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[Treatment of unstable angina pectoris]
Insights
Acute revascularisation for unstable angina offers good long-term results. This program showed low mortality and myocardial infarction rates, with 65% of revascularised patients remaining angina-free.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Context:
- Unstable angina (UA) is a critical condition requiring prompt intervention.
- Medical therapy is not always sufficient for patients with UA.
- Significant coronary artery disease (CAD) was present in most patients studied.
Purpose:
- To evaluate the outcomes of an acute revascularisation program for unstable angina.
- To assess the safety and efficacy of coronary bypass grafting (CABG) and percutaneous transluminal angioplasty (PTCA) in UA patients.
- To determine long-term results in patients undergoing revascularisation for refractory UA.
Summary:
- 63 consecutive patients with unstable angina were enrolled; 61 had significant CAD.
- 39 underwent CABG, 9 had PTCA; 13 were unsuitable for revascularisation.
- Perioperative complications included 2 myocardial infarctions and 1 in-hospital death. At 14-26 months follow-up, 95% of patients survived, with 65% of the revascularised group remaining free of angina pectoris.
Impact:
- Acute revascularisation is a viable option for patients with unstable angina unresponsive to medical therapy.
- The procedure demonstrates low operative mortality and a low incidence of perioperative myocardial infarctions.
- Good long-term angina-free survival rates support the use of acute revascularisation in selected UA patients.
Abstract:
We present the results of an acute revascularisation program for unstable angina. Of the 63 consecutive patients included in the program 61 had significant coronary artery disease. Coronary bypass grafting was performed in 39 and percutaneous transluminal angioplasty in 9. There were two perioperative myocardial infarctions and one death in hospital. 13 patients were found unsuitable for revascularisation. At follow-up (14-26 months) 60 patients were still alive (95%). In the revascularised group 30 patients (65%) were free of angina pectoris. Accordingly, in patients who do not respond to medical therapy, acute revascularisation may be performed with low operative mortality, low incidence of perioperative myocardial infarctions, and good long term results.