[Implanting of coronary stents in patients with unstable angina]. / L'impianto dello stent coronarico nei pazienti con angina instabile.

ABSTRACT

In the present study, we retrospectively examined our experience with the Palmaz-Schatz stent in patients with unstable angina to determine a) different outcomes between patients with stable and unstable angina, b) correlation between the class of unstable angina and 1-month and 6-month results, c) correlation between lesion morphology and procedural complications. From January 1994 to January 1996, 160 patients with unstable angina (Group A) and 104 with stable angina (Group B) underwent coronary stenting. According to the modified Braunwald classification patients with unstable angina were divided into four classes. Lesion morphology was classified in simple and complex. Procedural success was 98% in Group A patients and 99% in Group B patients. We observed 9 (5.6%) major complications in Group A vs 2 (1.9%) in Group B. Subacute thrombosis occurred in 9 patients in Group A and in 2 patients in Group B and these different rates were responsible for the higher number of acute myocardial infarction and urgent revascularization procedures in Group A patients. At 6-month follow-up there were no differences between Group A and Group B patients. Patients in different classes of angina showed a similar cardiac event rate at 1-month and 6-month follow-up. We found 108 complex lesions in patients with unstable angina vs 20 in patients with stable angina (p = 0.0001). Among the 9 patients with unstable angina and subacute thrombosis, 6 had a complex lesion and 3 a simple lesion (NS). In conclusion, patients with unstable angina receiving intracoronary stent have similar clinical outcome at 1-month and 6-month follow-up as compared to patients with stable angina. The class of unstable angina and the complex morphology of the lesion are not related to procedural complications.