Study On The Relationship Between Clinical Manifestation And Coronary Angiograms In Patients With Unstable Angina

Objective To evaluate the risk of UAP by investigating the relationship between the clinic and angiograms of coronary artery in patients with UAP. Methods 153 hospitalized patients with UAP were classified according to Braunwald criteria. The plasma cardiac troponin I or T(cTnI or cTnT) levels in 45 patients were measured by ELISA at 0, 6, 12 hours after chest pain, respectively. Standard surface 12 leads ECG were recorded during chest pain(18 leads ECG if necessary). All patients were performed on coronary angiography with the transfemoral approach using the Judkins technique. To compare the degree of coronary artery disease in patients with different duration of chest pain* serum level of cTnl(T) and changes of ST-T , and to compare the lesions of culprit artery , including the degree of stenosis, morphology and type of lesion, among subgroups of Braunwald classification in UAP patients. Results The rate of triple-vessel disease in patients with chest pain lasting over 20 minutes was higher than those with chest pain less 20minutes (38.7% VS 20.5%, p<0.05), and the rate of LMCA(left main coronary artery) disease was higher in UAP patients with changes of ST segment or T wave during chest pain than those without ECG changes(12% VS 0% , p<0.0 5). The rate of triple-vessel disease in patients with positive values ofcTnI(T) in class III was higher than those with negative cTnl(T) (50% VS 17.1%, p<0.05). The rate of triple-vessel disease, type C lesion, complex lesion and intracoronary thrombus (ICT ) in class III was significantly higher than that in class I, respectively(40% VS 14.6%; 55.6% VS 12.5 %; 73.3% VS 31.3%; 15.6 % VS 2.1 %, p<0.05), but the rate of the type A lesion , simple lesion in class III was lower than that in class I, respectively(13.3%VS41.7%; 10.2% VS43.8%, p<0.05). Conclusion The risk of the occurrence of triple-vessel disease in patients with chest pain lasting over 20 minutes was increased, and the rate of LMCA disease in UAP patients with changes of ST-T during chest pain was higher than those without ECG changes. The coronary lesions were more serious, the rate of type C lesion, complex lesion, ICT was higher in class III patients, and the rate of triple-vessel disease increased in those with positive values of cTnI(T).