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FACT SHEET 6
GLOSSARY
Ace inhibitors (angiotensin
converting enzyme inhibitors) commonly used in treating
chronic heart failure and high blood pressure, they are also used
during and after a heart attack. They prevent the normal
formation of angiotensin II, a hormone that causes constriction
(narrowing) of the blood vessels. The drug allows blood vessels
to dilate (widen), thus reducing blood pressure and making it
easier for the heart to pump blood.
Acute Myocardial Infarction
(MI) a heart attack (sometimes called a "coronary"). This
is what happens when the supply of oxygen-rich blood flowing
through one or more of the coronary arteries to the heart muscle
is cut off. If the oxygen supply is severely reduced the heart
can malfunction or cut out.
Angina a sensation of
heaviness or tightness in the centre of the chest that may spread
to the arms, neck, face etc. It is caused when the arteries
narrow and reduce the amount of oxygen-containing blood reaching
the heart muscle.
Anti-arrhythmic agents
drugs used to treat abnormal heart rates and rhythms
(arrhythmias). They stabilise the heartbeat and may be used
long-term to prevent future heart attacks.
Anticoagulants drugs that
help to reduce the risk of clotting (coagulation) of the blood.
Clots are formed from small blood cells called platelets and from
a protein called fibrin. Anticoagulants help to prevent fibrin
from forming.
Anti-platelet agents drugs
that help to prevent blood clotting by reducing the 'stickiness'
of the platelets in the blood. The COMMIT/CCS-2 study drug
clopidogrel is an anti-platelet agent.
Aspirin an antiplatelet
drug - it works by inhibiting an enzyme complex called
cyclooxygenase, blocking the formation of thromboxane A2, a
potent agent that makes the platelets in the blood stick
together. All patients in the COMMIT/CCS-2 study received
aspirin.
Asystole total failure of
the heart muscle to contract, leading to cardiac arrest.
AV block a condition in
which the signals from the heart's upper chambers (atria) to the
lower chambers (ventricles) are impaired or don't transmit. It is
classified as first, second or third degree (complete) heart
block.
Beta-blockers drugs that
block the transmission of adrenaline and noradrenaline - hormones
that make the heart beat faster and more vigorously. They are
used to lower blood pressure, to help prevent angina, to help
control abnormal heart rhythms and to reduce the risk of a
further heart attack. They are also used in certain types of
heart failure. The COMMIT/CCS-2 study drug metoprolol is a
beta-blocker.
Bleeding in the
COMMIT/CCS-2 study, non-cerebral bleeding is defined according to
severity as "major" (i.e. required transfusion or caused death)
or "minor" (any other overt bleeding, including skin
bruising).
Bradycardia a slow heart
rate, normally defined as heart rate less than 50 beats per
minute.
Bundle branch block bundle
branches are an important part of the heart's electrical system,
the system that coordinates muscular contraction to assure that
the heart works efficiently as a pump. A block occurs when the
system becomes damaged or diseased and stops conducting
electrical impulses. In the COMMIT/CCS-2, about 7% of patients
presented with new left bundle branch block, which is a strong
indicator of an acute heart attack and confers a high risk of
early death.
Calcium antagonists (also called
calcium channel blockers) may be prescribed to treat
angina and also high blood pressure. The muscle cells in the
heart need a regular supply of calcium to work normally. Calcium
antagonists reduce the amount of calcium entering the muscle
cells of the arteries, causing them to relax. This increases the
blood supply to the heart and reduces the amount of work the
heart has to do to pump blood around the body.
Cardiac arrest a sudden
profound disturbance in the heart's rhythm that stops the heart
beating or prevents it beating enough to keep the body
alive.
Cardiac rupture rupture of
heart muscle, almost always leading to death, which can occur as
a consequence of myocardial infarction and may be exacerbated by
rapid reperfusion following fibrinolytic therapy.
Cardiogenic shock a state
in which systolic blood pressure is less than 90 mm Hg, or 30 mm
Hg below baseline, for at least 30 minutes, along with evidence
of poor tissue perfusion (movement of blood through the tissues)
that persists after any non-myocardial factors have been
corrected.
Diuretics drugs used to
increase the output of urine and remove excess fluid from the
body. They are commonly used to treat high blood pressure and
chronic heart failure.
ECG an electrocardiogram
measures and records the electrical activity of the heart.
Elevation of the ST segment, or evidence of new left-sided bundle
branch block, on the ECG tracing is indicative of acute
myocardial infarction.
Fibrinolytic therapy
fibrinolytic or thrombolytic drugs (sometimes called "clot
busters") are used to dissolve blood clots rapidly. They are most
commonly given as emergency intravenous treatment in heart
attacks (or certain types of stroke).
Heart failure a condition
caused by weakening of the heart muscle, which makes the heart
pump less efficiently than normal.
Hypertension high blood
pressure - normally defined as a systolic pressure (measurement
when the heart contracts) averaging 140 mm Hg or greater, and/or
diastolic (measurement between heart beats) averaging 90 mm Hg or
greater.
Hypotension low blood
pressure, normally defined as systolic blood pressure less than
100 mmHg
Killip class a
classification of the severity of heart failure from I (normal)
to IV (cardiogenic shock). People in Killip class IV were
excluded from COMMIT/CCS-2 because beta-blockers (such as
metoprolol) are contraindicated in patients with cardiogenic
shock.
Nitrates used to prevent
and treat angina caused by coronary artery disease.
PCI (Percutaneous Coronary
Intervention or balloon angioplasty) is a treatment to
improve the blood supply through a coronary artery. A catheter
with a small inflatable balloon is inserted into a vein in the
groin and passed up to the affected artery. The balloon is gently
inflated to widen the artery by pressing back the fatty tissue
responsible for narrowing it.
Reinfarction a second or
subsequent heart attack (myocardial infarction)
STEMI (ST segment Elevation
Myocardial Infarction) An ECG measures the electrical
activity of the heart. If the ST segments of the electrical wave
pattern are elevated this is a strong indication of a heart
attack with damage to the heart muscle due to blocked coronary
arteries. About 90% of the patients in the COMMIT/CCS-2 study had
STEMI based on their presenting ECG. ST segment depression alone
(7% of patients in the study) is suggestive of less complete
coronary artery blockage, and other tests may be needed to
determine the extent of any heart muscle damage.
Stroke there are two types
of stroke - ischaemic (or occlusive) which involves a blockage in
a cerebral (brain) artery, and haemorrhagic which involves
bleeding into the brain from an artery.
Ventricular fibrillation A
life-threatening disturbance in the heart rhythm, which causes
the heart to fibrillate (quiver) in a disordered way.
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