Highly sensitive troponin I assay in the diagnosis of coronary artery disease in patients with suspected stable angina

BACKGROUND Evaluation of suspected stable angina patients with probable coronary artery disease(CAD)in the community is challenging.In the United Kingdom,patients with suspected stable angina are referred by community physicians to be assessed by specialists within the hospital system in rapid access chest pain clinics(RACPC).The role of a highly sensitive troponin I(uscTnI)assay in the diagnosis of suspected CAD in a RACPC in a“real-life”setting in a non-academic hospital has not been explored.AIM To examine the diagnostic value of uscTnI(detection limit 0.12 ng/L,upper reference range 8.15 ng/L,and detected uscTnI in 96.8%of the reference population),in the evaluation of stable CAD in a non-selected patient group,with several co-morbidities,who presented to the RACPC.METHODS One hundred and seventy two RACPC patients were assigned to either functional or anatomical testing according to the hospital protocol.RESULTS The investigations offered to patients were exercise tolerance test 7.6%,24 h ECG 1.2%,Echocardiogram 14.5%,stress echocardiogram 8.1%,coronary computed tomography angiography(CCTA)12.8%,coronary angiogram 13.4%,17.4%were diagnosed with non-cardiac chest pain,3.5%treated as stable angina,8.2%reviewed by cardiologists,electronic medical records were not available in 10.4%.Receiver operating characteristic curves for CAD used uscTnI values measured in patients who underwent functional testing,angiogram or CCTA.Values>0.52 ng/L showed 100%sensitivity and at>11.6 ng/L showed 100%specificity.In the range>0.52-11.6 ng/L,uscTnI may not have the same diagnostic potential.In patients assigned to coronary angiogram higher concentrations of uscTnI was associated with severe CAD.Low levels of uscTnI and low pre-test probability of CAD(QRISK3)may decrease patient numbers assigned to CCTA.CONCLUSION The uscTnI diagnostic cut-off values in a RACPC will depend on patient population and their presenting co-morbidity.In the presence of clinical comorbidities and previous CAD the uscTnI needs to be used in conjunction with clinical assessment.

Assessment of Acute Episodes in Chronic Stable Angina: A Clinical-Laboratory Approach to the Use of the Coronary Vasodilator Propatyl Nitrate

Background/Objectives: Propatyl nitrate is a coronary vasodilator with immediate and prolonged action, indicated in the treatment and prevention of acute angina pectoris episodes. Methods: This was an open, self-paired comparative study performed at UNIFESO Medical School evaluating the clinical and laboratory results of treatment with propatyl nitrate in patients with chronic stable angina pectoris. Subjects received 10 mg of propatyl nitrate, at the dose of three sublingual tablets per day, to be taken at 8:00 A.M., 2:00 P.M., and 8:00 P.M. Subjects returned to the study center after 15 days of treatment for Visit 2 assessments, and at the end of the 30-day treatment period (Visit 3). Results: A total of 200 subjects were included in the study. There was a statistically significant reduction in blood pressure (p < 0.0001) and heart rate (p = 0.0001), but no change in respiratory rate (p = 0.23). Laboratory results did not vary throughout the treatment period. There was no significant change from pretreatment in the SAQ Physical Limitation scale (p = 0.7415). The Angina Stability, Angina Frequency, and Treatment Satisfaction, and Quality of Life scales showed a significant improvement from pretreatment (p < 0.0001). Adverse events were observed among 41 subjects at Visit 2 and 35 subjects at Visit 3. Conclusions: Propatyl nitrate was safe and effective in treating chronic stable angina pectoris over the course of the 30-day treatment period. Treatment with propatyl nitrate increased angina stability and reduced angina frequency while increasing treatment satisfaction and quality of life in the patient population evaluated.

