Document Detail

Identification of patients at high risk for adverse coronary events while awaiting routine coronary angioplasty.
MedLine Citation:
PMID:  7727179     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Identification of patients at risk for progression of coronary stenosis and adverse clinical events while awaiting coronary angioplasty is desirable. OBJECTIVE: To determine the standard clinical or angiographic variables, or both, present at initial angiography associated with the development of adverse coronary events (unstable angina, myocardial infarction, and angiographic total coronary occlusion) in patients awaiting routine percutaneous transluminal coronary angioplasty (PTCA). PATIENTS AND METHODS: Consecutive male patients on a waiting list for routine PTCA. Routine clinical details were obtained at initial angiography. Stenosis severity was measured using computerised angiography. OUTCOME MEASURES: Development of one or more of myocardial infarction, unstable angina, or angiographic total coronary occlusion while awaiting PTCA were recorded as an adverse event. RESULTS: Some 214 of 219 patients underwent a second angiogram. One had a fatal myocardial infarction and four (2%) were lost to follow up. Fifty patients (23%) developed one or more adverse events (myocardial infarction five, unstable angina 35, total coronary occlusion 23) at a median (range) interval of 8 (3-25) months. Twenty (57%) of the 35 patients with unstable angina developed adverse events compared with 30 (17%) of the 180 with stable angina (P = 0.0001). Plasma triglyceride concentration was 2.6 (1.2) mmol/l in patients with adverse coronary events compared with 2.2 (1.1) mmol/l in those without such events (P < 0.05). Patients with adverse events were younger than those without (54 (9) years v 58 (9) years, P < 0.01). The relative risk of an adverse event in patients with unstable angina and increased plasma triglyceride concentrations was 6.9 compared with those presenting with stable angina and a normal triglyceride concentration (P < 0.02). CONCLUSIONS: The study shows that adverse events are not uncommon in patients awaiting PTCA. Patients at high risk for adverse events may be predicted by the presence of acute coronary syndrome, increased concentration of plasma triglyceride, and younger age at the time of the first angiogram.
M Chester; L Chen; J C Kaski
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  British heart journal     Volume:  73     ISSN:  0007-0769     ISO Abbreviation:  Br Heart J     Publication Date:  1995 Mar 
Date Detail:
Created Date:  1995-06-01     Completed Date:  1995-06-01     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0370634     Medline TA:  Br Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  216-22     Citation Subset:  AIM; IM    
Department of Cardiological Sciences, St George's Hospital Medical School, London.
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MeSH Terms
Age Factors
Angina, Unstable / etiology
Angioplasty, Transluminal, Percutaneous Coronary*
Coronary Disease / etiology
Middle Aged
Myocardial Infarction / etiology
Myocardial Ischemia / etiology*
Regression Analysis
Risk Factors
Triglycerides / blood
Waiting Lists
Reg. No./Substance:

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