| Results of coronary stenting for unstable versus stable angina pectoris. | |
MedLine Citation:
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PMID: 9165149 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
Authors:
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A Marzocchi; G Piovaccari; C Marrozzini; P Ortolani; T Palmerini; A Branzi; B Magnani |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The American journal of cardiology Volume: 79 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 1997 May |
Date Detail:
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Created Date: 1997-06-19 Completed Date: 1997-06-19 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1314-8 Citation Subset: AIM; IM |
Affiliation:
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Institute of Cardiology, University of Bologna, Italy. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angina Pectoris / therapy* Angina, Unstable / therapy* Angioplasty, Transluminal, Percutaneous Coronary / methods* Anticoagulants / therapeutic use Combined Modality Therapy Female Follow-Up Studies Humans Male Middle Aged Platelet Aggregation Inhibitors / therapeutic use Retrospective Studies Stents* Thrombosis / prevention & control |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants; 0/Platelet Aggregation Inhibitors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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