Relevance of multivessel disease in the development of in-hospital refractory angina and myocardial infarction in patients with unstable angina

Figueras, Jaume; Juncal, Alberto; Cortadellas, Josefa; Barrabés, José A.; Soler, Jordi Soler

doi:10.1016/j.ijcard.2003.04.035

Cited by 2 publications

(2 citation statements)

References 33 publications

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“…While moderate to severe and complex coronary lesions are most often associated with subsequent acute coronary syndrome [12,13], mild to moderate coronary lesions may also develop into future culprit lesions and result in acute coronary syndrome [14]. Thus, the concept of total coronary atheroma burden of coronary artery disease, as reflected by angiographic severity scoring system, may be an important consideration for adverse events related to coronary artery disease rather than simply consideration of lesions that produce significant coronary artery luminal diameter stenosis (> 70%).…”

Section: Introductionmentioning

confidence: 99%

Comparative predictive and diagnostic value of flow-mediated vasodilation in the brachial artery and intima media thickness of the carotid artery for assessment of coronary artery disease severity

Matsushima

Takase

Uehata

et al. 2007

International Journal of Cardiology

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Section: Introductionmentioning

confidence: 99%

Comparative predictive and diagnostic value of flow-mediated vasodilation in the brachial artery and intima media thickness of the carotid artery for assessment of coronary artery disease severity

Matsushima

Takase

Uehata

et al. 2007

International Journal of Cardiology

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“…They might also have experienced ischaemia as a result of a multiple plaque reactivity. [16][17][18] The three forms of ACS also shared the frequent presence of MR, which, in all likelihood, had also contributed to acute pulmonary oedema, particularly in patients with NSTEMI or UA. This is a relevant finding because the severity of MR at the time of acute pulmonary oedema was probably greater than that measured, since MR was not generally assessed in the very acute phase when the ischaemic episode was associated with intense peripheral vasoconstriction.…”

Section: Left Ventricular Function and Mrmentioning

confidence: 99%

Thirty day prognosis of patients with acute pulmonary oedema complicating acute coronary syndromes

Figueras

2005

Heart

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Objectives: To investigate the characteristics of the acute coronary syndromes underlying acute pulmonary oedema and their 30 day prognosis. Patients: 185 consecutive patients with acute coronary syndromes and acute pulmonary oedema admitted to a tertiary care centre. Main outcome and measures: Clinical, ECG, echocardiographic, enzymatic, and angiographic features were prospectively investigated. Results: Non-ST segment elevation myocardial infarction (NSTEMI) was the most frequent cause of acute pulmonary oedema (61%) followed by unstable angina (UA; 21%) and ST segment elevation myocardial infarction (STEMI; 18%). In each group, mean age was > 70 years, but NSTEMI patients were the oldest and > 65% of patients had chronic hypertension. Moreover, patients with NSTEMI and UA were older and had a higher incidence of diabetes, previous myocardial infarction, and moderate to severe mitral regurgitation but a similarly reduced ejection fraction (NSTEMI, 41%; UA, 39%; and STEMI, 39%) and increased incidence of diastolic dysfunction and rate of multivessel disease (94%, 87%, and 86%, respectively). However, patients with STEMI had a higher creatine kinase MB peak concentration (158 v 76 mg/l in the NSTEMI group, p , 0.001) and 30 day mortality (26% v 9% in the NSTEMI group and 8% in the UA group, p , 0.024). Multivariate analysis identified ejection fraction , 40% and a peak creatine kinase MB concentration . 100 mg/l as the main prognostic markers (p , 0.03). Conclusions: Acute pulmonary oedema is mostly a complication of elderly hypertensive patients with NSTEMI or UA (82%) and with multivessel disease often associated with mitral regurgitation. On the other hand, the larger infarct size and higher mortality in patients with STEMI with a similarly reduced ejection fraction suggest a more extensive acute systolic loss.

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Relevance of multivessel disease in the development of in-hospital refractory angina and myocardial infarction in patients with unstable angina

Cited by 2 publications

References 33 publications

Comparative predictive and diagnostic value of flow-mediated vasodilation in the brachial artery and intima media thickness of the carotid artery for assessment of coronary artery disease severity

Comparative predictive and diagnostic value of flow-mediated vasodilation in the brachial artery and intima media thickness of the carotid artery for assessment of coronary artery disease severity

Thirty day prognosis of patients with acute pulmonary oedema complicating acute coronary syndromes

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