Unstable angina pectoris: Morbidity and mortality in 57 consecutive patients evaluated angiographically

Clinical spectrum of “Unstable Angina”

“…After a follow-up period of more than 40 months progressive angina and the intermediate syndrome have the same characteristics as those reported in previous communications (3,4) and support opinion of other authors who separate them into two different risk groups (9,15,22).…”

Acute coronary insufficiency. Review of 46 patients.

“…The aspect of the natural history of coronary artery disease presented in this paper has been discussed in medical papers for many years under a variety of names, including impending coronary occlusion (Sampson and Eliaser, 1937), coronary failure (Freedberg et al, 1948), intermediate coronary syndrome (Graybiel, 1955), acute coronary insufficiency (Master et al, 1956), status anginosus (Papp and Smith, 1960), preinfarction angina (Fowler, 1971), and unstable angina (Conti et al, 1973). The absence of a uniform definition and longterm follow-up and, until lately, angiographic correlation has given no sound basis on which to compare the 2 forms of treatment, medical and surgical.…”

Unstable angina. The problem of definition.

“…Mortality of patients treated medically varied between 5 per cent in 8 months in one subgroup (Bertolasi et al, 1974) and 43 per cent in one year (Gazes et al, 1973) in another subgroup. Surgical mortality also varied between O (Auer et al, 1971) and 22 per cent (Conti et al, 1973).…”

“…Regardless of the term they selected, they have tried to define their patients according to a set of criteria (Gazes Received 14 July 1975Miller et al, 1973;Conti et al, 1973;Fischl, Herman and Gorlin, 1973). These included some or all of the following: (1) a change in the character of the chest pain, usually involving an increase in severity and/or frequency; (2) occurrence of angina at rest; (3) recent onset of angina; (4) occurrence of an episode of prolonged chest pain that results in admission to the coronary care unit to rule out myocardial infarction; (5) occurrence of recurrent prolonged episodes of chest pain lasting more than 15 or 20 minutes; (6) angina, resistant or incompletely relieved by nitroglycerin; (7) absence of any evidence of precipatating factors for the change in the anginal pattern; (8) documentation of electrocardiographic ST-T abnormalities suggestive of ischaemia, concomitant with the chest pain; (9) documentation of absence of serum enzyme increase to levels indicative of myocardial infarction; and (10) demonstration of 'critical lesions' (more than 70% luminal narrowing) in at least one major coronary artery.…”