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The ORBITA-2 trial ( NCT03742050 ) investigated the efficacy of Percutaneous Coronary Intervention (PCI) compared to placebo in 301 patients with stable angina. At the 12-week mark, the PCI group exhibited a significantly lower mean angina score (2.9) compared to the placebo group (5.6; odds ratio, 2.21; 95% CI, 1.41-3.47;
The perplexing landscape of angina with nonobstructive coronary arteries (ANOCA) encompasses diverse pathophysiological entities, including coronary microvascular disease (CMD), coronary artery spasm, and the enigmatic myocardial bridging (MB).
The primary outcome was a composite of death from any cause, myocardial infarction, or hospitalization for unstable angina at 2 years. The analysis composed of participants with multivessel or left main CAD.
The typical pain of cardiac origin is a central chest pain which occurs on walking or other forms of exercise, known as effort angina. Effort angina is commonly due to significant obstruction to a blood vessel (coronary artery) supplying a part of the heart muscle. Pain is likely to be more if you are walking after a heavy meal.
The primary endpoint consisted of a composite of all-cause mortality, MI, stroke, coronary revascularization, or hospitalization for unstable angina. However, CSR did significantly reduce the number of daily angina episodes compared to placebo. of patients in the PCI group compared to 3.4% in the medical therapy group.
This patient had reported with recent onset angina. In a case reported by Shinde RS et al, coronary angiography documented total occlusion of left coronary artery and the patient underwent emergency coronary artery bypass surgery. In that case there was ST depression in I, aVL, II, aVF and V2-V6. ST elevation was 2 mm in aVR and 1 mm in V1.
Angina is another common symptom due the hypertrophy which causes a coronary supply demand mismatch Symptoms of HCM include syncope/near syncope, which could be precipitated by exertion, hypovolemia, rapid standing, Valsalva manoeuvre, diuretics, vasodilators or arrhythmia.
That is usually with angina and ventricular strain patterns. So in anterior leads, for diagnosis of ST elevation myocardial infarction, V1, the cutoff is usually 2 mm, while 1 mm is enought in other leads. When there is ST depression, even 0.5 mm is enough, to consider abormal ST.
Recently published in EuroIntervention, additional analysis from the ISCHEMIA trial evaluated three main aspects: first, the association between participant sex and the likelihood of undergoing revascularization among those randomized to the INV arm; second, the risk of the ISCHEMIA primary composite outcome (cardiovascular death, myocardial infarction (..)
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