Changes of Lipid Profile and C-Reactive Protein after Withdrawal of Xuezhikang,an Extract of Cholestin,in Patients With Stable Angina Pectoris

Objectives In addition to its lipid-lowering properties, statin decreases the level of C-reactive protein （CRP） resulting in reduction of cardiovascular events. However, information about discontinuation of statin therapy in stable cardiac patients is limited. This was a prospective cohort study to explore whether withdrawal of statin treatment could result in rebound of inflammation in patients with stable angina pectofis in a short-term course. Methods and Results 75 patients with stable angina pectoris were randomly divided into three groups： ① Pretreatment with Xuezhikang （XZK, an extract of cholestin） for 6 weeks and then replaced by placebo; ②Treatment with XZK throughout the study; ③ Placebo. Lipid levels, highly sensitive CRP （hs-CRP） and serum cardiac troponin T （cTnT） were assessed before receiving the XZK therapy, 1 day before discontinuation of XZK, and on day 1, 2, 3, 7 and 14 after discontinuation of XZK, respectively. At day 14 after discontinuation of XZK therapy, total cholesterol, LDL-C and triglyceride significantly increased, whereas HDL-C level significantly decreased. The median level of hs-CRP increased significantly from the second day after withdrawal of XZK therapy. There was a prominent rebound of hs-CRP concentration 3 days after discontinuation of XZK therapy. 7 to 14 days after discontinuation of XZK therapy, the hs-CRP concentration declined to a similar level as in the placebo group. Elevated eTnT level did not occur throughout the study course in either guroup Conclusios Short-term discontinuation of statin therapy could induce a rapid rebound phenomenon of inflammatory response independently of changes of lipid parameters. However, it was not enough to induce myocardial injury in this cohort of patients with stable angina peetoris.

Relationship between resistin level in serum and acute coronary syndrome or stable angina pectoris

Objective： To investigate the relationship between serum resistin level and acute coronary syndrome （ACS） or stable angina pectoris （SAP）. Methods： Sixty-five patients, with coronary artery disease, were enrolled and divided into three subgroups： acute myocardial infarction （AMI）, unstable angina pectoris （UAP） and SAP, and 26 healthy people were recruited as controls in the cross-sectional study. Serum resistin levels were determined by ELISA （enzyme-linked immunosorbent assay）, and WBC （white blood cell count）, hsCRP （high sensitive C-reaction protein）, CKmax （maximum of creatinkinase）, CK-MBmax （maximum of isozyme of creatinkinase） and cTnImax （maximum of troponin） were measured by standard laboratory methods. Results： The serum resistin levels were 4 folds higher in AMI patients, 2.43 folds in UAP patients and I. 12 folds in SAP patients than in the healthy controls （P〈0.05）. The resistin levels were also significantly different between AMI [（8.16±0.79） ng/ml], UAP [（5.59±0.75） ng/ml] and SAP [（3.45±0.56） ng/ml] groups （P〈0.01）; WBC, hsCRP, CK CK-MBmax and cTnlmax were significantly increased in AMI patients over UAP and SAP patients. Spearman analysis showed that serum resistin levels were positively correlated with WBC （r=0.412, P=0.046）, hsCRP （r=0.427,p=0.037）, CK CK-MBmax and cTnImax （r=0.731, 0.678, 0.656; P〈0.01）. Conclusion： Serum resistin levels increased with inflammatory factors and myocardial impairment. The results suggest that human resistin might play an important role in the pathogenesis of atherosclerosis and AMI as an inflammatory factor.

Can music improve the symptoms of stable angina? A randomized controlled trial

Worldwide, the leading cause of death is ischemic heart disease. Other than medical and surgical management, alternative therapy such as relaxing music has been identified as having an impact on reducing morbidity in ischemic heart disease. Although several studies have been conducted to find out the impact of music on pain, anxiety, heart rate and stress in myocardial ischaemia, literature on the long term impact of music on severity of symptoms associated with stable angina is very sparse. Therefore, the whole purpose of this study was to determine the long term effects of Indian music on severity of symptoms in patients with stable angina. Methodology: A single blind randomized clinical trial was conducted on 60 patients of 45 to 65 years of age with stable angina. Intervention group (n = 30) listened to a music based on Indian classical system at home twice a day complementary to their regular treatment for a period of one month. Control group (n = 30) was only on their usual treatment. Both groups were assessed prior and one month after the study period for severity of symptoms based on Canadian classification of angina guidelines and their treatment. Results: Severities of symptoms (timing of the chest pain, chest pain during walking and climbing a staircase, the effect of chest pain in day to day physical activities, frequency and the number of GTN used per week and frequency of consultation a doctor for chest pain) were significantly improved in the study group (p < 0.05, p < 0.01) after intervention. However, the control group did not show any significant changes (p > 0.05). Conclusion: Systematically, regular listening of music based on Indian classical system significantly improves the severity of the stable angina symptoms. Hence music has a potential benefit in considering for use as complementary to angina treatment in reducing morbidity.

