Cigarette smoking is a major risk factor for coronary spasm.

Sugiishi, Munetaka; Takatsu, Fumimaro

doi:10.1161/01.cir.87.1.76

Cited by 353 publications

(200 citation statements)

References 12 publications

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“…15 Smoking also enhances platelet aggregability, promotes endothelial dysfunction, and causes coronary artery vasospasm. 16 The studies of Pais et al 17 conducted in India have shown very high percentage(55%) of patients to be smokers. Hypertension is firmly established as a risk factor for IHD.…”

Section: Discussion:-mentioning

confidence: 98%

Dyslipidemia is not the only Risk Factor for AMI in Non-Diabetic Population: A Hospital Based Prospective Observational Study

Rajkakati¹,

Baruah²,

Timung³

2017

IOSR JDMS

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I. BackgroundMyocardial infarction (MI) is the important manifestation of coronary heart disease. MI is myocardial necrosis occurring as a result of critical imbalance between coronary blood supply and myocardial demand. Myocardial infarction is the "impairment of heart function due to inadequate blood flow to the heart compared to its need, caused by obstructive changes in the coronary circulation to the heart". Acute myocardial infarction (AMI) is associated with obstruction of coronary artery, myocardial ischemia leading to myocardial necrosis and generation of reactive oxygen species (ROS).1 Diabetes mellitus (DM) increases the incidence of cardiovascular diseases (CVDs) and increases the risk of CVD-induced mortality in diabetic subjects compared to non-diabetic subjects.2,3 In more than 90% of cases, the cause of myocardial ischemia is reduced blood flow due to obstructive atherosclerotic plaque lesions in one of the three large coronary arteries or its branches. Coronary atherosclerosis is a complex inflammatory process characterized by accumulation of lipids, macrophages and smooth muscle cells resulting in the formation of intimae plaques in the large and medium sized epicardial coronary arteries. Dyslipidemia is one of the major risk factors for cardiovascular disease in diabetes mellitus. The characteristic features of diabetic dyslipidemia are a high plasma triglyceride concentration, low HDL cholesterol concentration and increased concentration of small dense LDL-cholesterol particles. The lipid changes associated with diabetes mellitus are attributed to increased free fatty acid flux secondary to insulin resistance. The increased risk of atherosclerosis in diabetes mellitus consists of multiple factors. Diabetesrelated changes in plasma lipid levels are among the key factors that are amenable to intervention. 4,5,6 Although atherosclerosis occurs in the general population, some people are at greater risk of developing coronary artery disease. The etiopathogenesis leading to atherogenesis is still unknown. Epidemiological studies have identified several cardiac disease risk factors for MI.7 These risk factors can be classified as modifiable and non-modifiable. Modifiable risk factors are serum lipids, lipoproteins, Hypertension (HTN), Diabetes Mellitus (DM), smoking and tobacco chewing etc. Non modifiable risk factors are age, sex, genetics, and family history of CAD. Atherosclerotic changes due to dyslipidemia were more common in diabetic patients than non diabetics as per available previous researches.The importance of the classical risk factors for heart disease was examined in the INTERHEART study, 8 which is a large, international, standardized, case-control study from 262 centers in 52 countries from Asia, Europe, the Middle East, Africa, Australia, North America, and South America. All these classical and novel risk factors for cardiovascular disease would be expected to have varying relative contributions to the disease outcome in different populations. Although, thrombus formation is the pr...

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Section: Discussion:-mentioning

confidence: 98%

Dyslipidemia is not the only Risk Factor for AMI in Non-Diabetic Population: A Hospital Based Prospective Observational Study

Rajkakati¹,

Baruah²,

Timung³

2017

IOSR JDMS

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“…Smoking is already an established and predominant risk factor for ACS. [16][17][18] Due to poverty and lack awareness, most of these patients were irregular to take medication or unable to purchase medication to control their risk factors particularly hypertension and diabetes. Both uncontrolled hypertension and diabetes have strong influence on ACS.…”

Section: Discussionmentioning

confidence: 99%

Socio-economic Status of the Patients with Acute Coronary Syndrome: Data from a District-level General Hospital of Bangladesh

Ahmed¹,

Shiraji

Chowdhury³

et al. 2017

Cardiovasc. j.

