Correlation between clinical course and quantitative analysis of the ischemia related artery in patients with unstable angina pectoris, refractory to medical treatment

摘要: Patients with unstable angina, refractory to intensive medical therapy, are at high risk for developing thrombotic complications, such as recurrent ischemia, myocardial infarction and coronary occlusion during angioplasty. As both platelet aggregation and/or thrombus formation play an important role in this ongoing ischemic process, a monoclonal GPIIb/IIIa receptor antibody (c7E3) or thrombolytic therapy (alteplase) might be able modify the clinical course underlying lesion morphology. To evaluate whether alteplase c7E3 could influence incidence of we randomized 36 60 patients, respectively placebo, placebo. All patients exhibited dynamic ECG changes pain attacks, despite maximal tolerated therapy. were studies after initial angiography had demonstrated culprit amenable After study drug infusion quantitative was repeated angioplasty performed. Recurrent ischemia occured 5, 6, 9 16 from alteplase, placebo group, respectively. Major events defined death, urgent intervention occurred 7, 3, 1 7 Two died: one group study. The first patient due retroperitoneal hemorrhage, second result infarction. Qualitative showed resolution clots only, while same 20% improvement TIMI flow grade, without deterioration any group. Quantitative significant percentage diameter stenosis which not observed all three other groups, although differences between groups significant. Alteplase angina did change course, nor morphology, on hand, improved morphology rheology category patients.