Core outcome set for stable angina pectoris in traditional Chinese medicine(COS-SAP-TCM)

Objective:This study aimed to develop a core outcome set(COS)for use in future studies of stable angina pectoris(SAP)in traditional Chinese medicine(TCM).Methods:Systematic literature reviews and qualitative interviews with cardiologists and patients with SAP treated using TCM were conducted to generate a set of outcomes.Outcomes were prioritized by stakeholders via two rounds of an online Delphi survey and face-to-face consensus meetings.Following the final consensus meeting,a final COS was generated.Results:An initial set of 324 outcomes was identified.A preliminary list of 65 outcomes was employed in the Delphi study.In total,223 participants from seven stakeholder groups were invited to score outcomes in the first Delphi round:87 completed round 1 and 47 completed round 2.Thirty-one participants attended the consensus meeting and agreed on a final core set of outcomes comprising six items across four domains:frequency of angina attack,duration of angina attack,Seattle angina questionnaire,total exercise duration in the exercise treadmill test,cardiovascular events,and QT interval on electrocardiography.Conclusions:The COS developed in this study provides the minimum requirements for measurement and reporting in future TCM clinical trials for the treatment of SAP.The employment of this COS may reduce heterogeneity across trials and facilitate evidencebased decision-making for stakeholders.

Coronary revascularization in the elderly with stable angina

A proportion of elderly with coronary artery disease is rapidly growing. They have more severe coronary artery disease, therefore, derive more benefit fi＇om revascularization and have a greater need for it. The elderly is a heterogeneous group, but compared to the younger cohort, the choice of the optimal revascularization method is much more complicated among them. In recent decades, results has improved dramatically both in surgery and percutaneous coronary intervention （PCI）, even in very old persons. Despite the lack of evidence in elderly, it is obvious, that coronary artery bypass surgery （CABG） has a more pronounced effect on long-term survival in price of more strokes, while PCI is certainly less invasive. Age itself is not a criterion for the selection of treatment strategy, but the elderly are often more interested in quality of life and personal independence instead of longevity. This article discusses the factors that influence the choice of the revascularization method in the elderly with stable angina and presents a complex algorithm for making an individual risk-benefit profile. As a consequence the features of CABG and PCI in elderly patients are exposed. Emphasis is centered on the frailty and non-medical factors, including psychosocial, as essential components in making the decision of what strategy to choose. Good communication with the patients and giving them unbiased information is encouraged.

Coronary Angiography: Indications, Results and Cost-Effectiveness in the Diagnosis of Stable Angina Pectoris in Two Hospitals in Senegal

Background: The current gold standard for the diagnosis of stable coronary artery disease (CAD) is invasive coronary angiography. But a large proportion of patients undergoing coronary angiography don’t have obstructive coronary artery disease. Objective: The aim of the present study was to evaluate the diagnostic performance of invasive coronary angiography for patients without known coronary artery disease presenting with stable chest pain syndrome at two hospitals structures in Senegal. Method: We conducted a prospective, descriptive, and analytical study from March 1, 2019, to December 31, 2020 in the Cardiology Departments of General Hospital Idrissa Pouye (HOGIP) and Aristide Le Dantec Hospital (HALD). During the study period a cohort of patients referred to angiography coronary for diagnostic CAD because of suspected stable angina were enrolled. Demographic characteristics, risk factors, symptoms, and noninvasive test results were correlated with the presence of obstructive coronary artery disease. Results: A total of 143 patients were included in our study with a median age of 60.91 ± 10.58 years;men were 96 (67.13%) and women 47 (32.87%). The prevalence of hypertension was 60.84%;diabetes was 34.27%;dyslipidemia was 32.17% and sedentary was 26.57% in our study population. Typical and atypical angina symptoms were present in 37.76% (n = 54) and 49.65% (n = 71) respectively, while 10.49% had dyspnea. Coronary angiography revealed 59 (41.26%) patients with no CAD as well as 27 (18.88%) with one-vessel;28 (19.58%) with two-vessel, and 29 (20.28%) with three-vessel disease. Independent predictive factors for stable angina with the presence of obstructive lesion were: patient age (OR, 2.36;95% CI, 1.05 - 5.29;p = 0.036);male gender (OR, 1.6;95% CI, 0.72 - 3.57;p = 0.24);diabetes (OR, 2.14;95% CI, 0.96 - 4.75;p = 0.06) and necrosis Q waves (4.75;CI, 0.98 - 23.09;p = 0.05). Conclusion: In our study, more than half of the patients (58.74%) referred for coronary angiography had a confirmed diagnosis. A better clinical and non-invasive assessment is needed to improve the efficiency of patient selection for coronary angiography.

