Beta-endorphins during coronary angioplasty in patients with silent or symptomatic myocardial ischemia

Colomba Falcone, Luigina Guasti, Michael Ochan, Silvia Codega, Maria Tortorici, Luigi Angoli, Roberto Bergamaschi, Carlo Montemartini

Research output: Contribution to journalArticlepeer-review


Objectives. The aims of this study were to correlate betaendorphin plasma levels and anginal pin in patients with ischemia induced by percutaneous transluminal coronary angioplasty and to detect eventual endorphin variations during balloon occlusion. Background. The opioid system appears involved in the absence of pain occurring in silent myocardial ischemia. Methods. Beta-endorphin plasma levels were measured 24 h before, just before, during and after coronary angioplasty (performed on the left anterior descending artery) in 53 men with documented coronary artery disease and exercise-induced myocardial ischemia. Results. Group 1 (33 patients) reported symptoms; group 2 (20 patients) was asymptomatic during angioplasty. In these patients, the prevalence of exercise-induced silent ischemia was 57%. The occurrence of angina during exercise or angioplasty was related to the frequency of angina during daily life when patients were subgrouped. The severity and distribution of coronary artery disease did not differ between the two groups. During angioplasty, the number of balloon inflations and the Inflation time and pressure were similar in symptomatic and asymptomatic patients. In each group, no short-term variability of baseline betaendorphin plasma levels was observed during 2 consecutive days. Corresponding beta-endorphin plasma levels (at baseline and during and after angioplasty) were significantly in Group 2. During balloon occlusion, the levels decreased significantly in the symptomatic group at the onset of angina but remained stable in the asymptomatic group. Conclusions. Methodologic variables and the severity of coronary artery disease did not influence the presence of symptoms during angioplasty-induced ischemia. Beta-endorphin plasma levels were higher and more stable in patients with silent ischemia during angioplasty, suggesting that opiate levels and their variation during ischemia are associated with individual attitude toward anginal pain.

Original languageEnglish
Pages (from-to)1614-1620
Number of pages7
JournalJournal of the American College of Cardiology
Issue number6
Publication statusPublished - Nov 15 1993

ASJC Scopus subject areas

  • Nursing(all)


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