Early percutaneous transluminal coronary angioplasty in the management of unstable angina.

This report describes the results of percutaneous transluminal coronary angioplasty in 56 patients with unstable angina. In each case diagnostic coronary angiography had demonstrated a critical proximal stenosis in a major vessel. The stenosis was successfully dilated without complication in 70% of cases. Angiographic success was reflected by the abolition of symptoms and a nonischaemic predischarge stress test in 82 and 72% of cases, respectively. Importantly, at six months follow-up 69% of these patients remained symptom free though repeat angioplasty had been necessary in 21% of cases. The in-hospital incidence of myocardial infarction and death was 7.1 and 5.4%, respectively, but during the six month follow-up period only one additional complicating event occurred. Results were particularly favourable in patients with single vessel disease, 83% of whom had successful procedures. There was one uncomplicated myocardial infarct in this subgroup but no deaths. These data indicate that percutaneous transluminal coronary angioplasty may be undertaken with relative safety in patients with unstable angina and leads to a substantial improvement in symptoms that is sustained during early follow up. The benefits of this therapeutic approach may be particularly marked in patients with single vessel disease.