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Background: Several studies have reported the correlation between socio-economic status (SES) and incidence of acute coronary syndrome (ACS). However, none of these studies have included data on Bangladesh. Hence, we aimed to find out the SES among the patients with ACS admitted in a district-level general hospital of Bangladesh.Methods: All the patients with a diagnosis of ACS admitted from March 2016 to February 2017 in the Cardiology department of 250-bedded General Hospital (Abdul Malek Ukil Medical College & Hospital), Noakhali were enrolled in this study. Data on demography, risk factors and SES parameters of the patients was screened and recorded with the help of a pre-defined questionnaire. Socioeconomic profile of the patients was defined according to modified Kuppuswamy SES scale.Results: A total of 366 patients were included (mean age 56.6 ± 11.5 years, 261 male and 105 female). Most of the patients had multiple risk factors like smoking, hypertension, diabetes, dyslipidemia and family history of cardiovascular disease. 80.1% (n=293) of the studied patients were from lower socio-economic class followed by 18.3% (n=67) from middle class and only 1.6% (n=6) were from upper class.Conclusion: This study found that most of the patients admitted due to ACS in a district-level general hospital of Bangladesh are from lower socio-economic class. These findings could be useful to draw the attention of health authorities towards people of lower socio-economic class and to adopt preventive strategies for them against ACS.Cardiovasc. j. 2017; 10(1): 17-20

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“…Spasms may produce endothelial damage and generate a local thrombotic process that may or may not undergo spontaneous lysis. In addition, smoking is known to be closely related to vascular spasm 21 . II) Coronary embolisms -Clinical and echocardiographic evidence gathered in this case do not support mitral valve prolapse, myxoma, or endocarditis as causes of disease in our patient.…”

Section: Discussionmentioning

confidence: 99%

Dyspnea and pain in the left lower limb in a 52-year-old male patient

2000

Arq. Bras. Cardiol.

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A 52-year-old male patient was admitted to the hospital complaining of dyspnea and pain in the left lower limb.The patient reported that he sought medical care 7 years earlier due to dyspnea triggered by moderate exertion, which lasted for 3 months. He also reported at that time an episode of dizziness and an episode of nocturnal paroxysmal dyspnea.Two months before, he was diagnosed with hypertension. He reported smoking until 10 years ago.On physical examination, the patient was in good condition, his pulse was regular, his heart rate was 72bpm, and his blood pressure was 170/110mmHg. His lung examination revealed no abnormalities. His heart examination showed normal first and second heart sounds, and a systolic murmur (+/4) in the aortic area. His liver was palpable 2cm from the right costal margin. No edema existed in the lower limbs.The electrocardiogram showed sinus rhythm, a heart rate of 72bpm, a QRS axis of -10° backwards, left chamber hypertrophy, and alterations of ventricular repolarization ( fig. 1).The echocardiogram (Table I) revealed diffuse left ventricular hypokinesia, calcification of the aortic valve, and double dysfunction of the aortic valve.Serology for the diagnosis of Chagas' disease was negative.The following diagnoses were established: hypertension, mild aortic stenosis, and ventricular dysfunction.The continuous treadmill stress test showed a good physical capacity, a duration of exertion of 8 minutes, and initial and final velocities of 2 miles/hour and 5 miles/hour, respectively. The patient's heart rate at rest was 100bpm and on maximum exertion 143bpm; his blood pressure ranged from 160/99mmHg to 220/74mmHg.Rest-exercise equilibrium radionuclide ventriculography with red blood cells labeled with technecium-99m revealed diffuse left ventricular hypokinesia. Left ventricular ejection fraction at rest was 0.30 and on exertion (25 W), 0.37.The patient remained asymptomatic until 4 years ago, when he experienced severe precordial pain, which lasted for 2 hours, and he sought medical care on an emergency

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Cigarette smoking is a major risk factor for coronary spasm.

Cited by 353 publications

References 12 publications

Dyslipidemia is not the only Risk Factor for AMI in Non-Diabetic Population: A Hospital Based Prospective Observational Study

Dyslipidemia is not the only Risk Factor for AMI in Non-Diabetic Population: A Hospital Based Prospective Observational Study

Socio-economic Status of the Patients with Acute Coronary Syndrome: Data from a District-level General Hospital of Bangladesh

Dyspnea and pain in the left lower limb in a 52-year-old male patient

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