Randomized trial comparing intravenous nitroglycerin and heparin for treatment of unstable angina secondary to restenosis after coronary artery angioplasty.

Abstract:

BACKGROUND:The treatment of unstable angina targets the specific pathophysiological thrombotic process at the site of the active culprit lesion. In unstable angina due to a restenotic lesion, smooth muscle cell proliferation and increased vasoreactivity may play a more important role than thrombus formation. Therefore, the relative benefits of nitroglycerin and heparin might differ in unstable angina associated with restenosis compared with classic unstable angina. METHODS AND RESULTS:We randomized 200 patients hospitalized for unstable angina within 6 months after angioplasty (excluding those with intracoronary stents) to double-blind administration of intravenous nitroglycerin, heparin, their combination, or placebo for 63+/-30 hours. Recurrent angina occurred in 75% of patients in the placebo and heparin-alone groups, compared with 42.6% of patients in the nitroglycerin-alone group and 41.7% of patients in the nitroglycerin-plus-heparin group (P<0.003). Refractory angina requiring angiography occurred in 22.9%, 29.2%, 4. 3%, and 4.2% of patients, respectively (P<0.002). The odds ratios for being event free were 0.24 (95% CI, -0.13 to 0.45, P=0.0001) for nitroglycerin versus no nitroglycerin and 0.98 (95% CI, -0.55 to 1. 73, P=NS) for heparin versus no heparin. No patient died or suffered myocardial infarction. CONCLUSIONS:Intravenous nitroglycerin is highly effective in preventing adverse ischemic events (recurrent or refractory angina) in patients with unstable angina secondary to restenosis, whereas heparin has no effect.

journal_name

Circulation

journal_title

Circulation

authors

Doucet S,Malekianpour M,Théroux P,Bilodeau L,Côté G,de Guise P,Dupuis J,Joyal M,Gosselin G,Tanguay JF,Juneau M,Harel F,Nattel S,Tardif JC,Lespérance J

doi

10.1161/01.cir.101.9.955

subject

Has Abstract

pub_date

2000-03-07 00:00:00

pages

955-61

issue

9

eissn

0009-7322

issn

1524-4539

journal_volume

101

pub_type

临床试验,杂志文章,随机对照试验
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    authors: Rihal CS,Nishimura RA,Hatle LK,Bailey KR,Tajik AJ

    更新日期:1994-12-01 00:00:00

  • Effects of ramipril on plasma fibrinolytic balance in patients with acute anterior myocardial infarction. HEART Study Investigators.

    abstract:BACKGROUND:The long-term administration of ACE inhibitors to selected patients with left ventricular dysfunction appears to reduce the incidence of recurrent myocardial infarction (MI) and unstable angina pectoris. The mechanisms responsible for the reduction in ischemic events are unknown, but likely candidates includ...

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    pub_type: 临床试验,杂志文章,随机对照试验

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    authors: Vaughan DE,Rouleau JL,Ridker PM,Arnold JM,Menapace FJ,Pfeffer MA

    更新日期:1997-07-15 00:00:00

  • Outcome after the single-stage, nonfenestrated Fontan procedure.

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    pub_type: 杂志文章

    doi:

    authors: Hsu DT,Quaegebeur JM,Ing FF,Selber EJ,Lamour JM,Gersony WM

    更新日期:1997-11-04 00:00:00

  • In vivo molecular imaging of acute and subacute thrombosis using a fibrin-binding magnetic resonance imaging contrast agent.

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    更新日期:2004-04-27 00:00:00

  • Integrin α6β1 is the main receptor for vascular laminins and plays a role in platelet adhesion, activation, and arterial thrombosis.

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    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.112.000799

    authors: Schaff M,Tang C,Maurer E,Bourdon C,Receveur N,Eckly A,Hechler B,Arnold C,de Arcangelis A,Nieswandt B,Denis CV,Lefebvre O,Georges-Labouesse E,Gachet C,Lanza F,Mangin PH

    更新日期:2013-07-30 00:00:00

  • Prognostic values of clockwise and counterclockwise rotation for cardiovascular mortality in Japanese subjects: a 24-year follow-up of the National Integrated Project for Prospective Observation of Noncommunicable Disease and Its Trends in the Aged, 1980-

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    pub_type: 杂志文章

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    更新日期:2012-03-13 00:00:00

  • Beta2-adrenergic receptor polymorphisms and risk of incident cardiovascular events in the elderly.

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    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000065231.07729.92

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    更新日期:2003-04-22 00:00:00

  • Total anomalous pulmonary venous connection and severe pulmonic stenosis in a 52-year-old man.