Effect of Music on State of Ischaemia in Stable Angina;a Randomized Controlled Trial

Introduction: Ischaemic heart disease is the number one cause of deaths in the world. As these patients experience severe distress due to a number of associated reasons, it is important to focus on both physiological and psychological needs of the patients in the management. Beyond the standard medical and surgical treatments, relaxation therapies such as relaxing music have been identified as having impact in reducing morbidity in ischaemic heart disease. Even though several studies have been conducted to find out the impact of music on pain, anxiety, heart rate and stress associated with myocardial ischaemia, it is hard to find literature on the long-term effects of music on ischaemia. Therefore the effort of this study was to determine the long-term effects of Indian classical music on state of ischaemia in stable angina. Methodology: A single blind randomized clinical trial was conducted on 60 patients of 45 to 65 years of age with stable angina. Intervention group (n = 30) listened to a music based on Indian classical system at home twice a day complementary to their regular treatment for a period of one month. Control group (n = 30) was only on their usual treatment. Both groups were assessed before and one month after the study period for state of ischaemia based on exercise ECG results. Results: Significant improvement in state of ischaemia (p 0.05). Conclusion: Systematic, regular listening of music based on Indian classical system significantly improved the severity of the state of ischaemia associated with stable angina. Hence music therapy has a potential benefit in considering for use as complementary to angina treatment in reducing morbidity.

Managing the treatment of the patients with stable angina like a chess player： making moves considering the next move of atherosclerosis

We read the article entitled Coronary revascularization in the elderly with stable angina with interest. In the guidelines related to stable coronary artery disease, it does not exist any age-related net proposals for the patients with stable angina pectoris.

Effect of Music on Quality of Life in Stable Angina: A Randomized Controlled Trial

Introduction: Quality of life associated with coronary artery disease can be affected by number of factors. Even though standard treatment has improved survival of such patients, the quality of life may be less than ideal as the disease affects the physical, social, and emotional functioning of such individuals. Therefore improvement of the quality of life of the patients with coronary artery disease is vital. Though music has been identified having a potential benefit in improving quality of life for many years, researches conducted to recognize the effect of music on quality of life were sparse. Therefore the aim of this study was to determine the effect of frequent long term listening to Indian classical music on quality of life in chronic stable angina (SA) patients. Methodology: This single blind randomized clinical trial was conducted for one month. The intervention group of 30 patients listened to a music based on Indian classical system at home twice a day complementary to their regular treatment. The control group of 30 was only on their usual treatment. Both groups were assessed before and after the intervention for the quality of life by the Sinhala version of SF-36 questionnaire. Results: A statistically significant increase of scores for physical function by 16.17

Conservative Approach Might Be the Strategy by Default in Stable Angina Patients: A Case Report

