title: [Prognostic factors in unstable angina with dynamic electrocardiographic changes. Value of fibrinogen].
abstract: OBJECTIVE
  The prognosis of unstable angina varies between series depending on the inclusion criteria and management protocol used. The aim of this study was to analyze in-hospital events and their predictors in a homogeneous single-center series of patients with unstable angina.
  
  
  METHODS
  A total of 246 patients with the following inclusion criteria were studied: 1) resting anginal pain, 2) transient electrocardiographic changes during anginal pain, 3) normal CK-MB levels and 4) exclusion of postinfarction angina. All patients were treated with aspirin and enoxaparin (1 mg/kg/12 h). Coronary angiography was performed in the case of recurrent angina or ischemia in Bruce I-II stage during the predischarge effort stress test. The variables recorded were risk factors, history of ischemic heart disease, history of coronary surgery, ECG upon admission, and fibrinogen.
  
  
  RESULTS
  During the hospital stay the following events were recorded: 36% recurrent angina, 58% cardiac catheterization, and 5,7% major events (infarction or death). Multivariate analysis found recurrent angina to be more frequent in patients with a history of coronary bypass surgery (p = 0.004. OR = 22; CI 95%, 3-182), ST-segment changes (p = 0.01. OR = 4.7, CI 95%; 1.4-15.9) and higher fibrinogen (p = 0.002. OR = 1,4, CI 95%; 1.1-1.7). Fibrinogen was the only variable related to cardiac catheterization (p = 0,009. OR = 1.3. CI 95%, 1.1-1.6) and major events (p = 0.001. OR = 2.0. CI 95%, 1.4-3.1).
  
  
  CONCLUSIONS
  1) Unstable angina with electrocardiographic changes was associated to a high rate of in-hospital events. 2) Fibrinogen was related to any event, and previous by-pass surgery and ST changes were related to recurrent angina.
authors.affiliation: Servei de Cardiologia, Hospital Clínic Universitari, València, Spain. sanchis_juafor@gva.es
authors.forename: Juan
authors.initials: J
authors.lastname: Sanchis
authors.forename: Vicent
authors.initials: V
authors.lastname: Bodí
authors.forename: Alejandro
authors.initials: A
authors.lastname: Navarro
authors.forename: Angel
authors.initials: A
authors.lastname: Llácer
authors.forename: Marisa
authors.initials: M
authors.lastname: Blasco
authors.forename: Luis
authors.initials: L
authors.lastname: Mainar
authors.forename: José V
authors.initials: JV
authors.lastname: Monmeneu
authors.forename: Luis
authors.initials: L
authors.lastname: Insa
authors.forename: José A
authors.initials: JA
authors.lastname: Ferrero
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Chorro
authors.forename: Rafael
authors.initials: R
authors.lastname: Sanjuán
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000097:blood* / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D005340:Fibrinogen / Q000032:analysis*; D006801:Humans; D008297:Male; D011379:Prognosis
chemical_list: D005340:Fibrinogen