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Hydroxychloroquine Sulfate in Angina Pectoris

William M. McCrae, MB, MRCPG, MRCPE; Robert Hume, MB, MRCPG, MRCPE; John B. McGuinness, MB, MRCP, MRCPG
JAMA. 1964;187(1):53. doi:10.1001/jama.1964.03060140059016.
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A NEW APPROACH to the symptomatic treatment of angina pectoris seemed to be indicated following the description, principally by M. H. Knisely and his colleagues in 1947,1 of sludging of the blood. This has been shown to be produced by the intravascular agglutination of red blood cells into masses which cause a disturbance of the flow pattern of the blood in small vessels and may possibly lead to consequent tissue anoxia and predisposition to thrombosis.2

Sludging of the blood is rarely present in healthy subjects,1 but has been described in several disease states. Of particular interest to us, however, was the demonstration of sludging by Madow in 1960,3 in 44 patients with coronary, cerebral, or peripheral vascular disease. By microscopic observation of the conjunctival capillaries he showed that sludging could be abolished by treatment with the anti-malarial agent, hydroxychloroquine sulfate, and that there was a resultant


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