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Comparison of Mid-term Angiographic and Clinical Outcomes between Patients with Stable versus Unstable Angina Pectoris in the Drug-Eluting Stent Era
고려대학교 구로병원 순환기내과
Yong-Jian Li, 나승운, Kang-Yin Chen, Kanhaiya L. Poddar, 박재형, 나진오, 최철웅,
Background: Although patients (pts) with unstable angina pectoris usually have more unfavorable clinical courses compared with stable angina, the differences of the angiographic and clinical outcomes between these 2 distinct groups have not been fully understood in drug-eluting stent (DES) era. Methods: From the pts who underwent PCI with DES (Cypher, Taxus or Endeavor) from Aug 2004 to Dec 2007, those with previous MI were excluded.Thus,360 pts with stable angina and 483 pts with unstable angina were enrolled. Angiographic and clinical outcomes at 6 months were evaluated. Results: Pts with stable versus unstable angina had similar baseline & procedural characteristics. Unstable angina group showed worse mid-term angiographic outcomes including significantly smaller follow up minimum lumen diameter (MLD), higher restenosis percentage and a trend toward higher late lossb but the clinical outcomes were similar between the 2 groups. There were 3 cases of stent thrombosis (ST) in unstable angina group, whereas, there was no ST cases in stable angina group (Table). Conclusions: Despite more unfavorable mid-term angiographic outcomes in unstable angina group, these benefits were not translated into worse mid-term clinical outcomes.Further study with larger study population and longer follow-up period will be warranted to get final conclusions.

Table: Angiographic and clinical outcomes at 6 months

Variables, n (%)

Stable angina Group

(n=360 pts, 569 lesions)

Unstable angina Group

(n=483 pts, 781 lesions)

P value

Restenosis percentage, %

21.04 ± 18.58

25.19 ± 22.03

0.02

Late loss, mm

0.62 ± 0.62

0.74 ± 0.68

0.058

MLD, mm

2.50 ± 0.78

2.33 ± 0.78

0.004

Death

10 (2.8)

7 (1.4)

0.175

Q-wave MI

0 (0)

0 (0)

--

TLR

19 (5.3)

15 (3.1)

0.113

TVR

23 (6.4)

22 (4.6)

0.241

Repeat PCI

29 (8.1)

30 (6.2)

0.299

TVR-MACE

34 (9.4)

32 (6.6)

0.132

Stent thrombosis

0 (0)

3 (0.6)

0.265



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