PMID: 3383883Apr 1, 1988Paper

Prognostic implications of transient--predominantly silent--ischaemia in patients with unstable angina pectoris

European Heart Journal
T von ArnimB Höfling

Abstract

The occurrence of unstable angina pectoris, despite medical treatment, is generally regarded as an ominous prognostic sign and an indication for invasive diagnosis and revascularization. We investigated 38 consecutive patients with severe unstable angina with a mean of 2.5 days of continuous two-channel, frequency modulated Holter monitoring for ST segment analysis. In 16 patients, transient ischaemic episodes (more than 0.1 mV lasting more than 1 min) occurred despite maximal medical treatment: 82% of the episodes were silent. Compared to the 22 patients without ischaemic episodes there were no significant differences in prevalence of risk factors, numbers of vessels diseased (69% vs. 74% triple-vessel disease) or ejection fraction (54 +/- 15% vs. 53 +/- 16%). The 30-day prognosis, however, varied: of 16 patients with ischaemic episodes, 14 (88%) had a subsequent cardiac event (death, AMI, PTCA or CABG) compared to only 10 of 22 patients (45%) without ischaemic episodes (P less than 0.02 for all events, P less than 0.1 for death/AMI only). Transient ischaemic episodes, predominantly silent, are frequent in patients with severe unstable angina. Objective evidence of ongoing ischaemia despite medical treatment has a guarded shor...Continue Reading

Citations

Sep 10, 2003·Circulation·Peter F CohnCaroline Daly
Jul 16, 1992·The New England Journal of Medicine·C W HammH A Katus
Nov 1, 2000·Journal of Hypertension·D BoonG A van Montfrans
May 11, 2005·Expert Opinion on Investigational Drugs·Juan Carlos KaskiRamón Arroyo Espliguero
Jan 16, 2007·Journal of Thrombosis and Thrombolysis·C Michael GibsonJacqueline Buros
Feb 15, 2002·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Carlos AguiarRicardo Seabra-Gomes
Mar 1, 1993·Current Problems in Cardiology·P Théroux, R M Lidón

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