Key result
Transient reduction of coronary flow due to arterial spasm or platelet aggregation is the immediate cause of ischemia in most instances of unstable rest angina with ST-segment depression.
Unstable rest angina with ST-segment depression is primarily driven by transient coronary flow reduction, supporting a multi-drug regimen to prevent flow reduction and oxygen consumption increases.
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Challenges demand-driven mechanism in unstable rest angina; leaves open spasm versus aggregation pending prospective validation.
Philip B. Oliva (1984) conducted a review in Unstable rest angina with ST-segment depression. Combination therapy (nitrates, beta-blocker, calcium-channel blocker, aspirin/heparin) was evaluated. Transient reduction of coronary flow due to arterial spasm or platelet aggregation is the immediate cause of ischemia in most instances of unstable rest angina with ST-segment depression.
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