Active clinical trials for "Coronary Artery Disease"

The investigators' hypothesis is that restriction of circulating fluids in comparison to a liberal fluid administration policy would lead to a reduction of allogenic red blood cells exposure in patients undergoing cardiopulmonary bypass (CPB) for primary coronary artery bypass graft supported by reinfusion of washed shed blood from thoracic cavities.

This study will measure blood levels of endothelial progenitor cells (EPCs) and nitric oxide (NO) in patients with coronary artery disease (CAD) who are participating in a 3-month cardiac rehabilitation program at Suburban Hospital in Bethesda, MD. EPCs are a kind of stem cell produced by the bone marrow that can develop into cells found in arteries and in the heart and, therefore, can repair diseased vessels. The study will examine whether the EPCs are affected by exercise and will look at how they may contribute to repair of cells lining the diseased arteries as a result of participation in the rehabilitation program. People with coronary artery disease may be eligible for this study. Candidates are screened with a medical history, physical examination, electrocardiogram, and blood tests. CAD patients also to a treadmill exercise test. Volunteers' participation ends at the screening visit. The blood drawn at screening is used to identify EPC specific genes to compare with the EPC genes from patients with CAD. CAD patients participate in Suburban Hospital's cardiac rehabilitation program. The exercise portion of the program includes 36 sessions of about 60 minutes each, spaced over approximately 3 months. Patients have a baseline blood test at screening and repeat blood tests at the end of each month of participation in the rehabilitation program. Some of the blood will be used for genetic tests to see how genes of the EPCs are changed by the patient's participation in the rehabilitation program.

The proposed study is a prospective one, and will be held on consecutive individuals undergoing the non-invasive brachial artery flow-mediated dilation (FMD) ultrasound for endothelial function at the endothelial function laboratory of the Sheba Medical Center. The study group will be divided into healthy subjects group and coronary artery disease (CAD) patients group, both of which will be analyzed in respect to age, cardiovascular risk factors and the results of the platelet and endothelial functions tests. The association between platelet and endothelial functions will be then assessed in the healthy subjects group and in the CAD patients group.

Family history of early atherosclerotic disease in a first-degree relative [(FDR) sibling, parent or child] is an important risk factor for coronary artery and/or vascular disease. The risk increases ~ 2 - 7 times over that of general population. Increased thickness of the intima and media of carotid arterial wall, increased rate of plaque formation is an independent predictor of cardiovascular disease. Also it is shown that increased level of calcium deposition in the arterial wall is also associated with increased level of coronary artery narrowing. We will assess the occurrence and severity of abnormalities of intima media thickness (IMT) and/or plaque formation and increased calcium deposition in the coronary arteries and their relation to the well known traditional risk factors (plasma glucose, smoking, BMI, waist circumference, blood pressure, total cholesterol, low density lipoprotein, total cholesterol/high density lipoprotein ratio) and non-traditional risk factors (C-reactive protein, Lpa, homocysteine) in FDRs of index patients with early onset of heart or vascular disease and appropriate control population. Also to determine which of the above factor can assess IMT and Ca score better. This may help to reduce the cost of investigation, and to identify the population at high risk of developing cardiovascular disease, which may help the physicians to treat early on before cardiovascular complications occur. Also this may help to reduce the cost of invasive tests, hospital admissions and medical costs overall by reducing the morbidity and mortality.

We hypothesize that the combination of the thin-strut MULTI-LINK (i.e. VISION(tm) and/or MINI-VISION(tm)) stent and pharmacologic therapy with the oral PPAR-gamma agonist rosiglitazone will significantly reduce restenosis after intracoronary stenting in type 2 diabetic patients. This approach would present a more effective and economical alternative to the use of drug-eluting stents to reduce stent restenosis.

To assess the associations of serum sex hormones with the presence and progression of subclinical atherosclerosis.

To rescan 6,700 subjects in the MESA study to obtain computed tomography measures of calcification.

Evaluation of skin cholesterol for cardiovascular risk assessment in asymptomatic individuals at low, intermediate, or high risk based on Framingham Global Risk estimates. Carotid intima-media thickness (IMT), a surrogate marker for atherosclerotic burden, that independently predicts the occurrence of heart attack and stroke, will be the "gold standard" comparator. Hypothesis: Skin cholesterol, as measured by two non-invasive tests, correlates with CAD, as measured by CIMT in this population.

To examine the role of reduced vagal control of heart rate in the increased risk of cardiac mortality associated with anxiety in a population with established coronary artery disease (CAD). A second objective is to determine whether the effects of anxiety are independent of the effects of depression.

To develop and evaluate a nutrition education program to reduce cardiovascular disease risk in persons with low literacy skills.