Coronary Angioplasty in Patients with Unstable Angina

pp. 137-142

Abstract

Background

Balloon coronary angioplasty is frequently indicated in patients with unstable angina. It is impor tant to determine which of these patients are at a higher risk regarding angioplastic procedures .

Objective
The aim of this study was to compare in-hospital balloon coronary angioplasty results in subsets of patients with unstable angina.

Method
Four hundred twenty-five patients with unstable angina from 857 consecutive balloon coronary angioplasty patients (from June 1992 to March 1995) were divided into two groups. Group A : 63 patients with refractory angina episodes (despite full treatment with anticoagulation, antiaggregation, betablockers and nitrates) and group B : 362 patients with no angina episodes in the last 72 hours .

Results
Both groups had no differences concerning age, coronary risk factors, previous coronary bypass surgery, number of diseased vessels, number of treated lesions, need of stent implantation or directional atherectomy. Group A had a tendency to a higher incidence of three vessel disease (25 .4 versus 24.9%; p = 0.06) . Both groups had equal clinical success (final obstruction < 50% without major complications -AMI, emergent CABG, or death-): 87.3 versus 90 .1%; p = NS. Group B had a tendency to less major complications (5.5 versus 12.7%; p = 0 .06) .

Group B had less mortality (1.4 versus 6.3%; p = 0 .03), less use of intraaortic balloon counterpulsation (3 .6 versus 11.1%; p = 0.03) and more failures without major complications (4.4 versus 0% ; p = 0 .07) .

Conclusions

The incidence of success was similar . Those unstable angina refractory patients had, with balloon coronary angioplasty, more major complications with major inhospital death and major need of circulatory assistance.