OBJECTIVE To determine whether a single blood test for the measurement of C reactive protein, or troponin I or T concentrations could be used to stratify patients with intractable unstable angina awaiting transfer for coronary angiography by correlating these values with coronary anatomy and transient myocardial ischaemia. DESIGN Prospective study. SETTING Tertiary cardiac unit. PATIENTS ...

Myocardial ischaemia in daily life varies according to a circadian rhythm and is induced by many factors, including both increased myocardial oxygen demand and changes in coronary tone. In most patients, ischaemia is induced by a combination of different contributing factors, although the relative contribution of each mechanism varies from patient to patient. Moreover, in the same individual, v...

BACKGROUND Nitric oxide (NO) plays a vital role in vascular homeostasis and in the pathophysiology of coronary heart disease. Its metabolites, nitrite and nitrate, have vasculoprotective properties, whereas peroxynitrite, an oxidant metabolite of NO, is cytotoxic and can aggravate myocardial damage during ischaemic reperfusion injury. Peroxynitrite nitrates free and protein bound tyrosine resid...

OBJECTIVE To establish why recurrent myocardial ischaemia predicts adverse outcome in patients with refractory unstable angina on maximal medical treatment. DESIGN Prospective observational study in 101 patients with refractory unstable angina who underwent continuous ST-segment monitoring and kept detailed pain charts prior to cardiac catheterization. Setting Tertiary referral centre. RESU...

Previous angiographic studies have shown that coronary spasm occurs in association with the variant angina described by Prinzmetal, confirming his original hypothesis. In this work we recorded the heart rate changes and the incidence of arrhythmias during variant angina. The patients were divided into two groups: anterior, with electrocardiographic signs of anterior ischaemia, and inferior, wit...

2 Introduction It has been widely documented that plasma ET-1 and big ET-1 levels are increased in patients within a day of onset of acute myocardial infarction [1,2,3,4]. Similar changes in systemic plasma ET-1 are seen in animal models of myocardial ischaemia [5,6]. The source of the released ET-1 appears to be the area subjected to ischaemic damage, since in a study in anaesthetised pigs bot...

Twenty-six patients underwent arterial counterpulsation for refractory heart failure without shock complicating acute myocardial infarction. Patients were divided into a group of 12 with continuing myocardial ischaemia, evidenced by anginal pain associated with abnormal ST segment elevation, and a group of 14 without continuing ischaemia. Clinical features (apart from pain) and prognostic indic...

Background Rheumatoid arthritis (RA) commonly involves the cardiovascular system, and is associated with significant morbidity and mortality. Mechanisms of cardiovascular disease (CVD) involvement are not fully understood, but cardiovascular inflammation is thought to drive many of the CVD manifestations, including myocardial ischaemia. The clinical utility of CMR firstpass perfusion for assess...