[Unstable angina: study of in-hospital and short-term prognosis]

The aim of our study was to identify predictor factors of coronary ischemic events to stratify the risk. 367 patients, mean age 59 years (22-90), 288 men (88%), Coronary risk factors: Smoking (62%), diabetes (38%), hypertension (37%), hypercholesterolemia (18%). BRAUNWALD class III was predominant (60%). Electrocardiographic changes were present in 113 patients. Coronary angiography identified: 148 single-vessel disease, 92 double-vessel and 68 triple-vessel. In the hospital phase, 296 patients (80.5%) were stabilised. 65 had recurrent ischemia (17.5%), 6 myocardial infarction (1.5%) and 6 deaths (1.5%). After multivariate logistic regression the predictors factors of ischemic events were. Age > or = 65 years (p = 0.03), coronary artery bypass grafting (p = 0.05), left ventricular failure (p = 0.024), modified baseline electrocardiogram (p = 0.04), ST-segment depression (p = 0.05), without aspirin (p = 0.043) and heparin (p = 0.047). At 6 months, 181 patients were asymptomatic (59.1%), 101 had recurrent ischemia (33%), 14 myocardial infarction (4.6%) and 10 deaths (3.3%). After multivariate analysis, the predictor factors were: Age > or = 65 years (p = 0.026), previous unstable angina (p = 0.023), left main stenosis (p = 0.008) and without aspirin (p = 0.003).

Our study identified a subgroup of high risk patients who would benefit most from either low-molecular-weight heparins and Glycoprotein IIb/IIIa receptor blockers with an early revascularisation strategy.