Natural History of Unstable Angina with Medical or Surgical Therapy

Bertolasi, Carlos A.; Trongé, Jorge; Riccitelli, Miguel A.; Villamayor, Rosa; Zuffardi, Ezio A.

doi:10.1378/chest.70.5.596

Cited by 86 publications

(13 citation statements)

References 36 publications

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“…Significant prognostic differences between subgroups of unstable angina were found by Bertolasi et al (1976). After a mean follow-up of 32 months, the mortality in a medically treated group with recurrent angina pectoris not related to effort was 46%.…”

Section: Discussionmentioning

confidence: 90%

“…The only significant difference between the groups was a higher functional capacity among the surgical patients. Bertolasi et al (1976) studied 113 patients with unstable angina assigned by lot to medical o r surgical therapy. The patients were separated in two subgroups, one with intermediate syndrome characterized by recurrent angina pectoris not related to effort and one with progressive angina during the last three months.…”

Section: Discussionmentioning

confidence: 99%

“…The clinical patterns frequently exist together. In recent years, attempts have been made to identify subgroups of unstable angina with a high risk of AM1 and sudden death (Gazes et al, 1973;Selden et al, 1975;Bertolasi et al, 1976;Day et al, 1977). Therefore, in the present report, a subgroup of unstable angina was studied and defined as continued episodes of angina at rest during 48 hours, despite medical treatment in the coronary care unit (CCU).…”

Section: From the Department Of' Medicine Karolinska Lnstitutet At Hmentioning

confidence: 95%

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A High Risk Subgroup of Patients with Unstable Angina Pectoris Treated Medically or Surgically

Nordlander

Nyquist

1979

Scandinavian Journal of Thoracic and Cardiovascular Surgery

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Among patients consecutively admitted to a coronary care unit (CCU) without a subsequent diagnosis of acute myocardial infarction (AMI), a subgroup fo unstable angina was selected, defined as continued episodes of angina at rest during a 48-hour period, despite medical treatment in the CCU. During a four-year period, 15 patients fulfilled these criteria. Eight patients were medically treated, seven of whom developed an AMI with three subsequent deaths. Six of the infarcts occurred within eight days of admission. In six patients, fulfilling the criteria, surgical treatment was performed. Angiography and surgery in this group were associated with low incidences of myocardial infarction, late infarction and death. In one patient, surgery was declined due to unfavourable anatomical conditions. This patient subsequently developed an AMI and died. It is concluded that the combination of recent onset of angina and continued episodes of angina at rest, despite medical treatment, selects a high risk subgroup of unstable angina. Acute coronary angiography and surgery ought to be considered in this subgroup.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: From the Department Of' Medicine Karolinska Lnstitutet At Hmentioning

confidence: 95%

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A High Risk Subgroup of Patients with Unstable Angina Pectoris Treated Medically or Surgically

Nordlander

Nyquist

1979

Scandinavian Journal of Thoracic and Cardiovascular Surgery

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“…Patients with unstable angina are at in creased risk of myocardial infarction and death [16][17][18][19], Prolonged and recurrent ad mission to specialized cardiac units are com mon [20. 21], and the attendant cumulative costs are elevated [20], given the high preva lence of unstable angina within the hospital ized coronary artery disease population [22], PTCA, when feasible, offers the promise of quick restoration of blood flow, relief of symptoms, shortened hospitalization [20] and containment of costs [20], Its widespread use in patients with unstable angina is readily understood.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous Transluminal Coronary Angioplasty in Unstable and Stable Angina pectoris: A Comparison of Immediate Success and Complications

et al. 1992

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To determine the success rate and the safety of percutaneous transluminal coronary angioplasty in patients with unstable angina pectoris (group 1) versus stable angina (group 2), we studied 299 consecutive patients who underwent coronary angioplasty of 373 consecutive lesions. Of these patients, 149 had unstable angina pectoris and dilation of 188 arteries. The success rate was high and similar in both groups (95 and 93%, respectively). The groups did not differ in regard to the lesion characteristics, vessels and number of sites dilated except for an increase in the presence of thrombus in the unstable angina group (p < 0.03). Although there was a higher incidence of coronary thrombus and more acute myocardial infarction in group 1 the major complication rate did not differ from that of group 2 and was low in both of them (3 and 2%, respectively). No deaths occurred. Six patients (3 in each group) needed urgent coronary artery bypass grafting while 3 additional patients developed acute Q-wave myocardial infarction (all of them in group 1). Thus, percutaneous transluminal coronary angioplasty is a safe and successful procedure in patients with unstable angina as well as in patients with stable angina pectoris.

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“…Only patients grouped as intermediate syndrome and progressive angina were included in a previous report (4) and compared with another similar but surgically treated group (not presented here).…”

Section: Plan Of Studymentioning

confidence: 99%

Clinical spectrum of “Unstable Angina”

Bertolasi

Trongé

Mon

et al. 1979

Clinical Cardiology

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Summary:In order to determine the natural evolution of different clinical types of "unstable angina", 167 patients were included in a prospective study. After angiography, 11 (6.5%) were excluded because they had no significant coronary lesions. The remaining 156 were sorted into different groups according to their clinical characteristics and were followed up for a period of 24 months at least. After that follow-up period, mortality and incidence of acute myocardial infarction (AMI) were as follows: angina of recent onset (Class III-IV NYHA): 8.5 % (3/35) and 34.2 % (12/35). Progressive angina: 7.4% (2/27) and 7.4% (2/27). Intermediate syndrome: 41.6% (10/24) and 37.5% (9/24).Prinzmetal's angina: 10% (1110) and 10% (1110). Post acute myocardial infarction angina: 35% (7/20) and 10% (2120). Acute persistent ischemia: 2.5% (1140) and 20% (8/40). Comparison of these figures pointed out significant differences (p < 0.001 for mortality and p < 0.03 for AMI incidence respectively).We conclude that it is clinically possible to identify different groups within the so-called unstable angina. Such a division not only allows for the creation of more homogeneous groups, but it contributes to a more rational

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Natural History of Unstable Angina with Medical or Surgical Therapy

Cited by 86 publications

References 36 publications

A High Risk Subgroup of Patients with Unstable Angina Pectoris Treated Medically or Surgically

A High Risk Subgroup of Patients with Unstable Angina Pectoris Treated Medically or Surgically

Percutaneous Transluminal Coronary Angioplasty in Unstable and Stable Angina pectoris: A Comparison of Immediate Success and Complications

Clinical spectrum of “Unstable Angina”

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