Coronary angioplasty for treatment of unstable angina with transient marked ST-segment elevation

The immediate and short-term results of coronary angioplasty were analysed in 16 patients who presented with chest pain at rest associated with transient marked ST-segment elevation (≥0.5 mV). The number of in hospital ischaemic attacks was on average 2.8 (range 1.8). All patients had at least one haemodynamically significant coronary artery stenosis for angioplasty. Multivessel coronary artery disease was present in 37% (6 of 16 patients). Before angioplasty the patients were premedicated with a combination ofnitroglycerin, calcium-antagonists and beta-receptor blockers. The initial success rate was 87% (14 of 16 patients). There were no deaths and no urgent CABG. Two patients sustained a procedure related myocardial infarction; in one patient a cerebrovascular accident occurred.After a mean follow-up of 13 ± 8 months (range 3-25) angina had recurred in 19% (3 of 16 patients). One patient died due to carcinoma of the lung. Repeat angiography was performed 3.2± 1.7 months after the procedure. Angiographic restenosis had occurred in 27% (4 of 15 patients) at this time. These results suggest that angioplasty in these patients is effective in relieving ischaemic symptoms and in preventing progression to myocardial infarction.