Open AccessAngiographic morphology and response to therapy in unstable angina
Author(s) -
Sansa M.,
Cernigliaro C.,
Bolognese L.,
Bongo S. A.,
Rossi L.,
Rossi P.
Publication year - 1988
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960110302
Subject(s) - medicine , cardiology , morphology (biology) , unstable angina , stable angina , coronary angiography , coronary heart disease , myocardial infarction , genetics , biology
The coronary anatomy of 69 patients with unstable angina, subgrouped according to response to medical therapy, was investigated. All patients received oral treatment with nitrates, calcium antagonists, and beta‐blocking agents. When combined oral treatment was not effective, an intravenous infusion of nitrates (10–100 m̈g/min) was subsequently administered. Coronary arteriography was performed within hours (14±9 h) from the last episode of chest pain in 28 patients refractory to medical treatment, while in 41 patients who became asymptomatic during medical therapy, angiography was performed after an observation period of several days (8 ± 6 days). On angiography, the nonresponder group was characterized by a prevalence of eccentric and multiple lesions, and by a 46% incidence of thrombi (p <0.001). Recurrent symptoms requiring emergency bypass operation were common in this group. In patients responsive to medical treatment, a high percentage of concentric lesions (37%) and totally occluded (34%) coronary arteries was found (p <0.05). No infarcts and low rate of recurrent angina were noted in these patients during hospitalization. In conclusion, the finding of intracoro‐nary thrombotic material and eccentric or multiple lesions can be an accurate markers of the active phase of the disease, while “silent” occlusion of the involved vessel may be accompanied by relief of symptoms during medical therapy.