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    pub_type: 杂志文章

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    更新日期:1977-01-01 00:00:00

  • Effects of weight loss and long-term weight maintenance with diets varying in protein and glycemic index on cardiovascular risk factors: the diet, obesity, and genes (DiOGenes) study: a randomized, controlled trial.

    abstract:BACKGROUND:We sought to separately examine the effects of either weight loss or diets varying in protein content and glycemic index without further changes in body weight on cardiovascular risk factors within the Diet, Obesity, and Genes study (DiOGenes). METHODS AND RESULTS:DiOGenes is a pan-European controlled dieta...

    journal_title:Circulation

    pub_type: 杂志文章,多中心研究,随机对照试验

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    更新日期:2011-12-20 00:00:00

  • Collagen-targeting vascular endothelial growth factor improves cardiac performance after myocardial infarction.

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    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.108.800565

    authors: Zhang J,Ding L,Zhao Y,Sun W,Chen B,Lin H,Wang X,Zhang L,Xu B,Dai J

    更新日期:2009-04-07 00:00:00

  • Acute right ventricular dilatation in response to ischemia significantly impairs left ventricular systolic performance.

    abstract:BACKGROUND:Right ventricular (RV) dilatation that occurs as a consequence of RV infarction is thought to produce hemodynamic instability by reducing left ventricular (LV) preload and compliance. We hypothesized that these geometric changes may also adversely affect LV systolic performance. METHODS AND RESULTS:Twelve 4...

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    authors: Brookes C,Ravn H,White P,Moeldrup U,Oldershaw P,Redington A

    更新日期:1999-08-17 00:00:00

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    pub_type: 杂志文章

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    更新日期:1999-03-16 00:00:00

  • Secondary prevention by raising HDL cholesterol and reducing triglycerides in patients with coronary artery disease.

    abstract:BACKGROUND:Coronary heart disease patients with low high-density lipoprotein cholesterol (HDL-C) levels, high triglyceride levels, or both are at an increased risk of cardiovascular events, but the clinical impact of raising HDL-C or decreasing triglycerides remains to be confirmed. METHODS AND RESULTS:In a double-bli...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1161/01.cir.102.1.21

    authors: Bezafibrate Infarction Prevention (BIP) study.

    更新日期:2000-07-04 00:00:00

  • Strut coverage and late malapposition with paclitaxel-eluting stents compared with bare metal stents in acute myocardial infarction: optical coherence tomography substudy of the Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial In

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    journal_title:Circulation

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1161/CIRCULATIONAHA.110.963181

    authors: Guagliumi G,Costa MA,Sirbu V,Musumeci G,Bezerra HG,Suzuki N,Matiashvili A,Lortkipanidze N,Mihalcsik L,Trivisonno A,Valsecchi O,Mintz GS,Dressler O,Parise H,Maehara A,Cristea E,Lansky AJ,Mehran R,Stone GW

    更新日期:2011-01-25 00:00:00

  • Direct evidence for tumor necrosis factor-alpha signaling in arteriogenesis.

    abstract:BACKGROUND:Arteriogenesis serves as an efficient mechanism for flow restoration after arterial occlusion. This process is associated with inflammatory mediators such as tumor necrosis factor-alpha (TNF-alpha), although their role in arteriogenesis remains unclear. We hypothesized that arteriogenesis is reduced in mice ...

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    pub_type: 杂志文章

    doi:10.1161/01.cir.0000014987.32865.8e

    authors: Hoefer IE,van Royen N,Rectenwald JE,Bray EJ,Abouhamze Z,Moldawer LL,Voskuil M,Piek JJ,Buschmann IR,Ozaki CK

    更新日期:2002-04-09 00:00:00

  • Gene transfer of human guanosine 5'-triphosphate cyclohydrolase I restores vascular tetrahydrobiopterin level and endothelial function in low renin hypertension.

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    pub_type: 杂志文章

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    authors: Zheng JS,Yang XQ,Lookingland KJ,Fink GD,Hesslinger C,Kapatos G,Kovesdi I,Chen AF

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  • Elevated endothelin-1 in heart failure and loss of normal response to postural change.

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    pub_type: 杂志文章

    doi:10.1161/01.cir.85.2.510

    authors: Stewart DJ,Cernacek P,Costello KB,Rouleau JL

    更新日期:1992-02-01 00:00:00

  • Genotype-phenotype correlations in hypertrophic cardiomyopathy. Insights provided by comparisons of kindreds with distinct and identical beta-myosin heavy chain gene mutations.

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    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.89.1.22

    authors: Fananapazir L,Epstein ND

    更新日期:1994-01-01 00:00:00

  • Emergency polytetrafluoroethylene-covered stent implantation to treat coronary ruptures.

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    pub_type: 临床试验,杂志文章

    doi:10.1161/01.cir.102.25.3028

    authors: Briguori C,Nishida T,Anzuini A,Di Mario C,Grube E,Colombo A

    更新日期:2000-12-19 00:00:00

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    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000157096.95223.D7

    authors: Spertus JA,Eagle KA,Krumholz HM,Mitchell KR,Normand SL,American College of Cardiology.,American Heart Association Task Force on Performance Measures.

    更新日期:2005-04-05 00:00:00

  • Increased accumulation of tissue ACE in human atherosclerotic coronary artery disease.

