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Prognostic significance of electrocardiographic change during anginal attack in patients with unstable angina
Insights
ST depression during anginal attacks is a significant predictor of future cardiac events in unstable angina patients. This electrocardiographic change, unlike C-reactive protein or fibrinogen levels, independently signals increased risk.
Area of Science:
- Cardiology
- Clinical Medicine
- Diagnostic Markers
Background:
- Unstable angina (UA) poses a significant risk for adverse cardiac events.
- Identifying reliable prognostic markers in UA is crucial for patient management.
Purpose of the Study:
- To evaluate the prognostic value of electrocardiographic (ECG) changes during anginal attacks.
- To assess the predictive significance of C-reactive protein (CRP) and fibrinogen levels in UA patients.
Main Methods:
- Prospective study of 169 patients with unstable angina.
- 90-day follow-up for new cardiac events (death, myocardial infarction, urgent revascularization).
- Multivariate analysis to identify independent risk factors.
Main Results:
- ST depression during anginal attack emerged as an independent predictor of cardiac events (RR 7.507, p<0.01).
- Diabetes mellitus, elevated total cholesterol, and thrombolytic agent use were also significant risk factors.
- C-reactive protein and fibrinogen levels did not demonstrate prognostic significance.
Conclusions:
- ST depression during anginal attack is a valuable independent risk predictor for new cardiac events in unstable angina.
- ECG monitoring during angina provides critical prognostic information.
- CRP and fibrinogen are not reliable prognostic markers in this UA cohort.
Objective And Methods:
We examined the prognostic significance of electrocardiographic change during anginal attack, C-reactive protein and fibrinogen in 169 patients with unstable angina.
Results:
During the 90-day follow-up period, 26 patients (15%) exhibited new cardiac events (death, myocardial infarction or urgent revascularization). Using multivariate analysis, ST depression (relative risk 7.507 [95 % confidence intervals 1.842-30.592], p<0.01) during anginal attack was found to be an independent risk factor to predict cardiac events as well as diabetes mellitus, an increased total cholesterol level and the use of a thrombolytic agent. C-reactive protein and fibrinogen did not have prognostic significance.
Conclusion:
ST depression during anginal attack is an independent risk predictor for new cardiac events in patients with unstable angina.