2004
DOI: 10.1161/01.cir.0000100722.34034.e4
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Angiotensin-Converting Enzyme Inhibitors and 3-Hydroxy-3-Methylglutaryl Coenzyme A Reductase in Cardiac Syndrome X

Abstract: Background— Morbidity of patients with Syndrome X (SX; chest pain and normal coronary angiograms) is high and is associated with continuing episodes of chest pain and hospitalization. Impairment of microvascular endothelial function caused by increased oxidative stress has been suggested to be a mechanism of the disease. Superoxide dismutase (SOD) is the major antioxidant enzyme system of the vascular wall. This study sought to establish whether combination treatment with ACE inhibitor… Show more

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Cited by 161 publications
(52 citation statements)
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“…101 Angiotensin converting enzyme (ACE) inhibitors have been shown to improve exercise tolerance and angina symptoms. 102 In the WISE control trial, women who received quinapril had improved CFR after 16 weeks compared to the placebo group. In addition, the experimental group also had improvement in angina symptoms based on the Seattle Angina Questionnaire.…”
Section: Managementmentioning
confidence: 99%
See 1 more Smart Citation
“…101 Angiotensin converting enzyme (ACE) inhibitors have been shown to improve exercise tolerance and angina symptoms. 102 In the WISE control trial, women who received quinapril had improved CFR after 16 weeks compared to the placebo group. In addition, the experimental group also had improvement in angina symptoms based on the Seattle Angina Questionnaire.…”
Section: Managementmentioning
confidence: 99%
“…Mechanistically, the combination produced greater increases in brachial artery flow-mediated dilation vs placebo and reduced extracellular superoxide dismutase. 102 …”
Section: Managementmentioning
confidence: 99%
“…Chronic stable symptoms may require a more selective intervention. Therapy with statins, and perhaps angiotensin-converting enzyme inhibitors, should be used for patients with evidence of coronary endothelial dysfunction and/or atherosclerotic plaques within the arterial wall detected by IVUS [38,40]. …”
Section: Approach To Management Of Individual Patientsmentioning
confidence: 99%
“…reported improved FMD and quality of life following 6 months of atorvastatin 40 mg (in addition to an angiotensin converting enzyme inhibitor) when compared to placebo. 44 In MCD patients, it is therefore reasonable to prescribe statins with a goal LDL of <2.0 in those who qualify by the presence of risk factors, evidence of atherosclerosis, and/or endothelial dysfunction.…”
Section: Therapymentioning
confidence: 99%
“…44,48,49 In MCD patients, the WISE compared quinapril 80 mg daily to placebo and reported improvements in both CFR by invasive coronary reactivity testing (p<0.019) and angina frequency (p=0.037) with ACEI over 16 weeks. 50 Therefore, ACEI are recommended in women with MCD particularly in patients with a reduced ejection fraction, uncontrolled risk factors, and/or endothelial dysfunction demonstrated on invasive testing.…”
Section: Therapymentioning
confidence: 99%