Unstable Angina: Predictor Variables of Major Complications in the Percutaneous Transluminal Coronary Angioplasty in the Stent Era

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Abstract

Objectives

The purpose of this study was to determine the fre-quency and predictor variables of major in-hospital ischemic complications after percutaneous transluminal coronary angioplasty in patients with unstable angina.

Material and method

602 patients with unstable angina that went through a coronary angioplasty were prospectively included. The patients came from 13 centers, which were involved in The Angioplasty in UnstableA ngina Registry from the Interventional Cardiology Council of the Sociedad Argentina de Cardiologia. The utilization of the stent was up to the interventional cardiologist criteria. Twenty six clinic and angiographic variables and the presence of major complications during hospitalization were linked and analyzed using univariate and multi-variate analysis.ResultsThe average age of the patients was 61.3 ± 10. 9years; 78% of them were male and 70.3% received at least one stent. Major complications prevailed in a 2.34% of the patients (infarction 1.17%, death 0,5% and revascularization surgery1,17%). The statistical analysis showed that refractory angina (odds ratio10.1, 95% IC 3.07-33.99,p = 0.00008), the ECG changes 48 hours previous to angioplasty (odds ratio 5.1, 95% IC 1.51-17.48, p=0.0037), female sex (odds ratio 3.7,95% IC 1.14-11.99, p = 0.018) and a complex type of lesion (lesion type 1320 (odds ratio 6.06, IC 95% 1.27-39.56, p=0.016) determined a greater incidence, statistically significant, of major complications post-PTCA inpatients withu nstable angina. In the multivariate analysis the refractory angina on females and complex lesions kept their predictive importance.

Conclusions

In unstable angina angioplasty, the major complications rate with large use of stent is 2.34%. The presence of refractory angina, the female sex and complex lesions were the variables that in our sample population identified a group of patient of high risk of major complications.