Journals / Koşuyolu Heart Journal / 2016 / Cilt: 19 - Sayı: 1

Predictive Value of Nitrate-Induced Headache on Atherosclerotic Burden in Patients with Stable Coronary Artery Disease

Kararlı Koroner Arter Hastalığı Olan Hastalarda Nitratların Oluşturduğu Baş Ağrısının Aterosklerotik Yükü Öngörmedeki Değeri

Pages
12–16
Publication Date
2016-04-04
DOI
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Patients and Methods: Overall, 40 patients with NIH (group I: 61.2 ± 8.56 years, 32 males) and 62 patients without headache (group II: 63.5 ± 8.45 years, 41 males) were included in the study.

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Objective & Hypothesis:<!-- /* Font Definitions */ @font-face {font-family:Arial; panose-1:2 11 6 4 2 2 2 2 2 4; mso-font-charset:0; mso-generic-font-family:auto; mso-font-pitch:variable; mso-font-signature:3 0 0 0 1 0;} @font-face {font-family:"MS 明朝"; panose-1:0 0 0 0 0 0 0 0 0 0; mso-font-charset:128; mso-generic-font-family:roman; mso-font-format:other; mso-font-pitch:fixed; mso-font-signature:1 134676480 16 0 131072 0;} @font-face {font-family:"Cambria Math"; panose-1:2 4 5 3 5 4 6 3 2 4; mso-font-charset:1; mso-generic-font-family:roman; mso-font-format:other; mso-font-pitch:variable; mso-font-signature:0 0 0 0 0 0;} @font-face {font-family:Cambria; panose-1:2 4 5 3 5 4 6 3 2 4; mso-font-charset:0; mso-generic-font-family:auto; mso-font-pitch:variable; mso-font-signature:3 0 0 0 1 0;} @font-face {font-family:MinionPro-Regular; panose-1:0 0 0 0 0 0 0 0 0 0; mso-font-charset:77; mso-generic-font-family:auto; mso-font-format:other; mso-font-pitch:auto; mso-font-signature:3 0 0 0 1 0;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-unhide:no; mso-style-qformat:yes; mso-style-parent:""; margin:0cm; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:Cambria; mso-ascii-font-family:Cambria; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"MS 明朝"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Cambria; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi; mso-ansi-language:EN-US; mso-no-proof:yes;} p.TemelParagraf, li.TemelParagraf, div.TemelParagraf {mso-style-name:"\[Temel Paragraf\]"; mso-style-priority:99; mso-style-unhide:no; margin:0cm; margin-bottom:.0001pt; line-height:120%; mso-pagination:none; mso-layout-grid-align:none; text-autospace:none; font-size:12.0pt; font-family:MinionPro-Regular; mso-fareast-font-family:"MS 明朝"; mso-fareast-theme-font:minor-fareast; mso-bidi-font-family:MinionPro-Regular; color:black; mso-ansi-language:EN-GB;} .MsoChpDefault {mso-style-type:export-only; mso-default-props:yes; font-family:Cambria; mso-ascii-font-family:Cambria; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"MS 明朝"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Cambria; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi; mso-ansi-language:EN-US;} @page WordSection1 {size:612.0pt 792.0pt; margin:72.0pt 90.0pt 72.0pt 90.0pt; mso-header-margin:36.0pt; mso-footer-margin:36.0pt; mso-paper-source:0;} div.WordSection1 {page:WordSection1;} --> Introduction: Nitrates, which lead to vasodilation in vessels, is one of the cornerstone drugs of antianginal therapy.
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Key Findings & Data:The most frequently encountered side effect of nitrates is headache, which is linked to vasodilation of the cerebral arteries.
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Conclusion & Impact:Patients and Methods: Overall, 40 patients with NIH (group I: 61.2 ± 8.56 years, 32 males) and 62 patients without headache (group II: 63.5 ± 8.45 years, 41 males) were included in the study.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Nitrat · baş ağrısı · ateroskleroz

Abstract

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Özet

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Cite This Article

ERKAN, H., KIRIŞ, G., KORKMAZ, L., ÇAVUŞOĞLU, İ. G., ÇELİK, Ş. (2016). Predictive Value of Nitrate-Induced Headache on Atherosclerotic Burden in Patients with Stable Coronary Artery Disease. Koşuyolu Heart Journal, Cilt: 19 - Sayı: 1, 12–16. https://ajindex.com/articles/63948

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References (13)

  1. Shirai K, Hiruta N, Song M, Kurosu T, Suzuki J, Tomaru T, et al. Cardio-ankle vascular index (CAVI) as a novel indicator of arterial stiffness: theory, evidence and perspectives. J Atheroscler Thromb 2011;18:924-38. 2. van den Oord SC, Sijbrands EJ, ten Kate GL, van Klaveren D, van Domburg RT, van der Steen AF, et al. Carotid intima-media thickness for cardiovascular risk assessment: systematic review and meta-analysis. Atherosclerosis 2013;228:1-11
  2. Gensini GG. A more meaningful scoring system for determining the severity of coronary heart disease. Am J Cardiol 1983;51:606
  3. Abrams J. Mechanism of action of the organic nitrates in the treatment of myocardial ischaemia. Am J Cardiol 1992;70:30-40
  4. Raitakari OT, Seale JP, Celermajer DS. Impaired vascular responses to nitroglycerin in subjects with coronary atherosclerosis. Am J Cardiol 2001;15;87:217-9
  5. Akerman S,Williamson DJ, Kaube H, Goadsby PJ. Nitric oxide synthase inhibitors can antagonize neurogenic and calcitonin generelated peptide induced dilation of dural meningeal vessels. Br J Pharmacol 2002;137:62-8
  6. Sivri N, Tekin G, Erbay AR, Yalta K, Senen K, Gür M, et al. Headache response to nitrate in patients with coronary artery disease and systolic heart failure. Int J Cardiol 2012 26;158:453-4
  7. Fye WB, Lauder T. Brunton and amyl nitrite: a Victorian vasodilator. Circulation 1986;74:222-9
  8. Battock DJ, Levitt PW, Steele PP. Effects of isosorbide dinitrate and nitroglycerin on central circulatory dynamics in coronary artery disease. Am Heart J 1976;92:455-8
  9. Fremont RE. The actions of organic nitrates on the cardiopulmonary and peripheral circulations. Angiology 1961;12:391-400
  10. Bassan MM, Weiler-Ravell D. The additive antianginal action of oral isosorbide dinitrate in patients receiving propranolol. Magnitude and duration of effect. Chest 1983;83:233-40
  11. Chrysant SG, Glasser SP, Bittar N, Shahidi FE, Danisa K, Ibrahim R, et al. Efficacy and safety of extended-release isosorbide mononitrate for stable effort angina pectoris. Am J Cardiol 1993;72:1249-56
  12. Hansen JM, Pedersen D, Larsen VA, Sánchez-del-Rio M, Alvarez Linera JR, Olesen J, et al. Magnetic resonance angiography shows dilatation of the middle cerebral artery after infusion of glyceryl trinitrate in healthy volunteers. Cephalalgia 2007;27:118-27
  13. Dahl A, Russell D, Nyberg-Hansen R, Rootwelt KDahl A, Russell D, Nyberg-Hansen R, et al. Effect of nitroglycerin on cerebral circulation measured by transcran