Document Detail

Short and long term outcome of percutaneous transluminal coronary angioplasty in unstable versus stable angina pectoris: a report of the 1985-1986 NHLBI PTCA Registry.
MedLine Citation:
PMID:  1889076     Owner:  NLM     Status:  MEDLINE    
In a cohort of 1,720 consecutive patients from the National Heart, Lung, and Blood Institute, Percutaneous Transluminal Coronary Angioplasty (PTCA) Registry (August 1985-May 1986), we compared 768 patients (45%) with stable angina and 952 patients (55%) with unstable angina pectoris. Unstable angina patients exhibited at least one of the following characteristics: new onset angina, rapidly progressing angina, angina at rest, angina refractory to medication, variant angina, acute coronary insufficiency, or angina recurring shortly after an acute myocardial infarct. The distribution of single- and multi-vessel disease was similar among stable and unstable angina patients; multi-vessel disease predominated. Average severity of stenosis and incidence of tubular and diffuse stenosis morphology were higher among patients with unstable angina (both p less than 0.001). Patient success rates were similar in stable and unstable patients. However, on a per lesion basis, overall angiographic success rate and average reduction of severity of stenosis in successfully dilated lesions were significantly higher among patients with unstable angina (both p less than 0.001). Incidence of major patient complications (p less than 0.01) and of emergency coronary bypass surgery (p less than 0.05) were also higher in patients with unstable angina but consistent with their more precarious clinical condition and stenosis morphology. During a two year follow-up, the cumulative distributions of death, myocardial infarct, repeat PTCA, and coronary bypass surgery were not significantly different in patients with stable angina compared to patients with unstable angina. Comparison of the current PTCA Registry cohort with the cases reported in the 1979-1982 Registry revealed a 19% higher success rate for both stable and unstable angina patients. Major complication rates decreased between time periods for stable but not for unstable angina patients. Incidence of emergency bypass surgery decreased more for stable than for unstable angina patients. Coronary angioplasty is indicated in properly selected patients with unstable angina and both single- and multi-vessel coronary disease.
L G Bentivoglio; R Holubkov; S F Kelsey; D R Holmes; G Sopko; M J Cowley; R K Myler
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Catheterization and cardiovascular diagnosis     Volume:  23     ISSN:  0098-6569     ISO Abbreviation:  Cathet Cardiovasc Diagn     Publication Date:  1991 Aug 
Date Detail:
Created Date:  1991-10-15     Completed Date:  1991-10-15     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  7508512     Medline TA:  Cathet Cardiovasc Diagn     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  227-38     Citation Subset:  IM    
Lankenau Hospital, Philadelphia, PA.
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MeSH Terms
Angina Pectoris / mortality,  therapy*
Angina, Unstable / mortality,  therapy*
Angioplasty, Transluminal, Percutaneous Coronary* / mortality
Cause of Death
Coronary Artery Bypass / mortality
Coronary Disease / mortality,  therapy
Follow-Up Studies
Middle Aged
Myocardial Infarction / mortality
Grant Support
Comment In:
Cathet Cardiovasc Diagn. 1992 Jan;25(1):79   [PMID:  1555230 ]

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

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