Management of stable angina is still a matter of debate. Whether a conservative or invasive approach is better remains unclear. Even though recent large-scale randomized trials depict the conservative strategy as safe and efficient. In this report, we present a case of a 53-year-old male patient with cardiovascular risk factors of hypertension and hypercholesterolemia. He complained about typical chest pain at exertion. The coronary angiogram (CA) revealed severe stenosis of the proximal left anterior descending artery (LAD) ostium. After heart team discussion, coronary artery bypass graft (CABG) was advocated. However, due to a lack of means, the CABG was postponed. Meanwhile, he was managed with guideline-based medical therapy. In addition, he exercised regularly and adopted a healthy diet. Evolution was favorable with excellent symptoms control. A regular follow-up was organized with his cardiologist. A new CA before an eventual CABG six years later showed a significant plaque volume regression of the proximal LAD. We decided to continue conservative management. The stress echocardiogram to assess symptoms and exercise tolerance was normal. Our patient was sent to surgery on top of optimal medical therapy even though angioplasty was a good indication and was feasible. However, while he was struggling to afford the CABG procedure, he adopted a very healthy lifestyle along with medical therapy. Six years later, the result of that approach was without appeal, suggesting and reinforcing the conservative management of stable heart disease over invasive strategy. The recent ISCHEMIA trial is a major argument supporting that approach.

A Meta-analysis of Ginseng combined with conventional therapy for stable angina pectoris

Objective:To evaluate the efficacy of Ginseng combined with conventional therapy for stable angina pectoris(SAP).Methods:From the Cochrane Library,Pubmed,Embase,Web of Science,CNKI(China National Knowledge Infrastructure),Wanfang Datebase,VIP(Chinese Scientific Journals Database),CBM(Chinese Biomedicine Database),we reviewed the clinical randomized controlled trial(RCT),after screening and assessing the risk of bias,used RevMan 5.3 and Stata 15.0 software to make the Meta-analysis.Results:Thirteen studies were included with 1176 cases,involving 606 cases in the experimental group and 570 in the control group.The results of Meta-analysis showed that Ginseng combined with conventional therapy significantly has obvious effect on clinical effective rate(RR=1.29,95%CI[1.21,1.36],P<0.00001);ECG effective rate(RR=1.35,95%CI[1.22,1.50],P<0.00001);number of angina attacks(MD=-1.77,95%CI[-2.64,-0.91],P<0.00001);duration of angina pectoris(MD=-2.16,95%CI[-2.54,-1.78],P<0.00001);nitroglycerin dosage(MD=-1.52,95%CI[-1.81,-1.23],P<0.00001),and it is better than using conventional therapy alone.Conclusion:Ginseng combined with conventional therapy for SAP can significantly improve clinical effective rate and ECG effective rate,reduce the number of angina attacks,shorten the duration of angina pectoris,and reduce nitroglycerin dosage.The development of ginseng-related proprietary Chinese medicines has good prospects.But due to the quality of studies is medium and low,it still needs to be confirmed by conducting high-quality RCTs.

Effcet of Pravastatin to Reduce the Onset of Transient Myocardial lschemia in Patients with Stable Angina of Coronary Heart Disease

One of the major pathogenesis of coronary heart disease is hyperchoresterolemiaAlthough choresterol reducing therapy can decrease the morbidity and mortality ofcoronary heart disease,what is less certain is the portential antimyocardial ischemiaeffect of it.Besides the conventional therapy,the application of choresterol reducingtherapy can decrease the onset of transient myocardial ischemia in patients withunstable angina in this trial,we initiated the application of 3-hydroxy-3-methylglutaryl coenzyme A(HMG-CoA) reductase inhibitor pravastatin to reduce thelevel of serum total choresterol and LDL-C(low-density lipoprotein choresterol) andto decrease the onset of transient myocardial ischemia in pationts with stable angina ofcoronary heart disease.Patient selection.There were 368 patients aged 45-80 years,with stable angina of coronary heart discase and hyperlipidemia,randomized intopravastatin group and placebo group besides the convientional antiangina therapy in12 months,with 266 male and 102 female.Serum total choresterol was 4-8mmol/L(155-310mg/dL).All patients received 48 hours Hoter monitoring pre andpost the trial.The definition of the onset of transient myocardial ischemia isdownsloping or horizontal ST segment depression≥0.1mv from 80msec after the Jpoint with duration≥60secends.I.In pravastatin group,the level of serum totalchoresterol and LDL--C reduced significantly(total choresterol from 6.08 mmol/L to4.80mmol/L,LDL-C from 4.20 mmol/L to 1.46 mmol/L),high-density lipoproteinchoresterol raised markedly(from 0.9 mmol/L to 1.02 mmol/L),p【0.001.Nosignificant change was noted in placebo group.2.Inpravastatin group,the onset oftransient myocardial ischemia was 26% before the trial.and was 19% after the trial.While in placebo group,the rate was 19% to 22% reapectively.There were significantdifference between the two groups.3.Duration of the episode of transient myocardialisohemis was shortened from 80±12 seconds to 42±10 seconds in pravastatin groupand was shortened from 60±13 seconds to 51±9 seonds in placebo group.In patientswith stable angina of coronary heart disease,the application of HMG-CoA reductaseinhibitor reduced blood lipids.hindered the growth of atherosclerotic plaque,improved myocardial blood supply and decreased the onset of transient myocardialischemia.

