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Coronary angiographic characteristics in unstable angina pectoris
1Department of Cardiology, First Hospital, Beijing Medical University, Beijing 100034, China.
Insights
Unstable angina pectoris patients show distinct coronary lesion characteristics. Angina at rest and post-infarction angina warrant intensive treatment, including anticoagulation.
Area of Science:
- Cardiology
- Interventional Cardiology
- Diagnostic Imaging
Background:
- Unstable angina pectoris (UAP) encompasses diverse clinical presentations.
- Understanding angiographic differences in UAP subgroups is crucial for targeted therapy.
Purpose of the Study:
- To investigate the angiographic characteristics of coronary lesions in different subgroups of unstable angina pectoris.
Main Methods:
- Analysis of coronary angiograms and clinical data from 388 patients.
- Subgroup classification based on angina presentation (e.g., new onset effort, rest, post-infarction, Prinzmetal variant).
Main Results:
- Single-vessel disease prevalent in new onset effort angina.
- Triple-vessel and left main disease common in rest angina.
- Subtotal/total occlusions and thrombi more frequent in post-infarction and rest angina.
- Prinzmetal variant angina often associated with mild lesions.
Conclusions:
- Patients with angina at rest require more intensive management.
- Aggressive anticoagulation is recommended for post-infarction and rest angina patients.
Objective:
To investigate the angiographic characteristics of coronary lesions in patients of different subgroups of unstable angina pectoris.
Methods:
Coronary angiograms and clinical manifestations were analysed on 388 patients.
Results:
Single-vessel disease was more common in new onset effort angina (69.64%) than in other subgroups (P < 0.05); triple-vessel disease and left main coronary artery disease appeared more frequently in patients with rest angina than in other subgroups (72.34% and 27.66% respectively, P < 0.05), so did complex lesions and type C lesions (36.07% and 60.64% respectively, P < 0.05). More than half of the culprit lesions in post-infarction angina were subtotal or total occlusions (53.12%), being more frequently found in this than in other subgroups (P < 0.05). Most of the patients with Prinzmetal variant angina had mild coronary lesions only. Coronary thrombi were found in 10.45% of the 388 patients; they were more frequent in patients with post-infarction angina (20.00%) than in the subgroups of new onset effort angina, aggravated effort angina and Prinzmetal variant angina (4.26%, 7.53% and 0% respectively, P < 0.05). Coronary thrombi were also more frequent in patients with chest pain at rest (16.39%) than in the subgroups of new onset effort angina and Prinzmetal variant angina (P < 0.05).
Conclusions:
It is suggested that patients with angina at rest should be treated more intensively. Energetic anticoagulation treatment should be given to patients with post-infarction angina and angina at rest.