| The prognosis in stable and unstable angina. | |
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MedLine Citation:
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PMID: 2029704 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The average annual mortality in unselected patients with chronic stable angina is 4%. Mortality is increased in male patients and in patients who have risk factors such as hypertension, previous MI, or abnormal ECGs. We do not routinely recommend cardiac catheterization in the initial management of patients with stable angina unless the patient exhibits evidence for severe myocardial ischemia on non-invasive testing or has symptoms that are refractory to treatment. In patients who undergo cardiac catheterization, the most important determinant of survival is left ventricular function followed by the number of diseased vessels. Noninvasive testing provides important additional prognostic information to cardiac catheterization data and should be used in the decision to treat a patient medically or surgically. Mortality is increased in patients who have low exercise tolerance, exercise-induced ischemia, or a poor hemodynamic response to exercise. Unstable angina in medically treated patients is associated with a 3% to 5% hospital mortality and 7% to 8% mortality in the first year. The rate of nonfatal MI is about 8% to 10% in the first 2 weeks. We routinely recommend coronary angiography unless patients have had recent cardiac catheterization or there is a major contraindication. Mortality is increased in those who fail to respond to initial therapy, who have severe left ventricular dysfunction, and who have multivessel CAD, particularly left main CAD. The question of whether all patients with unstable angina require coronary angiography for risk stratification and possible revascularization is being addressed in the TIMI III trial. |
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Authors:
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T C Hilton; B R Chaitman |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Cardiology clinics Volume: 9 ISSN: 0733-8651 ISO Abbreviation: Cardiol Clin Publication Date: 1991 Feb |
Date Detail:
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Created Date: 1991-06-18 Completed Date: 1991-06-18 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8300331 Medline TA: Cardiol Clin Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 27-38 Citation Subset: IM |
Affiliation:
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Department of Medicine, St. Louis University School of Medicine, Missouri. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Angina Pectoris / diagnosis, mortality* Angina, Unstable / diagnosis, mortality* Female Humans Male Middle Aged Prognosis Survival Rate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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