Willingness-to-pay (WTP) measures of the effects of changes in health on a person's welfare are more comprehensive than traditional cost-of-illness (COI) measures, but they are sometimes difficult to obtain. The authors investigated two approaches for measuring heart patients' WTP for changes in their angina symptoms. First, actual expenditures and perceived angina episodes avoided were used to...

Chronic stable angina is a debilitating illness affecting at least 6.6 million US residents. Despite being optimally treated by pharmacotherapy and revascularization up to 26% of patients still experience angina. Diabetes mellitus is a common co-morbid condition in angina patients. Several new investigational medications are being tested for chronic angina. Advances in understanding of myocardi...

Twelve patients with stable angina pectoris received a placebo for 7 days and then oral phentolamine for an additional 7 days. Exercise was performed at the conclusion of the 2 drug periods. All of the patients developed angina with the stress of exercise while taking placebos. The average time to develop angina was 208sec. In comparison, 9 of the 12 patients were able to exercise longer after ...

OBJECTIVES This study sought to define the predictors and prognosis of postoperative angina in patients undergoing coronary artery bypass surgery. BACKGROUND Angina recurs in the first postoperative year in 20% to 30% of patients after coronary artery bypass surgery. The Coronary Artery Surgery Study Registry provides an opportunity to study the predictors and prognosis of postoperative angin...

AIMS To determine whether an increase in effort-reward imbalance over time increases the risk of angina, and whether such increases are associated with lower occupational position. METHODS Effort-reward imbalance (ERI) at work was measured in the Whitehall II occupational cohort of London based civil servants at baseline (1985-88) and in 1997. Coronary heart disease was measured in a self-rep...

BACKGROUND Sublingual nitroglycerin increases exercise duration in patients with stable angina. Brief results from this study were published previously in German. Here, we more fully describe the study methodology, patient characteristics, and detailed results. METHODS This double-blind, crossover study enrolled 51 patients with stable angina. Patients were randomized to 1 of 5 treatment sequ...

A patient with a sinus bradycardia and angina is described who was unable to increase his heart rate on vigorous exercise by more than a few beats. His severe angina was attributed to the bradycardia. Atrial pacing of his heart abolished his angina and increased his exercise tolerance. Circulatory changes at rest, on exertion, and with atrial pacing are described. The cause of angina in this pa...

Around half of the patients undergoing an elective coronary angiogram to investigate typical stable angina symptoms are found have non-obstructive arteries (defined as < 50% stenosis). These younger with a female predilection. While underlying mechanisms responsible for these presentations heterogeneous, structural and functional abnormalities microvasculature highly prevalent. Thus, microva...

BACKGROUND The blood coagulation system is activated in the acute phase of unstable angina and acute myocardial infarction. However, it remains unclear whether augmented function of the hemostatic mechanism serves only as a marker of the acute thrombotic episode or whether a hypercoagulable state persists for a prolonged period after clinical stabilization. METHODS AND RESULTS We prospectivel...

BACKGROUND The CD40 ligand (CD40L) on activated T cells and platelets may be activating matrix metalloproteinases, inducing procoagulant activity, and be involved in the pathogenesis of acute coronary syndromes by promoting plaque rupture in atheroma. METHODS AND RESULTS To study the role of CD40L-CD40 interaction in coronary disease, we analyzed levels of soluble (s) and membrane-bound CD40L...