Patients with intractable angina: free thyroxine index, immunoreactive insulin and free fatty acids in blood, free adrenaline and noradrenaline in urine.

The activity of adrenergic system, thyroid gland and blood levels of insulin and FFA were studied in 120 patients with intractable angina. Noradrenaline excretion was normal but that of adrenaline was augmented in a vast majority of patients and even doubled in 27% of cases. Free thyroxine index values were abnormally high in 22% of cases and inversely correlated with ergometric performance. A diabetic-like insulin response after 50.0 g oral glucose intake was found in 10 out of 26 examined patients. Abnormally high values of FFA were observed in 66%. The mechanisms likely to account for these alterations and their suspected influence on clinical course of intractable angina are discussed.