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Comparative Study
. 1999 Apr;81(4):393-7.
doi: 10.1136/hrt.81.4.393.

Coronary artery stenting in unstable angina pectoris: a comparison with stable angina pectoris

P B Clarkson  1 , M Halim, K K Ray, S Doshi, M Been, H Singh, M F Shiu
Affiliations
Comparative Study

Coronary artery stenting in unstable angina pectoris: a comparison with stable angina pectoris

P B Clarkson et al. Heart. 1999 Apr.

Abstract

Objective: To compare early complication rates in unselected cases of coronary artery stenting in patients with stable v unstable angina.

Setting: Tertiary referral centre.

Patients: 390 patients with stable angina pectoris (SAP) and 306 with unstable angina (UAP). Patients treated for acute myocardial infarction (primary angioplasty) or cardiogenic shock were excluded.

Interventions: 268 coronary stents were attempted in 211 patients (30.3%). Stents used included AVE (63%), Freedom (14%), NIR (7%), Palmaz-Schatz (5%), JO (5%), and Multilink (4%). Intravascular ultrasound was not used in any of the cases. All stented patients were treated with ticlopidine and aspirin together with periprocedural unfractionated heparin.

Results: 123 stents were successfully deployed in 99 SAP patients v 132 stents in 103 UAP patients. Failed deployment occurred with nine stents in SAP patients, v four in UAP patients (NS). Stent thrombosis occurred in four SAP patients and 11 UAP patients. Multivariate analysis showed no relation between stent thrombosis and clinical presentation (SAP v UAP), age, sex, target vessel, stent length, or make of stent. Stent thrombosis was associated with small vessel size (p < 0.001) and bailout stenting (p = 0.01) compared with elective stenting and stenting for suboptimal PTCA, with strong trends toward smaller stent diameter (p = 0.052) and number of stents deployed (p = 0.06). Most stent thromboses occurred in vessels < 3 mm diameter.

Conclusions: Coronary artery stenting in unstable angina is safe in vessels >/= 3 mm diameter, with comparable initial success and stent thrombosis rates to stenting in stable angina.

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Figures

Figure 1
Figure 1
Percentages of stents deployed for elective, suboptimal, and bailout indications in patients with stable and unstable angina pectoris.
Figure 2
Figure 2
Number of vessels in which stent implantation was performed, separated by vessel type in stable and unstable angina pectoris. LAD, left anterior descending coronary artery (including diagonal lesions); RCA, right coronary artery; Cx, circumflex coronary artery (including obtuse marginal lesions); SVG, saphenous vein graft; L main, left main stem artery (all protected by previous coronary surgery).
Figure 3
Figure 3
Diameter of vessels stented in patients with stable and unstable angina pectoris.
See this image and copyright information in PMC

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