Information obtained during the past decade suggests the need to reexamine the possibility that the onset of myocardial infarction and sudden cardiac death is frequently triggered by daily activities. The importance of physical or mental stress in triggering onset of coronary thrombosis is supported by the findings that 1) the frequencies of onset of myocardial infarction, sudden cardiac death, and stroke show marked circadian variations with parallel increases in the period from 6:00 AM to noon, 2) transient myocardial ischemia shows a similar morning increase, and episodes are often preceded by mental or physical triggers, 3) a ruptured atherosclerotic plaque, often nonobstructive by itself, lies at the base of most coronary thrombi, 4) a number of physiologic processes that could lead to plaque rupture, a hypercoagulable state or coronary vasoconstriction, are accentuated in the morning, and 5) aspirin and beta-adrenergic blocking agents, which block certain of these processes, have been shown to prevent disease onset. The hypothesis is presented that occlusive coronary thrombosis occurs when 1) an atherosclerotic plaque becomes vulnerable to rupture, 2) mental or physical stress causes the plaque to rupture, and 3) increase...Continue Reading
Norepinephrine and epinephrine release and adrenergic mediation of smoking-associated hemodynamic and metabolic events
Suppression of silent ischemia by metoprolol without alteration of morning increase of platelet aggregability in patients with stable coronary artery disease.
Dilation of normal and constriction of atherosclerotic coronary arteries caused by the cold pressor test
Major circadian fluctuations in fibrinolytic factors and possible relevance to time of onset of myocardial infarction, sudden cardiac death and stroke
Can coronary angiography predict the site of a subsequent myocardial infarction in patients with mild-to-moderate coronary artery disease?
Angiographic features in the infarct-related artery after intracoronary urokinase followed by prolonged anticoagulation. Role of ruptured atheromatous plaque and adherent thrombus in acute myocardial infarction in vivo
Mental stress and the induction of silent myocardial ischemia in patients with coronary artery disease.
Frequency of ST-segment depression produced by mental stress in stable angina pectoris from coronary artery disease
Are anti-platelet drugs of value in the management of patients with chronic stable angina? A study with ticlopidine
Concurrent morning increase in platelet aggregability and the risk of myocardial infarction and sudden cardiac death
Coronary vasoconstrictor response to cold pressor test in variant angina: lack of relation to intracoronary thromboxane concentrations
Circadian variation in occurrence of transient overt and silent myocardial ischemia in chronic stable angina and comparison with Prinzmetal angina in men
Circadian variation in the incidence of sudden cardiac death in the Framingham Heart Study population
Influence of arterial damage and wall shear rate on platelet deposition. Ex vivo study in a swine model
Hemodynamic and electrocardiographic correlates of symptomatic and silent myocardial ischemia: pathophysiologic and therapeutic implications
Nocturnal angina: precipitating factors in patients with coronary artery disease and those with variant angina
Plaque fissuring--the cause of acute myocardial infarction, sudden ischaemic death, and crescendo angina
Incomplete lysis of thrombus in the moderate underlying atherosclerotic lesion during intracoronary infusion of streptokinase for acute myocardial infarction: quantitative angiographic observations
Early detection of silent ischaemic heart disease by 24-hour electrocardiographic monitoring of active subjects
Blood fibrinolytic activity in man. Diurnal variation and the response to varying intensities of exercise
Protective effects of aspirin against acute myocardial infarction and death in men with unstable angina. Results of a Veterans Administration Cooperative Study
Comparison between diurnal distribution of onset of infarction in patients with acute myocardial infarction and circadian variation of blood pressure in patients with coronary artery disease
Stress-induced hemodynamic and hemostatic changes in patients with systemic hypertension: effect of verapamil
Comparison of the effects of terazosin and enalapril on laboratory stress testing blood pressure in patients with essential hypertension
Long-term hemodynamic effects at rest and during exercise of newer antihypertensive agents and salt restriction in essential hypertension: review of epanolol, doxazosin, amlodipine, felodipine, diltiazem, lisinopril, dilevalol, carvedilol, and ketanserin
[Circadian variation of ventricular tachyarrhythmias in patients with an implantable cardioverter-defibrillator].
Relation of plasma catecholamine levels with pulse wave velocity in hypertensive patients compared with normotensive subjects.
Circadian variation in the circulatory responses to exercise: relevance to the morning peaks in strokes and cardiac events.
Prospective validation that vulnerable plaque associated with major adverse outcomes have larger plaque volume, less dense calcium, and more non-calcified plaque by quantitative, three-dimensional measurements using intravascular ultrasound with radiofrequency backscatter analysis : results from the ATLANTA I Study
Time-series analysis of long-term ambulatory myocardial ischemia: effects of beta-adrenergic and calcium channel blockade
The suprachiasmatic nucleus controls the circadian rhythm of heart rate via the sympathetic nervous system
Tolerability and antihypertensive efficacy of Fosinopril on 24-hr ambulatory blood pressure in hypertensive elderly subjects
Anti-ischemic effects of atenolol versus nifedipine in patients with coronary artery disease and ambulatory silent ischemia.
Modifiers of timing and possible triggers of acute myocardial infarction in the Thrombolysis in Myocardial Infarction Phase II (TIMI II) Study Group
Identification of a secondary peak in myocardial infarction onset 11 to 12 hours after awakening: the Cardiac Arrhythmia Suppression Trial (CAST) experience
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