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    pub_type: 杂志文章

    doi:10.1161/01.cir.94.11.2756

    authors: Diet F,Pratt RE,Berry GJ,Momose N,Gibbons GH,Dzau VJ

    更新日期:1996-12-01 00:00:00

  • Inducible nitric oxide synthase inhibition of weibel-palade body release in cardiac transplant rejection.

    abstract:BACKGROUND:Inducible nitric oxide synthase (iNOS, or NOS2) reduces the severity of accelerated graft arteriosclerosis (AGA) in transplanted organs, although the precise mechanism is unclear. METHODS AND RESULTS:We transplanted wild-type murine hearts into either wild-type or NOS2-null recipient mice; we then measured ...

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    pub_type: 杂志文章

    doi:10.1161/hc4401.098471

    authors: Qian Z,Gelzer-Bell R,Yang Sx SX,Cao W,Ohnishi T,Wasowska BA,Hruban RH,Rodriguez ER,Baldwin WM 3rd,Lowenstein CJ

    更新日期:2001-11-06 00:00:00

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    doi:10.1161/01.cir.99.7.883

    authors: Bech GJ,Pijls NH,De Bruyne B,Peels KH,Michels HR,Bonnier HJ,Koolen JJ

    更新日期:1999-02-23 00:00:00

  • Increased immunoreactivity of plasma after fibrinolytic activation in an anti-DD ELISA system. Role of soluble crosslinked fibrin polymers.

    abstract::After addition of a low concentration of thrombin to normal plasma, a progressive and significant increase in crosslinked fibrin polymers was found by sodium dodecyl sulfate agarose gel electrophoresis, reaching 27% of total fibrinogen and fibrin before gel formation. As measured by enzyme-linked immunosorbent assay w...

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    pub_type: 杂志文章

    doi:10.1161/01.cir.79.3.666

    authors: Francis CW,Doughney K,Brenner B,Klingbiel K,Marder VJ

    更新日期:1989-03-01 00:00:00

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    pub_type: 临床试验,杂志文章,多中心研究

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    更新日期:1996-03-01 00:00:00

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    doi:10.1161/01.cir.102.18.2243

    authors: Koyanagi M,Egashira K,Kitamoto S,Ni W,Shimokawa H,Takeya M,Yoshimura T,Takeshita A

    更新日期:2000-10-31 00:00:00

  • Early atrial fibrillation during evolving myocardial infarction: a consequence of impaired left atrial perfusion.

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    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.75.1.146

    authors: Hod H,Lew AS,Keltai M,Cercek B,Geft IL,Shah PK,Ganz W

    更新日期:1987-01-01 00:00:00

  • Long Noncoding RNA MANTIS Facilitates Endothelial Angiogenic Function.

    abstract:BACKGROUND:The angiogenic function of endothelial cells is regulated by numerous mechanisms, but the impact of long noncoding RNAs (lncRNAs) has hardly been studied. We set out to identify novel and functionally important endothelial lncRNAs. METHODS:Epigenetically controlled lncRNAs in human umbilical vein endothelia...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.116.026991

    authors: Leisegang MS,Fork C,Josipovic I,Richter FM,Preussner J,Hu J,Miller MJ,Epah J,Hofmann P,Günther S,Moll F,Valasarajan C,Heidler J,Ponomareva Y,Freiman TM,Maegdefessel L,Plate KH,Mittelbronn M,Uchida S,Künne C,Stello

    更新日期:2017-07-04 00:00:00

  • Effects of cycle length on atrial vulnerability.

    abstract::The effect of cycle length on atrial vulnerability was studied in 14 patients manifesting reproducible repetitive atrial firing during atrial extra-stimulus (A2) testing. Repetitive atrial firing was defined as the occurrence of two or more premature atrial responses with return cycle (A2-A3) of 250 msec or less and s...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.55.2.260

    authors: Wyndham CR,Amat-y-Leon F,Wu D,Denes P,Dhingra R,Simpson R,Rosen KM

    更新日期:1977-02-01 00:00:00

  • Phosphodiesterase 1 upregulation in pulmonary arterial hypertension: target for reverse-remodeling therapy.

    abstract:BACKGROUND:Pulmonary arterial hypertension (PAH) is a life-threatening disease, characterized by vascular smooth muscle cell hyperproliferation. The calcium/calmodulin-dependent phosphodiesterase 1 (PDE1) may play a major role in vascular smooth muscle cell proliferation. METHODS AND RESULTS:We investigated the expres...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.106.676809

    authors: Schermuly RT,Pullamsetti SS,Kwapiszewska G,Dumitrascu R,Tian X,Weissmann N,Ghofrani HA,Kaulen C,Dunkern T,Schudt C,Voswinckel R,Zhou J,Samidurai A,Klepetko W,Paddenberg R,Kummer W,Seeger W,Grimminger F

    更新日期:2007-05-01 00:00:00