Coronary artery stenting in unstable angina pectoris: a comparison with stable angina pectoris.
OBJECTIVE
To compare early complication rates in unselected cases of coronary artery stenting in patients with stable v unstable angina.


METHODS
Tertiary referral centre.


METHODS
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.


METHODS
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.
Clarkson
P B
PB
Department of Cardiology, Walsgrave Hospital, Clifford Bridge Road, Coventry CV2, UK. pbclarkson@aol.com
Halim
M
M
Ray
K K
KK
Doshi
S
S
Been
M
M
Singh
H
H
Shiu
M F
MF
D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery; D000789:Angina, Unstable / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D015607:Stents; D013927:Thrombosis / Q000209:etiology; D017211:Treatment Failure