RISK STRATIFICATION IN UNSTABLE ANGINA - HOW TO SELECT PATIENTS WHO NEED EMERGENCY REVASCULARIZATION

被引:8
作者
CONTI, CR
机构
[1] Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida
关键词
D O I
10.1111/j.1540-8191.1993.tb00381.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Patients considered to have unstable angina have a varying prognosis depending on their clinical presentation. Prognosis can be influenced by several factors including persistent pain, transient ST segment shifts, left main coronary artery stenosis, and silent myocardial ischemia. Most patients who present with unstable angina have their symptoms controlled initially with pharmacological management. If symptoms persist, coronary angioplasty or heart surgery can be performed but morbidity and mortality is slightly higher than in patients who are stable. Patients who will benefit from early revascularization include those with persistent myocardial ischemia as manifested by spontaneous angina, spontaneous ST segment shifts on ambulatory ECG, a positive exercise test at a low cardiac workload, or a markedly positive radionuclide or cardiac ultrasound imaging test.
引用
收藏
页码:391 / 395
页数:5
相关论文
共 11 条
[1]  
Conti CR, Hill JA, Mayfield WR, Unstable angina pectoris: Pathogenesis and management, Curr Prob Cardiol, 14, pp. 557-623, (1989)
[2]  
Gazes PC, Moble EM, Faris HM, Et al., Pre‐infarctional (unstable) angina: A prospective study— Ten‐year follow‐up, Circulation, 48, pp. 331-337, (1973)
[3]  
Neill WA, Staccato left anterior descending artery occlusion: A recognizable subset of unstable angina, J Lab Clin Med, 105, pp. 390-396, (1985)
[4]  
Takaro T, Hultgren HN, Lipton MJ, Et al., The VA cooperative randomized study of surgery for coronary arterial occlusive disease: II. Subgroup with significant left main lesions, Circulation, 54, (1976)
[5]  
Gottlieb SO, Weisfeldt ML, Ouyang P, Et al., Silent myocardial ischemia predicting infarction and death during two year follow‐up of unstable angina, J Am Coll Cardiol, 10, (1987)
[6]  
Nademanee K, Intarachot V, Josephson MA, Et al., Prognostic significance of silent myocardial ischemia in patients with unstable angina, J Am Coll Cardiol, 10, (1987)
[7]  
Russell RO, Moraski RE, Kouchoukos NT, Et al., National Cooperative Study Group to Compare Surgical and Medical Therapy: Unstable angina pectoris II. In hospital experience and initial follow‐up results in patients with one, two, and three‐vessel disease, Am J Cardiol, 42, pp. 839-848, (1978)
[8]  
Plokker H, Ernst S, Bal E, Et al., Percutaneous transluminal coronary angioplasty in patients with unstable angina pectoris refractory to medical therapy: Long‐term clinical and angiographic results, Cathet Cardiovasc Diagn, 14, pp. 15-18, (1988)
[9]  
Goldman BS, Katz A, Christakis G, Et al., Determinants of risk for coronary artery bypass grafting in stable and unstable angina pectoris, Can J Surg, 28, pp. 505-508, (1985)
[10]  
Rankin JS, Newton JR, Callif RM, Et al., Clinical characteristics and current management of medically refractory unstable angina, Ann Surg, 200, (1984)