Effects of auricular point pressing + Danshen Dropping Pill on platelet function, inflammatory response and protease expression in patients with stable angina pectoris

Objective:To investigate the effects of auricular point pressing plus Danshen Dropping Pill on platelet function, inflammatory response and protease expression in patients with stable angina pectoris.Methods:A total of 92 patients with stable angina pectoris who were treated in this hospital between November 2014 and November 2017 were divided into the auricular point pressing group (n=46) and routine group (n=46) by random number table method. Routine group were treated with routine western medicine plus Danshen Dropping Pill, auricular point pressing group were treated with auricular point pressing on the basis of the therapy of routine group, and both groups had been continuously treated for 1 month. The differences in platelet function, inflammatory response and protease expression were compared between the two groups before and after treatment.Results:Before treatment, there was no statistically significant difference in the platelet activation index levels, serum inflammatory factor contents or protease expression between the two groups. After 1 month of treatment, peripheral blood platelet activation index CD42b level of auricular point pressing group was higher than that of routine group whereas CD63 and PAC-1 levels were lower than those of routine group;serum inflammatory factors IL-6, IL-10, IL-18 and hs-CRP contents were lower than those of routine group;serum proteases MMP-1, MMP-2 and MMP-9 contents were lower than those of routine group.Conclusion:Compound Danshen Dropping Pill combined with auricular point pressing can further optimize the platelet function and improve the systemic inflammatory state and protease expression in patients with stable angina pectoris.

Chinese patent medicine for stable angina pectoris:protocol for a systematic review and network meta-analysis

Stable angina pectoris is a common condition that affects a wide group of patients with coronary artery diseases.A number of Chinese patent drugs based on classic herbal formulations are available for angina management.A network meta-analysis is proposed to assess the relative efficacy and safety of commonly used drugs for stable angina and generate a clinically meaningful ranking for each important outcome.We composed a list of 24 widely-used oral blood-quickening Chinese patent drugs from literature review and expert consultation.Three English and five Chinese electronic databases will be searched up to July 2021 for randomised clinical trials comparing between drugs on the list or with nitrates or placebo for stable angina.Unpublished data or grey literature will be sought through trial registries and correspondence to the report authors.Two reviewers independently screen literature,extract data and assess clinical and methodological features of included studies.The WinBUGS software will be used to perform network meta-analysis and the Stata 13.0 software to generate graphic demonstrations of the results.Primary outcomes are the incidence of cardiovascular events and changes in angina frequency,duration and intensity.We will use the surface under the cumulative ranking curve and the mean value for the numeric presentation of efficacy and safety ranking probabilities of multiple treatments.Heterogeneity and inconsistency will be assessed using appropriate statistical tests,and subgroup analysis and network meta-regression will be resorted when necessary.The quality of evidence for each outcome will be graded with the web-based GRADEpro GDT.

Research on acupuncture treatment of chronic stable angina by Chinese scholars

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].

Comparison of Results of Coronary Angioplasty in Patients with Unstable vs. Stable Angina

