaum.
来源: Circulation. 1994年89卷5期2396-400页
Therapy with racemic compounds produces effects that can be attributed to both (S)- and (R)-enantiomers. Here we have tested the hypothesis that an enantiomer-enantiomer interaction would modulate the effects of treatment with a racemate, the antiarrhythmic propafenone. Previous studies have shown that while the enantiomers of propafenone exert similar sodium channel-blocking (QRS widening) effects, it is the (S)-enantiomer that produces beta-blockade; moreover, we have demonstrated recently that (R)-propafenone inhibits the metabolism of (S)-propafenone in vitro.
3294. Plasma endothelin determination as a prognostic indicator of 1-year mortality after acute myocardial infarction.
Plasma endothelin concentrations are increased in the acute phase of myocardial infarction and in chronic heart failure. Since endothelin may contribute to hemodynamic deterioration by potent vasoconstrictory and cardiotoxic actions, increased plasma levels may be associated with an unfavorable prognosis after myocardial infarction.
3295. A pilot, early angiographic patency study using a direct thrombin inhibitor as adjunctive therapy to streptokinase in acute myocardial infarction.
作者: R M Lidón.;P Théroux.;J Lespérance.;B Adelman.;R Bonan.;D Duval.;J Lévesque.
来源: Circulation. 1994年89卷4期1567-72页
The success of streptokinase in acute myocardial infarction is hampered by the high failure rate to achieve early reperfusion. This study evaluates the possible benefit of Hirulog (Biogen, Cambridge, Mass), a direct thrombin inhibitor, as adjunct therapy to streptokinase to enhance early patency and prevent rethrombosis. Heparin has been shown to be of very limited benefits in this setting.
3296. Recombinant hirudin for unstable angina pectoris. A multicenter, randomized angiographic trial.
作者: E J Topol.;V Fuster.;R A Harrington.;R M Califf.;N S Kleiman.;D J Kereiakes.;M Cohen.;A Chapekis.;H K Gold.;M A Tannenbaum.
来源: Circulation. 1994年89卷4期1557-66页
Coronary artery thrombosis plays an important pathophysiological role in unstable angina and non-Q-wave myocardial infarction. To date, heparin and thrombolytic therapy has not provided complete or consistent benefit. We hypothesized that recombinant hirudin, a direct thrombin inhibitor, would prevent accumulation of coronary artery thrombus in a manner superior to heparin.
3297. Effects of tissue plasminogen activator and a comparison of early invasive and conservative strategies in unstable angina and non-Q-wave myocardial infarction. Results of the TIMI IIIB Trial. Thrombolysis in Myocardial Ischemia.
来源: Circulation. 1994年89卷4期1545-56页
Although coronary thrombosis plays a critical role in the pathogenesis of unstable angina and non-Q-wave myocardial infarction (NQMI), the effects of thrombolytic therapy in these disorders is not clear. Also, the role of routine early coronary arteriography followed by revascularization has not been established.
3298. Short-term cholesterol lowering decreases size and severity of perfusion abnormalities by positron emission tomography after dipyridamole in patients with coronary artery disease. A potential noninvasive marker of healing coronary endothelium.
作者: K L Gould.;J P Martucci.;D I Goldberg.;M J Hess.;R P Edens.;R Latifi.;S J Dudrick.
来源: Circulation. 1994年89卷4期1530-8页
Cholesterol lowering over 1- to 3-year trials is associated with modest regression or no progression of focal coronary artery stenoses compared with progression in controls, a decrease in cardiac events proportionately more than the modest improvement in percent stenosis, and in experimental animals improved endothelial-mediated coronary vasodilation.
3299. Dose-response of chronic beta-blocker treatment in heart failure from either idiopathic dilated or ischemic cardiomyopathy. Bucindolol Investigators.
作者: M R Bristow.;J B O'Connell.;E M Gilbert.;W J French.;G Leatherman.;N E Kantrowitz.;J Orie.;M L Smucker.;G Marshall.;P Kelly.
来源: Circulation. 1994年89卷4期1632-42页
Small-scale clinical investigations have demonstrated that single doses of beta-blocking agents can improve left ventricular function in heart failure from idiopathic dilated cardiomyopathy (IDC). The purpose of this multicenter clinical trial was to determine the dose-effect characteristics of beta-blockade in a heart failure population that includes ischemic dilated cardiomyopathy (ISCD).
3300. Effects of intensive multiple risk factor reduction on coronary atherosclerosis and clinical cardiac events in men and women with coronary artery disease. The Stanford Coronary Risk Intervention Project (SCRIP).
作者: W L Haskell.;E L Alderman.;J M Fair.;D J Maron.;S F Mackey.;H R Superko.;P T Williams.;I M Johnstone.;M A Champagne.;R M Krauss.
来源: Circulation. 1994年89卷3期975-90页
Recent clinical trials have shown that modification of plasma lipoprotein concentrations can favorably alter progression of coronary atherosclerosis, but no data exist on the effects of a comprehensive program of risk reduction involving both changes in lifestyle and medications. This study tested the hypothesis that intensive multiple risk factor reduction over 4 years would significantly reduce the rate of progression of atherosclerosis in the coronary arteries of men and women compared with subjects randomly assigned to the usual care of their physician.
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