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Total ischemic burden. Implications for prognosis and therapy.

P F Cohn1

  • 1Department of Medicine, State University of New York Health Sciences Center, Stony Brook 11794.

The American Journal of Medicine
|January 16, 1989
PubMed
Summary
This summary is machine-generated.

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Silent myocardial ischemia patients can be type 1, 2, or 3. Prognosis depends on ischemic activity and heart function. Calcium antagonists can reduce ischemic activity in angina patients.

Area of Science:

  • Cardiology
  • Ischemic Heart Disease

Background:

  • Silent myocardial ischemia presents in three clinical types, varying in symptomatic versus asymptomatic episodes.
  • Prognosis is influenced by total ischemic activity, coronary artery disease extent, and left ventricular dysfunction.

Purpose of the Study:

  • To classify patients with silent myocardial ischemia.
  • To identify factors influencing prognosis in these patients.
  • To evaluate the efficacy of therapeutic interventions in reducing ischemic activity.

Main Methods:

  • Classification of patients into three types based on symptoms.
  • Assessment of prognostic factors including ischemic activity, coronary artery disease, and left ventricular function.
  • Utilizing exercise testing and Holter monitoring to assess therapeutic effects.

Related Experiment Videos

  • Conducting the Nifedipine Total Ischemia Awareness Program, a multicenter study using Holter monitoring.

    • Main Results:

    • Total ischemic activity can be similar across patient types, but the ratio of symptomatic to asymptomatic episodes differs.
    • Prognosis is linked to the degree of total ischemic activity and cardiac structural/functional status.
    • The Nifedipine Total Ischemia Awareness Program demonstrated benefits of adding calcium antagonists.
    • Calcium antagonists, combined with nitrates and/or beta-blockers, maximize the reduction of total ischemic activity in angina patients.

    Conclusions:

    • Silent myocardial ischemia can be clinically categorized, impacting prognostic considerations.
    • Therapeutic monitoring via exercise or Holter testing is crucial.
    • Adding calcium antagonists to existing regimens significantly reduces total ischemic activity in angina patients.