Objectives To compare the short and mid - term outcomes in cases of percutaneous transluminal coronary angioplasty (PTCA) in patients with unstable v stable angina. Methods Patients selected for PTCA/stenting were divided in to two groups, one with stable angina pectoris (SA group, n = 92) and one with unstable angina pectoris (UA group, n = 112). The outcomes of coronary an giographies (CAG), initial (30-d) success of the procedure, and follow - up status in the two groups were compared. Results Baseline characteristics were similar, although the patients with unstable symptoms more females ( P< 0. 05), and had a higher average CCS class (P< 0. 05) and a higher incidence of postinfarction angina ( P< 0. 01). The frequency of ' complex stenosis in patients with unstable angina was higher than that of patients with stable angina, 33% v 20% ( P< 0. 01). A total of 309 vessels ac cepted the procedure; including 210 stents were sue cessfully delivered to 156 patients. 143 and 67 stents were implanted in the UA and SA group, respectively ( P< 0. 01 ) . No major complication occurred in the two groups, except 12 patients experienced reoccur ring chest pain initially, 9 in UA group v 3 in SA group ( P< 0. 05). The averaged six - month follow -up status was compared too. Only 3 cases developed myocardial infarction, including 2 patients with unsta ble angina. 12 and 16 reoccurring chest pains were found in the two groups, respectively ( 13% in SA group vs 14% in UA group). There were no signifi cant differences between groups in rates of clinical restenosis, follow - up angina class, or overall clinical success. Conclusions Patients with unstable angina receiving PTCA/stenting have similar complication, restenosis, and initial and midterm success rate as compared to patients with stable symptoms with strict cases select and careful preparation.

Analysis of the Nursing Effect of Continuity of Care on Elderly Patients with Coronary Heart Disease Unstable Angina and its Impact on Quality of Life

Objective:To analyze the effect of using continuity of care for elderly patients with coronary heart disease(CHD)with unstable angina pectoris(UAP)and its impact on their quality of life.Methods:100 cases of elderly patients with CHD with UAP admitted to our hospital from March 2022 to March 2023 were selected and grouped into an observation group and a control group of 50 cases each according to the randomized number table method.The nursing effect and quality of life of the observation group(continuity nursing)and the control group(routine nursing)were compared.Results:The total effective rate of nursing care was 96.00%observation group and 80.00%for the control group,and the differences were significant(χ2=6.061,P<0.05).Patients in the observation group had fewer episodes(1.42±0.21)times/week and a shorter duration(5.46±0.39)min,which were better than the control group(t=3.465,2.973;P<0.05).The depression self-rating depression scale(SDS)score(42.16±6.64)and anxiety self-rating scale(SAS)score(32.26±7.35)in the observation group were lower and the quality of life was higher as compared to that of the control group(P<0.05).Conclusion:Continuous nursing care improved the nursing effect of elderly CHD with UAP patients,promoted the alleviation of UAP symptoms,improved patient mentality,and improved their quality of life.Hence,continuous nursing care possesses significant clinical application value.

Effects of systematic cardiac rehabilitation training in elderly patients with unstable angina following cardiac stent implantation

BACKGROUND Coronary stent implantation is usually used to treat unstable angina to alleviate stenosis or occlusion,promoting blood flow restoration and alleviating symptoms such as myocardial ischemia.And postoperative cardiac rehabilitation is essential for enhancing recovery and prognosis.Nevertheless,conventional rehabilitation lacks specificity,particularly for elderly patients with multiple comorbidities and poor compliance,rendering it less effective.AIM To investigate the effects of systematic cardiac rehabilitation training in elderly patients with unstable angina following coronary stenting intervention.METHODS A retrospective enrollment was conducted comprising fifty-four elderly patients with unstable angina pectoris who underwent systematic cardiac rehabilitation training after receiving coronary intervention as the rehabilitation group,while fifty-three elderly patients who received basic nursing and rehabilitation guidance measures after coronary intervention were assigned to the control group.Differences in Seattle Angina Questionnaire scores,survival quality(SF-36)scores,cardiopulmonary exercise function assessment index,echocardiographic cardiac function index,and adverse cardiovascular events were compared between the two groups.RESULTS After intervention,the rehabilitation group observed greater VO2 Max,maximum metabolic equivalent,eft ventricular ejection fraction,left ventricular end-diastolic diameter and smaller left ventricular end-systolic diameter.And the rehabilitation group observed greater scores of physical activity limitation,stable angina pectoris,treatment satisfaction,and SF-36 score.The incidence of adverse cardiovascular events in the two groups,showed no significant difference.CONCLUSION Systematic cardiac rehabilitation following coronary stenting in elderly patients with unstable angina pectoris can enhance cardiac function recovery,consequently enhancing both quality of life and cardiopulmonary exercise tolerance.