Document Detail


Prognostic significance of silent myocardial ischemia in variant angina pectoris.
MedLine Citation:
PMID:  1746457     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The present study investigates the prognostic significance of silent myocardial ischemia in variant angina. Forty-eight-hour Holter monitoring and coronary angiography were performed in 54 patients with transient ST elevation and no history of myocardial infarction admitted to the coronary care unit for worsening of symptoms. Coronary artery spasm was documented in most of these patients. Over the subsequent month, 20 patients (group 1) had a major coronary event (2 died, 6 had nonfatal myocardial infarction and 12 had urgent coronary revascularization), and the remaining 34 patients (group 2) had a good clinical outcome. From 2,578 hours of recording, 547 ischemic episodes were identified of which only 9% were associated with angina. The mean daily number of ST elevation in group 1 was similar to that in group 2 (4.8 +/- 5.1 vs 4.1 +/- 4.6; p = not significant). Conversely, the mean daily duration of such ischemic episodes was consistently greater in group 1 than in 2 (79 +/- 36 vs 37 +/- 25 minutes; p less than 0.005). The occurrence of greater than or equal to 1 long-lasting (greater than or equal to 10 minutes) episode of ST elevation was observed in 18 of 20 patients in group 1 (sensitivity 90%), but only in 4 of 34 in group 2 (specificity 88%). Significant coronary atherosclerosis (greater than 50% stenoses) was found at angiography in 18 of 20 patients in group 1, and in 18 of 34 in group 2.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
R Bugiardini; A Borghi; B Sassone; A Pozzati; P Puddu
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  68     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1991 Dec 
Date Detail:
Created Date:  1992-01-16     Completed Date:  1992-01-16     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1581-6     Citation Subset:  AIM; IM    
Affiliation:
Institute of Patologia Speciale Medica e Metodologia Clinica, University of Bologna, Italy.
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MeSH Terms
Descriptor/Qualifier:
Angina Pectoris, Variant / complications*,  surgery
Coronary Angiography
Coronary Artery Disease / complications
Coronary Disease / complications*,  surgery
Coronary Vasospasm / complications
Electrocardiography, Ambulatory
Emergencies
Female
Humans
Male
Middle Aged
Myocardial Infarction / etiology*
Myocardial Revascularization
Probability
Prognosis
Sensitivity and Specificity
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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