Variant Angina: The Role of Thromboxane A2 with Observations on the Importance of Study Design

  • G. C. Friesinger
  • R. M. S. Robertson
  • D. Robertson
  • G. Fitzgerald
  • J. Roberts
  • R. Moss
  • J. Oates
Conference paper

Abstract

The principal focus of this symposium is on the relief of acute coronary artery obstruction, but it seems appropriate to be concerned with the mechanisms by which an acute occlusion may occur. Data are extremely fragmentary and incomplete concerning events immediately preceding and responsible for acute myocardial infarction, although the evidence that they result in acute obstruction in a large portion of patients now seems convincing.

Keywords

Placebo Catheter Creatinine Heparin Adenosine 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Aiken JW, Gorman RR, Shebuski RJ (1979) Prevention of blockage of partially obstructed coronary arteries with prostacyclin correlated with inhibition of platelet aggregation. Prostaglandins 17:483–494PubMedCrossRefGoogle Scholar
  2. 2.
    Ally AI, Horrobin DF (1980) Thromboxane A2 in blood vessel walls and its physiological significance: relevance to thrombosis and hypertension. Prostaglandins Med 4:431–438PubMedCrossRefGoogle Scholar
  3. 3.
    Boeynaems JM, Waelbroeck M, Dumont JE (1979) Cholinergic and β-adrenergic stimulation of prostaglandin release by dog thyroid in vitro. Endocrinology 105:988–995PubMedCrossRefGoogle Scholar
  4. 4.
    Chierchia S, Brunnelli C, Simonetti I, Lazzari M, Maseri A (1980a) Sequence of events in angina at rest: primary reduction in coronary flow. Circulation 61:759–768PubMedCrossRefGoogle Scholar
  5. 5.
    Chierchia S, Decaterina R, Brunelli S, Crea F, Patrono C, Maseri A (1980b) Lose-dose aspirin prevents thromboxane A2 synthesis by platelets but not attacks of Prinzmetal angina. Circulation 62 [Suppl]:III–215Google Scholar
  6. 6.
    Dagenais G, Gundel W, Conti C (1979) Peripheral venospasm associated with signs of transient myocardial ischemia. Am Heart J 80:544–546CrossRefGoogle Scholar
  7. 7.
    Endo M, Hirosawa K, Kameko N, Hase K, Inoue Y, Konna S (1976) Prinzmetal’s variant angina: coronary arteriogram and left ventriculogram during angina induced by methacholine. N Engl J Med 294:252–255PubMedCrossRefGoogle Scholar
  8. 8.
    Fitzpatrick F, Gorman R, McGuire J, Kelly R, Wynalda M, Sun F (1977) Radioimmunoassay for thromboxane B2. Anal Biochem 82:1–7PubMedCrossRefGoogle Scholar
  9. 9.
    Folts JD, Rowe GC (1980) Cyclical blood flow reductions in stenosed arteries: vasospasm or platelet aggregates? Clin Res 28:170AGoogle Scholar
  10. 10.
    Folts JD, Crowell EB, Rowe GG (1976) Platelet aggregation in partially obstructed vessels and its elimination with aspirin. Circulation 54:365–370PubMedCrossRefGoogle Scholar
  11. 11.
    Goldstein IM, Malmsten CL, Kindahl H et al. (1978) Thromboxane generation by human peripheral blood polymorphonuclear leukocytes. J Exp Med 148:787–792PubMedCrossRefGoogle Scholar
  12. 12.
    Hamberg M, Samuelsson B (1971) On the metabolism of prostaglandins E1 and E2 in man. J Biol Chem 246:6713–6721PubMedGoogle Scholar
  13. 13.
    Hamberg M, Svensson J, Samuelsson B (1975) Thromboxanes: A new group of biologically active compounds derived from prostaglandin endoperoxides. Proc Natl Acad Sci USA 72: 2994–2998PubMedCrossRefGoogle Scholar
  14. 14.
    Kuzuya T, Tada M, Inoue M et al. (1980) Increased levels of thromboxane A2 in peripheral and coronary circulation in patients with angina pectoris. Am J Cardiol 45:454CrossRefGoogle Scholar
  15. 15.
    Levin RI, Weksler BB, Jaffe EA (1980) Nitroglycerin induces production of prostacyclin by human endothelial cells. Clin Res 28:471AGoogle Scholar
  16. 16.
    Lewy RI, Wiener L, Smith JB, Walinsky P, Silver MJ, Saia J (1979a) Comparison of plasma concentrations of thromboxane B2 in Prinzmetal’s variant angina and classical angina pectoris. Clin Cardiol 2:404–406PubMedCrossRefGoogle Scholar
  17. 17.
    Lewy RI, Smith JB, Silver MJ, Saia J, Walinsky P, Wiener L (1979b) Detection of thromboxane B2 (TB2) in peripheral blood of patients with Prinzmetal’s angina. Clin Res 27:462AGoogle Scholar
  18. 18.
    Lewi RI, Wiener L, Walinsky P, Lefer AM, Silver MJ, Smith JB (1980) Thromboxane release during pacing-induced angina pectoris: Possible vasoconstrictor influence on the coronary vasculature. Circulation 61:1165–1171CrossRefGoogle Scholar
  19. 19.
    MacAlpin RN, Kattus AA, Alvaro AB (1973) Angina pectoris at rest with preservation of exercise capacity: Prinzmetal’s variant angina. Circulation 47:946–958PubMedCrossRefGoogle Scholar
  20. 20.
    Maseri A, Severi S, DeNes M et al. (1978a) ‘Variant’ angina: one aspect of a continuous spectrum of vasospastic myocardial ischemia. Am J Cardiol 42:1019–1035PubMedCrossRefGoogle Scholar
