Document Detail

Results of coronary stenting for unstable versus stable angina pectoris.
MedLine Citation:
PMID:  9165149     Owner:  NLM     Status:  MEDLINE    
Coronary artery stenting has been shown to improve the short- and long-term results of coronary angioplasty in mainly stable patients with 1-vessel disease, but it is uncertain whether its use in an unstable clinical setting may be safe and useful. To evaluate the stenting efficacy in patients with unstable angina, we retrospectively examined our experience with the Palmaz-Schatz balloon expandable stent in 231 consecutive patients. Patients were divided into 2 groups on the basis of symptoms at the time of stent implantation: group U (132 patients) had unstable angina, and group S (99 patients) had stable angina. After stent insertion, patients were treated with anticoagulant or combined antiplatelet therapy. Baseline characteristics of the 2 groups were comparable with the exception of age (higher in the unstable group) and angiographic characteristics of the target lesions (more unfavorable in unstable patients). In both groups, coronary stenting presented a high procedural success rate. Major in-hospital complications occurred in 9 unstable (6.8%) and in 2 stable (2%) patients (p = NS) and were mainly related to subacute stent thrombosis. In both groups, subacute stent thrombosis mostly occurred in patients treated with anticoagulant therapy (7 of 9 unstable patients, 2 of 2 stable patients). At 6-month follow-up, unstable and stable patients had a similar incidence of death (0%), Q-wave myocardial infarction (0%), and need of coronary artery bypass graft (3.2% vs 4%, p = NS), but coronary angioplasty repetition (4.8% vs 14%, p = 0.027) and target vessel revascularization (6.3% vs 17%, p = 0.019) rates were lower in the unstable group. In conclusion, stent insertion increases the short- and midterm coronary angioplasty effectiveness in unstable angina, making it possible to achieve outcomes quite comparable to stable angina. Compared with conventional anticoagulant regimen, combined antiplatelet therapy after placement of coronary stents seems to reduce the incidence of subacute thrombosis also in this clinical setting.
A Marzocchi; G Piovaccari; C Marrozzini; P Ortolani; T Palmerini; A Branzi; B Magnani
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  79     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1997 May 
Date Detail:
Created Date:  1997-06-19     Completed Date:  1997-06-19     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1314-8     Citation Subset:  AIM; IM    
Institute of Cardiology, University of Bologna, Italy.
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MeSH Terms
Angina Pectoris / therapy*
Angina, Unstable / therapy*
Angioplasty, Transluminal, Percutaneous Coronary / methods*
Anticoagulants / therapeutic use
Combined Modality Therapy
Follow-Up Studies
Middle Aged
Platelet Aggregation Inhibitors / therapeutic use
Retrospective Studies
Thrombosis / prevention & control
Reg. No./Substance:
0/Anticoagulants; 0/Platelet Aggregation Inhibitors

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