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Prostacyclin and variant angina.

F Numano, S Nomura, T Aizawa

    Annals of the New York Academy of Sciences
    |January 1, 1985
    PubMed
    Summary

    Elevated thromboxane B2 (TXB2) in effort angina and low 6-keto PGF1 alpha in variant angina suggest prostanoid roles in coronary spasm. High TXB2 may link to atherosclerotic spasm, while low PGI2 contributes to variant angina.

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    Area of Science:

    • Cardiovascular Research
    • Prostanoid Metabolism
    • Coronary Artery Disease

    Background:

    • Coronary artery spasm is a critical cause of angina.
    • Prostanoids, including thromboxane B2 (TXB2) and 6-keto PGF1 alpha (a prostacyclin metabolite), play roles in vascular tone and inflammation.
    • The specific contribution of prostanoids to different types of angina, such as variant and effort angina, requires further elucidation.

    Purpose of the Study:

    • To investigate the role of prostanoids in coronary spasm.
    • To compare plasma levels of TXB2 and 6-keto PGF1 alpha in patients with variant angina and effort angina versus healthy controls.
    • To explore the relationship between prostanoid levels and the severity of coronary artery narrowing.

    Main Methods:

    • Radioimmunoassay was used to measure plasma levels of TXB2 and 6-keto PGF1 alpha.
    • Blood samples were collected from the coronary sinus and ascending aorta.
    • Patients included those with variant angina, effort angina, and healthy controls.

    Main Results:

    • Patients with effort angina showed significantly higher TXB2 levels compared to controls.
    • Variant angina patients exhibited elevated TXB2, particularly those with significant coronary narrowing (>50%).
    • Significantly lower levels of 6-keto PGF1 alpha were observed in variant angina patients compared to controls, especially with normal or mildly narrowed coronary arteries.

    Conclusions:

    • Elevated TXB2 in patients with atherosclerotic coronaries may contribute to coronary spasm.
    • Reduced levels of 6-keto PGF1 alpha (prostacyclin) appear to be a contributing factor in variant angina.
    • Prostanoid imbalances, specifically high TXB2 and low PGI2, may play distinct roles in the pathophysiology of different angina types.

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