Why the study?
What are the angiographic pathoanatomical mechanisms contributing to instability and refractoriness to therapy in patients with unstable angina?
What are the angiographic pathoanatomical mechanisms contributing to instability and refractoriness to therapy in patients with unstable angina?
Emergency coronary arteriography in medically refractory unstable angina reveals specific pathoanatomical mechanisms in nearly half of patients, suggesting the need for tailored therapeutic approaches.
Angiography may reveal mechanisms in refractory unstable angina; leaves open whether targeted interventions improve outcomes.
Ninety one patients with unstable angina were evaluated by clinical and angiographic study. Of 91 patients, 42 (46%) responded poorly to the intensive medical treatment. Emergency coronary arteriography was then performed on these patients. The important pathoanatomical mechanisms contributing to instability of angina pectoris and/or refractoriness to the intensive medical treatment were observed in 19 of 42 patients (45%). These include: 1) More severe disease with left main lesion; 2) Refractory coronary spasm; 3) Coronary dissection; 4) Rapid progression of atherosclerosis; 5) Ulcerating plaque and 6) Coronary thrombus. Our results presented here suggest that an appropriate knowledge regarding pathophysiology might improve the approach to treatment.
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Saitô et al. (1987) studied this question.
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