Coronary angioplasty in unstable angina: contemporary experience.
OBJECTIVE
To evaluate the role of percutaneous transluminal coronary angioplasty (PTCA) in the treatment of patients with unstable angina.


METHODS
Retrospective analysis of administrative records of all acute care hospital discharges at Robert Wood Johnson University Hospital from 1987 to 1993 with International Classification of Diseases, 9th revision, codes for coronary angioplasty and corresponding catheterization laboratory reports.


METHODS
Tertiary care teaching hospital.


RESULTS
Of 4826 PTCA cases, unstable angina was identified in 780 as the main indication for the procedure. Baseline clinical features of patients with unstable angina were not different from those in patients with stable angina. The overall success rate for PTCA in patients with unstable angina was significantly higher (707 of 780, 91%) than the success rate in patients with stable angina (3466 of 4046, 86%). The major complication rate in unstable angina patients was low (29 of 780, 3.7%) and did not differ from that in stable angina patients (136 of 4046, 3.4%). The success and complication rates in patients with unstable angina were analyzed in terms of time of PTCA, ie, early (less than 48 h from admission) versus late (48 h or more from admission). The procedure was successful in 343 of 380 (90%) patients treated early and 364 of 400 (91%) patients treated late (not significant), and the complication rates were low (12 of 380, 3.2% versus 17 of 400, 4.3%; not significant in both groups). However, length of hospital stay was considerably shorter for patients treated early than for patients treated late (4.5 +/- 3.3 days versus 10.4 +/- 6.6 days, respectively, P < 0.0001).


CONCLUSIONS
Contemporary results of PTCA in patients with unstable angina parallel those reported for stable angina. Thus, PTCA appears to be an effective and safe treatment for unstable angina patients, and treating these patients soon after admission does not appear to affect the success or complication rates.
Moreyra
A E
AE
Robert Wood Johnson Medical School, Department of Medicine, New Brunswick, NJ 08903-0019, USA.
Palmeri
S T
ST
Wilson
A C
AC
Kulkarni
A
A
Kulkarni
R
R
D000789:Angina, Unstable / Q000601:surgery*; D015906:Angioplasty, Balloon, Coronary; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors