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[Unstable angina pectoris--pathogenesis and therapy].

V Cervenka, V Vísek, P Widimský

    Vnitrni Lekarstvi
    |August 1, 1989
    PubMed
    Summary

    Unstable angina pectoris treatment with streptokinase shows promising results, especially for new angina cases. While subjective improvements are common in deteriorated angina, objective coronary improvements are more frequent in new cases.

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    Area of Science:

    • Cardiology
    • Interventional Cardiology
    • Pharmacology

    Background:

    • Unstable angina pectoris (UAP) is a critical condition marked by rapid angina deterioration or new onset.
    • Thrombotic coronary artery narrowing or occlusion is frequently observed in UAP patients.

    Purpose of the Study:

    • To evaluate the efficacy of intracoronary streptokinase in patients with unstable angina pectoris.
    • To compare treatment outcomes between newly developed and deteriorated angina pectoris.

    Main Methods:

    • Thirty UAP patients admitted within 24 hours underwent coronary angiography.
    • Intracoronary streptokinase (500,000 U) was administered to the most stenosed coronary artery.
    • Coronary and subjective improvements were assessed post-treatment.

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    Main Results:

    • Overall, 53% showed angiographic improvement and 77% subjective improvement after streptokinase.
    • Newly developed angina had 100% angiographic improvement, while deteriorated angina had 36%.
    • Subjective improvement was noted in 68% of deteriorated angina cases, often without angiographic changes.

    Conclusions:

    • Intracoronary streptokinase is effective in UAP, particularly for new-onset angina.
    • For new angina, streptokinase is recommended. For deteriorated angina, heparin or streptokinase are suggested.
    • Significant difference in angiographic improvement between new and deteriorated angina groups (p<0.01).