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Titolo:
Circadian activity of the endogenous fibrinolytic system in stable coronary artery disease: Effects of beta-adrenoreceptor blockers and angiotensin-converting enzyme inhibitors
Autore:
Sayer, JW; Gutteridge, C; Syndercombe-Court, D; Wilkinson, P; Timmis, AD;
Indirizzi:
London Sch Hyg & Trop Med, Dept Cardiol, London WC1, England London Sch Hyg & Trop Med London England WC1 ardiol, London WC1, England Londoniolh Hyg & Trop Med, Dept Haematol, Royal Hosp Trust, Environm Epidem London Sch Hyg & Trop Med London England WC1 Hosp Trust, Environm Epidem
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
fascicolo: 7, volume: 32, anno: 1998,
pagine: 1962 - 1968
SICI:
0735-1097(199812)32:7<1962:CAOTEF>2.0.ZU;2-I
Fonte:
ISI
Lingua:
ENG
Soggetto:
ACUTE MYOCARDIAL-INFARCTION; PLASMINOGEN-ACTIVATOR INHIBITOR; ISCHEMIC-HEART-DISEASE; PLATELET ACTIVATION; DIURNAL-VARIATION; BLOOD-PRESSURE; SYMPTOM ONSET; INVIVO; HYPERTENSION; CAPTOPRIL;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
35
Recensione:
Indirizzi per estratti:
Indirizzo: Timmis, AD London Chest Hosp, Royal Hosp Trust, Bonner Rd, London E2 9JX, England London Chest Hosp Bonner Rd London England E2 9JX 9JX, England
Citazione:
J.W. Sayer et al., "Circadian activity of the endogenous fibrinolytic system in stable coronary artery disease: Effects of beta-adrenoreceptor blockers and angiotensin-converting enzyme inhibitors", J AM COL C, 32(7), 1998, pp. 1962-1968

Abstract

Objectives. To examine circadian changes in the sympathovagal balance, theactivity of the renin-angiotensin system and hemostatic variables in patients with stable coronary artery disease, and the effects of beta-adrenoceptor blockade and angiotensin-converting enzyme inhibition. Background. Sympathovagal balance and key components of the fibrinolytic system show circadian variability. The effects of beta-adrenergic blocking agents and angiotensin converting enzyme inhibitors on these autonomic and hemostatic rhythms are not well defined. Methods. Twenty patients with coronary artery disease underwent 24-h Holter monitoring for heart rate variability and blood sampling (6 hourly for 24hours) after three consecutive treatment phases, (firstly with placebo, then bisoprolol, and finally quinapril). The effects on sympathovagal balance, hemostatic variables and the renin-angiotensin system activity were measured. Results. The fibrinolytic capacity shelved marked circadian variation at the end of the placebo phase (p = 0.002), plasminogen activator inhibitor-1 (PAI-1) activity peaking at 06.00 AM when tissue plasminogen activator (tPA) activity was at its nadir. Sympathovagal balance showed a sharp increase at approximately the same time but plasma renin activity did not rise untillater in the day. Inspection of the 24-h profiles suggested that bisoprolol reduced sympathovagal balance and the morning peak of PAI-1 activity and antigen, with a small increase in tPA activity, although these changes werenot significant. Quinapril produced a substantial rise in renin (p = 0.01)but did not significantly affect either PAI-1 or tPA. Sympathovagal balance was unaffected by quinapril. Conclusions. In patients with stable coronary artery disease, angiotensin-converting enzyme inhibition with quinapril does not affect either sympathovagal balance or the endogenous fibrinolytic system. Our data suggest that the sympathoadrenal system may modify fibrinolytic activity, judged by the response to beta-adrenoreceptor blockade with bisoprolol. (J Am Coll Cardiol 1998;32:1962-8) (C) 1998 by the American College of Cardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 02/10/20 alle ore 01:11:49