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Oestrogen replacement in postmenopausal women with angina pectoris
Başlık:
Oestrogen replacement in postmenopausal women with angina pectoris
Yazar:
Welsh, Colin John Percy, author.
ISBN:
9780438060487
Yazar Ek Girişi:
Fiziksel Tanımlama:
1 electronic resource (208 pages)
Genel Not:
Source: Dissertation Abstracts International, Volume: 76-08C.
Advisors: James M. McLenachan.
Özet:
Observational studies suggest that oestrogen replacement therapy has a role in the primary prevention of ischaemic heart disease. However, the single randomised controlled trial of oestrogen and progesterone replacement therapy, in secondary prevention, suggests an initial harmful effect. Alterations in haemostatic function have been suggested to explain this early hazard. High concentrations of oestradiol have beneficial effects on coronary artery tone, and appear to improve exercise capacity in women with angina. The aim of this thesis was to assess the effect of short-term (four weeks) replacement therapy with transdermal 17beta-oestradiol on symptoms, exercise capacity, ECG measures of ischaemia, and haemostatic risk profile in women with coronary artery disease (CAD), and women with the syndrome of angina, a positive exercise ECG, and normal coronary arteriography (Cardiac Syndrome X). In a doubleblind, randomised, placebo-controlled, parallel group study of 24 postmenopausal women with symptomatic coronary artery disease, 100mug/day of transdermal oestradiol had no significant effect on the frequency of angina, GTN use, exercise capacity or ECG measures of exercise-induced ischaemia. In a double-blind, randomised, placebo- controlled cross-over study of 10 women with Syndrome X, 100mug/day of transdermal oestradiol, given in addition to existing anti-anginal treatment, significantly reduced the frequency of angina, and GTN use, by 20% and 23% respectively; there was no significant change in exercise capacity or ECG evidence of myocardial ischaemia. Baseline evaluation in 40 postmenopausal women with coronary artery disease demonstrated a circadian variation in the haemostatic risk factors tissue plasminogen activator (tPA), its inhibitor (PAI-1), and factor VII, and an exercise-induced increase in factor VII, factor VIII, fibrinogen, tPA and plasminogen. These features have previously been observed in healthy volunteers and in men with CAD, but this is the first demonstration of the full complement of changes in women with CAD. In a double-blind, randomised, placebo-controlled, parallel group study, transdermal oestradiol, given at two doses (50 and 100 mug/day), had no significant effect on the morning concentration, circadian variation, or exercise-induced changes in the haemostatic risk factors fibrinogen, factor VII, factor VIII, von Willebrand factor, plasminogen, tPA or PAI-1. This study indicates that transdermal oestradiol has a neutral effect on symptoms, ECG evidence of myocardial ischaemia, and haemostatic risk profile in women with coronary artery disease. This study also suggests that transdermal oestradiol has a beneficial effect on symptoms in women with cardiac Syndrome X, and that it might be a useful adjunct to conventional anti-anginal treatment in this population. The mechanism of this benefit is unclear and is not related to a reduction in ECG evidence of myocardial ischaemia.
Notlar:
School code: 0547
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Yer Numarası | Demirbaş Numarası | Shelf Location | Lokasyon / Statüsü / İade Tarihi |
---|---|---|---|
XX(684817.1) | 684817-1001 | Proquest E-Tez Koleksiyonu | Arıyor... |
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