Document Detail


Unstable angina: relationship of clinical presentation, coronary artery pathology, and clinical outcome.
MedLine Citation:
PMID:  8435924     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Patients with unstable angina are heterogeneous with respect to presentation, coronary artery morphology, and clinical outcome. Subclassification of these patients based on clinical history has been proposed as a means of identifying individuals at increased cardiac risk. We applied such a classification system to 129 patients discharged from a coronary care unit with a diagnosis of acute myocardial ischemia. Patients were then assessed for cardiac events (recurrent angina requiring revascularization, myocardial infarction, death) 12 months following hospital discharge. Patients were classified as recent onset unstable angina preinfarction (n = 42), crescendo unstable angina preinfarction (n = 48), and unstable angina postinfarction (n = 39). Within each of these groups, the patients were further subclassified based on the occurrence of angina on effort, at rest, or both. No attempt was made to subset patients taking anti-ischemic drugs at the time of clinical presentation to the physician. Coronary angiographic pathology (morphology and number of vessels involved) was similar in the subgroups, but coronary artery thrombus was statistically more likely to be found in patients with crescendo rest angina preinfarction or with frequent anginal episodes at rest postinfarction. Mortality was significantly higher for patients with unstable angina postinfarction (7.7%) than preinfarction (1.1%). No statistical differences were noted between the subgroups with respect to the occurrence of myocardial infarction or recurrent unstable angina requiring revascularization. These data suggest that subclassification of unstable angina patients based on clinical characteristics at presentation is not useful to predict subsequent myocardial infarction or recurrent angina requiring revascularization.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
B D Bertolet; J Dinerman; R Hartke; C R Conti
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical cardiology     Volume:  16     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  1993 Feb 
Date Detail:
Created Date:  1993-03-25     Completed Date:  1993-03-25     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  116-22     Citation Subset:  IM    
Affiliation:
Department of Medicine, University of Florida College of Medicine, Gainesville, Florida.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angina, Unstable / classification*,  etiology,  pathology
Coronary Disease / complications,  pathology
Coronary Vessels / pathology*
Death, Sudden, Cardiac / epidemiology
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction / complications,  epidemiology
Prognosis
Recurrence
Risk Factors

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


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