Document Detail

The high-risk angina patient. Identification by clinical features, hospital course, electrocardiography and technetium-99m stannous pyrophosphate scintigraphy.
MedLine Citation:
PMID:  6456087     Owner:  NLM     Status:  MEDLINE    
We evaluated 193 consecutive unstable angina patients by clinical features, hospital course and electrocardiography. All patients were managed medically. Of the 193 patients, 150 (78%) had a technetium-99m pyrophosphate (Tc-PYP) myocardial scintigram after hospitalization. Of these, 49 (33%) had positive scintigrams. At a follow-up of 24.9 +/- 10.8 months after hospitalization, 16 of 49 patients (33%) with positive scintigrams died from cardiac causes, compared with six of 101 patients (6%) with negative scintigrams (p less than 0.001). Of 49 patients with positive scintigrams, 11 (22%) had had nonfatal myocardial infarction at follow-up, compared with seven of 101 patients (7%) with negative scintigrams (p less than 0.01). Age, duration of clinical coronary artery disease, continuing angina during hospitalization, ischemic ECG, cardiomegaly and a history of heart failure also correlated with cardiac death at follow-up. Ischemic ECG and a history of angina with a crescendo pattern also correlated with nonfatal infarction at follow-up. Patients with continuing angina, an ischemic ECG and a positive scintigram constituted a high-risk unstable angina subgroup with a survival rate of 58% at 6 months, 47% at 12 months and 42% at 24 and 36 months. We conclude that the assessment of clinical features, hospital course, ECG and Tc-PYP scintigraphy may be useful in identifying high-risk unstable angina patients.
H G Olson; K P Lyons; W S Aronow; P J Stinson; J Kuperus; H J Waters
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation     Volume:  64     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1981 Oct 
Date Detail:
Created Date:  1981-11-22     Completed Date:  1981-11-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  674-84     Citation Subset:  AIM; IM    
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MeSH Terms
Acute Disease
Angina Pectoris / radionuclide imaging*
Cardiomegaly / radiography
Coronary Disease / diagnosis
Heart Failure / complications
Middle Aged
Myocardial Infarction / complications,  mortality
Polyphosphates / diagnostic use*
Regression Analysis
Technetium / diagnostic use*
Technetium Tc 99m Pyrophosphate*
Tin Polyphosphates / diagnostic use*
Reg. No./Substance:
0/Polyphosphates; 0/Technetium Tc 99m Pyrophosphate; 0/Tin Polyphosphates; 54627-10-0/technetium Tc 99m stannous pyrophosphate; 7440-26-8/Technetium

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