Usefulness of percutaneous transluminal coronary angioplasty for unstable angina pectoris after non-Q-wave acute myocardial infarction

Safian, Robert D.; Snyder, Louis D.; Synder, Barbara A.; McKay, Raymond G.; Lorell, Beverly H.; Aroesty, Julian M.; Pasternak, Richard C.; Bradley, Arlene B.; Monrad, E. Scott; Baim, Donald S.

doi:10.1016/0002-9149(87)90796-x

Cited by 57 publications

(2 citation statements)

References 20 publications

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“…In accordance with previous studies [1,4,6,[14][15][16], we confirm a lower peak serum CK activity in NQM1 than in QM1, suggest ing that the infarct size is smaller in this subtype of NQMI than in QMI [5,14,[17][18][19][20], We also confirm other reports [2][3][4][5]7] saying that the incidence of pump failure and inhospital mortality is significantly lower for NQMI than for QMI. We observed a signifi cantly lower prevalence of multivessel dis ease about 4 weeks after the onset of this subtype of NQMI than of QMI.…”

Section: Discussionsupporting

confidence: 92%

Coronary Angiographic Features within 48 Hours from Onset of Non-Q Wave Myocardial Infarction with R Wave Regression and No ST Segment Depression

et al. 1990

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The clinical features of acute non-Q wave myocardial infarction (NQMI) with R wave regression and no ST segment depression are distinct from those of acute Q wave myocardial infarction (QMI). NQMI patients showed ST segment elevation at admission, and significantly earlier regression of the ST segment elevation and appearance of coronary T waves were observed compared to QMI patients. In addition to the significantly lower level of mean peak serum creatine kinase activity and the significantly lower incidence of pump failure during the acute phase, the incidences of in-hospital mortality and multivessel disease were significantly lower in the NQMI patients. With respect to acute-phase coronary angiographic features within 48 h after the onset, the rate of spontaneous opening of infarct-related vessels was significantly higher in the NQMI patients. Thirteen of the 19 NQMI patients responded to urokinase infusion. These facts suggest that transient, intermittent or incomplete obstruction may favor this type of NQMI over QMI, and that thrombus might be an important factor in the pathogenesis of this type of NQMI.

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Section: Discussionsupporting

confidence: 92%

Coronary Angiographic Features within 48 Hours from Onset of Non-Q Wave Myocardial Infarction with R Wave Regression and No ST Segment Depression

et al. 1990

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“…Although other earlier studies (predominantly from the 1980s) had suggested that patients with UA who undergo balloon PTCA have higher rates of MI and restenosis than patients with stable angina (592)(593)(594)(595)(596), contemporary catheter revascularization differs by often involving coronary stenting, DES, and adjunctive use of platelet GP IIb/IIIa receptor inhibitors, which are likely to affect not only immediate-but also long-term outcomes (512). Historically, PTCA had been limited by acute vessel closure, which occurs in approximately 5% of patients, and by coronary restenosis, which occurred in approximately 35% to 45% of treated lesions during a 6-month period.…”

Section: Percutaneous Coronary Interventionmentioning

confidence: 99%

ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction

Bridges¹,

Califf²,

Casey³

et al. 2007

Journal of the American College of Cardiology

1,578

557

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Short and long term outcome of percutaneous transluminal coronary angioplasty in unstable versus stable angina pectoris: A report of the 1985–1986 nhlbi ptca registry

Bentivoglio

Holubkov

Kelsey

et al. 1991

Cathet. Cardiovasc. Diagn.

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In a cohort of 1,720 consecutive patients from the National Heart, Lung, and Blood Institute, Percutaneous Transluminal Coronary Angioplasty (PTCA) Registry (August 1985-May 1986), we compared 768 patients (45%) with stable angina and 952 patients (55%) with unstable angina pectoris. Unstable angina patients exhibited at least one of the following characteristics: new onset angina, rapidly progressing angina, angina at rest, angina refractory to medication, variant angina, acute coronary insufficiency, or angina recurring shortly after an acute myocardial infarct. The distribution of single- and multi-vessel disease was similar among stable and unstable angina patients; multi-vessel disease predominated. Average severity of stenosis and incidence of tubular and diffuse stenosis morphology were higher among patients with unstable angina (both p less than 0.001). Patient success rates were similar in stable and unstable patients. However, on a per lesion basis, overall angiographic success rate and average reduction of severity of stenosis in successfully dilated lesions were significantly higher among patients with unstable angina (both p less than 0.001). Incidence of major patient complications (p less than 0.01) and of emergency coronary bypass surgery (p less than 0.05) were also higher in patients with unstable angina but consistent with their more precarious clinical condition and stenosis morphology. During a two year follow-up, the cumulative distributions of death, myocardial infarct, repeat PTCA, and coronary bypass surgery were not significantly different in patients with stable angina compared to patients with unstable angina. Comparison of the current PTCA Registry cohort with the cases reported in the 1979-1982 Registry revealed a 19% higher success rate for both stable and unstable angina patients. Major complication rates decreased between time periods for stable but not for unstable angina patients. Incidence of emergency bypass surgery decreased more for stable than for unstable angina patients. Coronary angioplasty is indicated in properly selected patients with unstable angina and both single- and multi-vessel coronary disease.

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Usefulness of percutaneous transluminal coronary angioplasty for unstable angina pectoris after non-Q-wave acute myocardial infarction

Cited by 57 publications

References 20 publications

Coronary Angiographic Features within 48 Hours from Onset of Non-Q Wave Myocardial Infarction with R Wave Regression and No ST Segment Depression

Coronary Angiographic Features within 48 Hours from Onset of Non-Q Wave Myocardial Infarction with R Wave Regression and No ST Segment Depression

ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction

Short and long term outcome of percutaneous transluminal coronary angioplasty in unstable versus stable angina pectoris: A report of the 1985–1986 nhlbi ptca registry

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