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ARTICLE |

Cardiac Catheterization in Patients With Unstable Angina: Title and subTitle BreakRecent Onset vs Crescendo Pattern FREE

Gary D. Plotnick, MD; Michael L. Fisher, MD; Nathan H. Carliner, MD; Lewis C. Becker, MD
[+] Author Affiliations

Reprint requests to Department of Medicine, Veterans Administration Medical Center, 3900 Loch Raven Blvd, Baltimore, MD 21218 (Dr Plotnick).


JAMA. 1980;244(6):574-576. doi:10.1001/jama.1980.03310060030017
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Among patients with unstable angina pectoris, those with crescendo angina seem to be at high risk for death and myocardial infarction. We reviewed the clinical, arteriographic, and hemodynamic findings in 218 consecutive catheterized patients with unstable angina. Unstable angina was defined as ischemic cardiac pain at rest associated with transient ECG changes but no evidence for acute myocardial infarction. Patients were divided into two groups according to the duration of symptoms: 134 patients with crescendo angina (new, or increasing, rest pain with previous ischemic symptoms present for more than three months) and 84 with recent onset angina (symptoms present for less than three months). Compared with patients with recent onset symptoms, patients with crescendo angina had more extensive coronary disease and lower ejection fractions, which may explain their poor prognosis.

(JAMA 244:574-576, 1980)

REFERENCES

Plotnick GD:  Approach to the management of unstable angina . Am Heart J 98:243-255, 1979;.
Gazes PC, Mobley EM Jr, Faris HM Jr, et al:  Preinfarctional (unstable) angina—a prospective study: Ten-year follow-up—prognostic significance of electrocardiographic changes . Circulation 48:331-337, 1973;.
Krauss KR, Hutter AM Jr, DeSanctis RW:  Acute coronary insufficiency—course and follow-up . Arch Intern Med 129:808-813, 1972;.
Alison HW, Russell RO, Mantle JA, et al:  Coronary anatomy and arteriography in patients with unstable angina pectoris . Am J Cardiol 41:204-209, 1978;.
Fischl SJ, Herman MV, Gorlin R:  The intermediate coronary syndrome . N Engl J Med 288:1193-1198, 1973;.
Hultgren HN:  Medical versus surgical treatment of unstable angina . Am J Cardiol 38:479-486, 1976;.
Day LJ, Thibault GE, Sowton E:  Acute coronary insufficiency: Review of 46 patients . Br Heart J 39:363-370, 1977;.
Becker J, Lichtlen P, Baumann PC, et al:  History and clinical findings related to selective coronary angiography , in Kaltenbach M, Lichtlen P (eds): Coronary Artery Disease . Stuttgart, Georg Thieme Verlag, 1971;, p 56.
Guthrie RB, Vlodaver Z, Nicoloff DM, et al:  Pathology of stable and unstable angina pectoris . Circulation 51:1059-1063, 1975;.
Friesinger GC, Page EE, Ross RS:  Prognostic significance of coronary arteriography . Trans Assoc Am Phys 83:78-92, 1970;.
Reeves TJ, Oberman A, Jones WB, et al:  Natural history of angina pectoris . Am J Cardiol 33:423-430, 1974;.
Humphries JO'N, Kuller L, Ross RS, et al:  Natural history of ischemic heart disease in relation to arteriographic findings: A 12-year study of 224 patients . Circulation 49:489-497, 1974;.
Bruschke AVG, Proudfit WL, Sones FM Jr:  Clinical course of patients with normal and slightly or moderately abnormal coronary arteriograms: A follow-up study on 500 patients . Circulation 47:936-945, 1973;.
 Unstable angina pectoris: National cooperative study group to compare medical and surgical therapy: I. Report of protocol and patient population . Am J Cardiol 37:896-902, 1976;.

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Plotnick GD:  Approach to the management of unstable angina . Am Heart J 98:243-255, 1979;.
Gazes PC, Mobley EM Jr, Faris HM Jr, et al:  Preinfarctional (unstable) angina—a prospective study: Ten-year follow-up—prognostic significance of electrocardiographic changes . Circulation 48:331-337, 1973;.
Krauss KR, Hutter AM Jr, DeSanctis RW:  Acute coronary insufficiency—course and follow-up . Arch Intern Med 129:808-813, 1972;.
Alison HW, Russell RO, Mantle JA, et al:  Coronary anatomy and arteriography in patients with unstable angina pectoris . Am J Cardiol 41:204-209, 1978;.
Fischl SJ, Herman MV, Gorlin R:  The intermediate coronary syndrome . N Engl J Med 288:1193-1198, 1973;.
Hultgren HN:  Medical versus surgical treatment of unstable angina . Am J Cardiol 38:479-486, 1976;.
Day LJ, Thibault GE, Sowton E:  Acute coronary insufficiency: Review of 46 patients . Br Heart J 39:363-370, 1977;.
Becker J, Lichtlen P, Baumann PC, et al:  History and clinical findings related to selective coronary angiography , in Kaltenbach M, Lichtlen P (eds): Coronary Artery Disease . Stuttgart, Georg Thieme Verlag, 1971;, p 56.
Guthrie RB, Vlodaver Z, Nicoloff DM, et al:  Pathology of stable and unstable angina pectoris . Circulation 51:1059-1063, 1975;.
Friesinger GC, Page EE, Ross RS:  Prognostic significance of coronary arteriography . Trans Assoc Am Phys 83:78-92, 1970;.
Reeves TJ, Oberman A, Jones WB, et al:  Natural history of angina pectoris . Am J Cardiol 33:423-430, 1974;.
Humphries JO'N, Kuller L, Ross RS, et al:  Natural history of ischemic heart disease in relation to arteriographic findings: A 12-year study of 224 patients . Circulation 49:489-497, 1974;.
Bruschke AVG, Proudfit WL, Sones FM Jr:  Clinical course of patients with normal and slightly or moderately abnormal coronary arteriograms: A follow-up study on 500 patients . Circulation 47:936-945, 1973;.
 Unstable angina pectoris: National cooperative study group to compare medical and surgical therapy: I. Report of protocol and patient population . Am J Cardiol 37:896-902, 1976;.
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