Angioplasty in unstable angina pectoris

Purpose: The purpose of the present study was to elucidate on the safety and long-term efficacy of angioplasty (PTCA) performed in patients with unstable angina pectoris (UAP). Methods: The study is a retrospective descriptive evaluation of consecutive patients admitted for coronary arteriography, during a one year period. UAP was diagnosed according to the Braunwald classification. In hospital as well as 6 months cardiovascular events were recorded. Results: At present, a total of 130 patient(pts) records have been evaluated. In 47 pts instability was related to a recent acute myocardial infarction (MI). No pts had secondary UAP. PTCA was performed in 79 pts, coronary artery bypass grafting(CABG) in 33 pts and 18 pts were scheduled for conservative treatment. There were no significant differences between the three groups with respect to demographic data or previous cardiac history. Intravenous nitroglycerin and heparin was given to 68 and 71% of pts respectively. The average duration of medical stabilization prior to coronary arteriography was six days. All of the patients in the CABG group had either three vessel disease or significant stenosis of the left main coronary artery. In hospital events for this group comprised one cardiac death and 7 MI. One patient was re-operated due to severe post operative ischaemia. In the PTCA group 8 patients had three vessel disease, 30 patients had 2 vessel disease and the remaining 41 patients had one vessel disease. The target vessel was left anterior descending artery(LAD) in 41 patients, right coronary artery in IS patients, circumflex in 16 patients and a vein graft in 4 patients. The average stenosis of the target vessel was 95%, total occlusion was present in 19 patients. 41 pts (52%) were stented. In hospital complication rate was low in the PTCA group. One patient underwent emergency CABG and died later, three pts had an emergency PTCA performed, one of these patients suffered an MI. None of the recorded adverse in hospital events could be related to the period of medical stabilization prior to invasive procedures. At present only a limited number of patients have been evaluated with regard to 6 months cardiac event rate. Conclusion: PTCA is a safe procedure and it can be performed early in patients with UAP.