title: Long-term survival and risk stratification in patients with angina at rest undergoing medical treatment.
abstract: In order to determine those factors which influence long-term prognosis in patients with angina at rest associated with transient ST-segment changes, 217 patients undergoing medical treatment were followed for a mean of 39 months. All patients underwent coronary arteriography. Univariate analysis identified 12 variables significantly related to prognosis. These were disease of the left main coronary artery; the number of diseased vessels; left ventricular end-diastolic pressure; ejection fraction; baseline electrocardiogram; presence of prior myocardial infarction; ST-segment depression and ventricular arrhythmias during pain; disease of the proximal anterior descending coronary artery; crescendo angina; hypertension; and age. Use of the Cox regression model for survival analysis revealed only 3 variables which were independent predictors of prognosis. They were disease of the left main coronary artery; the number of diseased vessels and left ventricular end-diastolic pressure. The model allowed stratification of patients into 3 groups. Survival at 3 years was 98% in the low risk group; 82% in the intermediate risk group; and 58% in the high risk group. These data indicate that disease of the left main coronary artery, the number of diseased vessels and left ventricular end-diastolic pressure are the independent predictors of prognosis in angina at rest. These variables may allow stratification of patients into groups having different long-term survivals.
authors.affiliation: Divisione di Cardiologia, Policlinico San Matteo, Istituto di Ricovero e Cura a Carattere Scientifico, Pavia, Italy.
authors.forename: S
authors.initials: S
authors.lastname: De Servi
authors.forename: C
authors.initials: C
authors.lastname: Berzuini
authors.forename: E
authors.initials: E
authors.lastname: Poma
authors.forename: M
authors.initials: M
authors.lastname: Ferrario
authors.forename: S
authors.initials: S
authors.lastname: Ghio
authors.forename: A
authors.initials: A
authors.lastname: Sciré
authors.forename: P
authors.initials: P
authors.lastname: Cioffi
authors.forename: D
authors.initials: D
authors.lastname: Ardissino
authors.forename: C
authors.initials: C
authors.lastname: Montemartini
authors.forename: G
authors.initials: G
authors.lastname: Specchia
mesh_terms: D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000188:drug therapy*; D000789:Angina, Unstable / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000401:mortality; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000008:administration & dosage*; D005996:Nitroglycerin / Q000008:administration & dosage*; D011379:Prognosis; D011433:Propranolol / Q000008:administration & dosage*
chemical_list: D011433:Propranolol; D005996:Nitroglycerin; D009543:Nifedipine