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Variant Angina—Correlation of Clinical, Electrocardiographic and Angiographic Features: Results of Medical and Surgical Management
Author(s) -
Saltups A.
Publication year - 1980
Publication title -
australian and new zealand journal of medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.596
H-Index - 70
eISSN - 1445-5994
pISSN - 0004-8291
DOI - 10.1111/j.1445-5994.1980.tb04243.x
Subject(s) - medicine , angina , cardiology , coronary artery disease , electrocardiography , angiography , st segment , artery , coronary angiography , ischemia , coronary vessel , radiology , myocardial infarction
Summary Angiographic coronary artery disease (CAD) was correlated with clinical features, electrocardiographic (ECG) findings and the results of medical management or aortocoronary bypass in 42 patients with angina at rest associated with transient ST segment elevation (variant angina). Patients were divided into three sub‐sets based on the coronary arteriographic findings. On the basis of > 75% luminal diameter narrowing, 28 patients had multiple vessel, ten had single vessel and four had minimal (< 50% narrowing) CAD. The angiographic sub‐sets did not differ significantly in age, sex, coronary risk factors, time from onset of rest pain to coronary angiography, or in the presence of arrhythmias during ischaemic episodes. Patients with multiple vessel CAD more commonly had prior coronary events (P < 0·01), an abnormal baseline ECG (P < 0·05) or both (P < 0·001). These features did not distinguish patients with single vessel from those with minimal CAD. ST elevation in the inferior leads during episodes of myocardial ischaemia was more common (P < 0·005) in patients with minimal CAD. Twenty‐four patients with multiple vessel and six with single vessel CAD underwent aortocoronary by‐pass surgery and relief of variant angina was achieved in all 25 long‐term survivors during an average follow‐up period of 36 months. Twelve patients (four of each subset) were treated medically. Among those with multiple vessel CAD, the small medically treated numbers precluded valid comparison of medical and surgical results. Patients with single vessel CAD followed for an average period of 17 months compared unfavourably with the operated group. Calcium antagonists or nitrates controlled variant angina in patients with minimal CAD followed for an average of 27 months.