  21. 21.
    Maseri A, L’Abbate A, Baroldi G et al. (1978b) Coronary vasospasm as a possible cause of myocardial infarction: a conclusion derived from the study of ‘preinfarction’ angina. N Engl J Med 299:1271–1277PubMedCrossRefGoogle Scholar
  22. 22.
    Masotti G, Poggesi L, Galanti G, Abbate R, Neri S, Severi GG (1979) Differential inhibition of prostacyclin production and platelet aggregation by aspirin. Lancet 2:1213–1216PubMedCrossRefGoogle Scholar
  23. 23.
    Mehta J, Mehta P (1980) Increased platelet prostaglandin generation and abnormal platelet sensitivity to prostacyclin and thromboxane A2 in angina pectoris. Am J Cardiol 45:454CrossRefGoogle Scholar
  24. 24.
    Nehta J, Mehta P, Pepine C, Conti CR (1980) Platelet function studies in coronary artery disease. VII, Effect of aspirin and tachycardia stress on aortic and coronary venous blood. Am J Cardiol 45:945–951CrossRefGoogle Scholar
  25. 25.
    Oelz O, Seyberth HW, Knapp HR, Sweetman BJ, Oates JA (1976) Effects of feeding ethyldihomogramma-lenolenate on prostaglandin biosynthesis and platelet aggregation in the rabbit. Biochem Biophys Acta 431:268–277PubMedGoogle Scholar
  26. 26.
    Oliva PV, Potts DE, Pluss RG (1973) Coronary arterial spasm in Prinzmetal angina; documentation by coronary arteriopaphy. N Engl J Med 288:745–751PubMedCrossRefGoogle Scholar
  27. 27.
    Osler W (1893) The principles and practice of medicine, 1st edn Appleton, New YorkGoogle Scholar
  28. 28.
    Preston F, Whipps S, Jackson CK, French AJ, Wyld PJ, Stoddard J (1981) Inhibition of prostacyclin and platelet thromboxane after low-dose aspirin. N Engl J Med 304:76–79PubMedCrossRefGoogle Scholar
  29. 29.
    Roberts LJ II, Sweetman BJ, Payne NA, Oates JA (1977) Metabolism of thromboxane B2 in man. J Biol Chem 252:7414–7417Google Scholar
  30. 30.
    Robertson D, Oates JA (1978) Variant angina and Raynaud’s phenomenon. Lancet 1:452PubMedCrossRefGoogle Scholar
  31. 31.
    Robertson RM, Breinig JB, Robertson D (1979a) Chronic recurrent variant angina. Southern Med 72:1297–1303CrossRefGoogle Scholar
  32. 32.
    Robertson D, Robertson RM, Nies AS, Oates JA, Friesinger GC (1979b) Variant angina pectoris: investigation of indexes of sympathetic nervous system function. Am J Cardiol 43: 1080–1085PubMedCrossRefGoogle Scholar
  33. 33.
    Robertson RM, Robertson D, Friesinger GC, Timmons S, Hawiger J (1980) Platelet aggregates in peripheral and coronary sinus blood in patients with spontaneous coronary astery spasm. Lancet 2:829–831PubMedCrossRefGoogle Scholar
  34. 34.
    Schafer AI, Alexander RW, Handin RI (1980) Inhibition of platelet function by organic nitrate vasodilators. Blood 55:649–654PubMedGoogle Scholar
  35. 35.
    Schror K, Smith EF, Bickerton M et al. (1980) Preservation of ischemic myocardium by pina-ne thromboxane A2. Am J Physiol 238:H87–92PubMedGoogle Scholar
  36. 36.
    Schwartz MB, Hawiger J, Timmons S, Friesinger GC (1980) Platelet aggregation in ischemic heart disease. Thromb Haemost 43:185–188PubMedGoogle Scholar
  37. 37.
    Seyberth MW, Sweetman BJ, Frolich JC, Oates JA (1976) Quantification of the major urinary metabolite of the E prostaglandins by mass-spectrometry. Evaluation of the methods application to clinical studies. Prostaglandins 11:381–397PubMedCrossRefGoogle Scholar
  38. 38.
    Sinzinger H, Feigl W, Silberbauer K (1979) Prostacyclin generation in atherosclerotic arteries. Lancet 2:469PubMedCrossRefGoogle Scholar
  39. 39.
    Taber DF, Lee CH (1978) The preparation of Dimethyl (7-2 H3 2-oxoheptyl) phosphonate. J Labelled Comp & Radiopharm 14:599–602CrossRefGoogle Scholar
  40. 40.
    Uchida Y, Yoshimoto N, Murao S (1978) Effects of anti-anginal agents on cyclical reductions of coronary blood flow. Jpn Heart J 19:904–912PubMedCrossRefGoogle Scholar
  41. 41.
    Whorton AR, Carr K, Smigel M, Walter L, Ellis K, Oates JA (1979) Reversed phase high performance liquid chromatography of prostaglandins — biological applications. J Chromatogr 163:64–71PubMedCrossRefGoogle Scholar
  42. 42.
    Yasue H, Touyama M, Kato H, Tanaka S, Akiyama F (1976) Prinzmetal’s variant form of angina as a manifestation of alpha-adrenergic receptor-mediated coronary artery spasm: documentation by coronary arteriography. Am Heart J 90:148–155CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1982

Authors and Affiliations

  • G. C. Friesinger
    • 1
  • R. M. S. Robertson
    • 1
  • D. Robertson
    • 1
  • G. Fitzgerald
    • 1
  • J. Roberts
    • 1
  • R. Moss
    • 1
  • J. Oates
    • 1
  1. 1.Divisions of Cardiology and Clinical PharmacologyVanderbilt Medical SchoolNashvilleUSA

Personalised recommendations