Variables predictive of successful medical therapy in patients with unstable angina: selection by multivariate analysis from clinical, electrocardiographic, and angiographic evaluations.

摘要: Although unstable angina can be initially controlled with medical therapy in most patients, there is a high incidence of subsequent death, myocardial infarction, or need for coronary bypass surgery to control symptoms. Identification at the time presentation patient likely do poorly on continued would useful advising consideration surgical therapy. Since arterial spasm may have significant role pathophysiology some recently developed calcium channel antagonists therefore particular benefit angina. One hundred thirty-eight patients were entered into randomized double-blind study efficacy adding nifedipine conventional treatment (nitrates and beta-blockers) followed 18 months. Of these 104 underwent arteriography. A multivariate Cox's hazard function analysis was applied variables selected from history, electrocardiographic (ECG) changes during chest pain, scintigraphic arteriographic data determine those predictive response The percentage left ventricular myocardium supplied by vessels 70% greater luminal stenosis variable influencing failure defined as sudden surgery. Whether not received second powerful variable, use reducing half relative risk failing These cigarette smoking presence global ST segment ischemia. After months group had fewer (p = .02), undergoing less than .01). However, did appear preventive effect against infarction death. Kaplan-Meier actuarial curves confirmed that significantly successful increasing numbers stenotic .03). provided beneficial two more .01) whom 50% Thus, although advanced obstructive disease greatest likelihood unfavorable outcomes, addition benefit.(ABSTRACT TRUNCATED AT 400 WORDS)