The intermediate coronary syndrome

Scanlon, Patrick J.

doi:10.1016/0033-0620(81)90021-9

Cited by 17 publications

(6 citation statements)

References 80 publications

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“…Contrary to all other series published on unstable angina, patients are carefully recruited and demonstrate lesions suitable for both surgery and angioplasty [19][20][21][22]401, leaving room for frequent fall back on emergency bypass. This method is so strict that results can in fact be superior to those in angioplasty in general [22], and those of unstable angina patients treated surgically [1,7,8,41] (mortality 1.6 to 6%). On the other hand our results (excluding emergencies) are similar to those found in the few series to deal with stable, but poor candidates for surgery patients [37,38] (Tables 11-111).…”

Section: Discussionmentioning

confidence: 99%

“…This clinical context has a characteristic development which, if left untreated, leads to infarct or death [l-31. By-pass surgery has been the main therapeutic development for this disease, but there is a higher risk of infarct and mortality than in stable angina, even if technical improvements have reduced perioperative mortality from 10 to 3% in recent series [1,7,8].…”

Section: Introductionmentioning

confidence: 99%

“…This well-known severity is linked with the particular type of coronary lesion. Various coronarographic [9,10] and/or anatomopathological [ 1 [1][2][3][4][5][6][7][8][9][10][11][12][13] or angioscopic [ 141 studies converge towards the theory of plaque rupture often with additional thrombus.…”

Section: Introductionmentioning

confidence: 99%

“…The literature is not clear on what will become of patients with unstable angina who have been refused surgery and are also refused angioplasty. This is an important point, because studies at the end of the Seventies showed us that it is in this group that the worst prognosis was outlined [ 1,7,6]. In this work we have explored the feasability for use of angioplasty on patients with unstable angina, including those who were poor candidates for surgery.…”

Section: Introductionmentioning

confidence: 99%

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Clinical factors affecting the immediate outcome of ptca in patients with unstable angina and poor candidates for surgery

Colle¹,

Delarche²

1991

Cathet. Cardiovasc. Diagn.

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Percutaneous Transluminal Coronary Angioplasty (PTCA) has been successfully applied in unstable angina to carefully selected patients. In this study, PTCA was performed in 277 consecutive patients suffering from unstable angina and for whom bypass surgery was not a valid alternative because either of inoperable conditions or of emergency, or because surgery was not the best option. All patients were admitted first to the intensive care unit where an attempt was made to control unstable angina under conventional medical therapy using at least iv nitroderivative, heparin, and calcium blockers. After a standardized preparation PTCA was performed either as an emergency procedure in medically refractory unstable angina (107 cases) or as an elective procedure in controlled situations after a 7 to 10 days symptom-free period. Three hundred fifty-three coronary vessels were attempted. Results of this group are compared with those of a control group made of 670 consecutive stable patients recruited during the same period, and clinical characteristics are envisaged as potential predictive factors. Unstable angina is undoubtedly associated with a higher overall complication rate, but the immediate outcome is strongly affected by the clinical context. As an example, respective success and mortality rates are: 93% and 0% when a full revascularization is attempted; 91% and 0% in elective procedures in patients under 60; 87% and 1.2% in elective PTCA for multiple vessel disease; 80% and 6.5% in emergency PTCA; 80% and 11% in the overall triple vessel disease; 84% and 16% in patients with deeply altered ejection fraction; and 58% and 26% in triple vessel disease with 2 previously occluded coronary arteries.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical factors affecting the immediate outcome of ptca in patients with unstable angina and poor candidates for surgery

Colle¹,

Delarche²

1991

Cathet. Cardiovasc. Diagn.

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“…Patients with stable angina are a relatively homogenous group with a well described natural history. However, unstable angina is a broad category which includes patients with a wide range of clinical presentations and varying prognosis [2][3][4]. While the angiographic characteristics of atherosclerotic plaque in stable and unstable angina have been widely studied, little information exists regarding the specific composition of the symptomproducing lesion in the various subsets of unstable angina.…”

Section: Introduction Methodsmentioning

confidence: 99%

Coronary artery plaque morphology in stable angina and subsets of unstable angina: an in vivo intracoronary ultrasound study

et al. 1995

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Little information is available regarding the in vivo composition of angina producing culprit atherosclerotic lesions in various anginal syndromes. In this study we used intracoronary ultrasound to determine the composition of culprit lesions in various subsets of anginal syndromes and correlated this composition with the patient's clinical presentation. One hundred and forty six patients referred for angioplasty or atherectomy were classified as having either chronic stable angina (angina which was clinically unchanged for > 2 months), crescendo angina (an accelerating pattern of frequent or prolonged anginal episodes), severe rest angina (abrupt onset of prolonged angina) or post-infarction angina (angina within 2 weeks of acute myocardial infarction). Intracoronary ultrasound imaging of the culprit lesion was performed before intervention. Lesions were classified as soft, mixed fibrous without calcium, mixed fibrous with calcium or calcified. Analysis of the ultrasound images revealed that the majority of culprit lesions were soft in severe rest (71%) and post-infarction angina (73%) whereas, the majority of culprit lesions were mixed fibrous or calcified in chronic stable (69%) and crescendo (53%) angina (X2 = 22.73, p = 0.007). In addition, the frequency of intralesional calcium in chronic stable or crescendo angina was significantly higher than that in severe rest or stable angina. We conclude that the composition of culprit lesions in various anginal subsets are different. The lesion morphology in crescendo angina frequently resembles that in chronic stable angina; while those in severe rest and post-infarction angina are frequently similar. These findings may have implications for medical or interventional treatment of patients with angina.

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Clinical Presentation of Ischemic Heart Disease

Antman

Rutherford

1986

Coronary Care Medicine

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The intermediate coronary syndrome

Cited by 17 publications

References 80 publications

Clinical factors affecting the immediate outcome of ptca in patients with unstable angina and poor candidates for surgery

Clinical factors affecting the immediate outcome of ptca in patients with unstable angina and poor candidates for surgery

Coronary artery plaque morphology in stable angina and subsets of unstable angina: an in vivo intracoronary ultrasound study

Clinical Presentation of Ischemic Heart Disease

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