Clinical Predictors & Risk Stratification of Unstable Angina
Abstract
Background: Detection of high risk patients with unstable angina is one of the important steps in saving their lives and preventing possible major cardiovascular events that can affect their morbidity and mortality.
Objectives: This study had been designed to estimate the effect of age, gender and different clinical parameters on the short term outcome of patients with unstable angina.
Methods: This study is a prospective study that enrolled 100 patients with unstable angina. The included patients had been randomly selected from those who had been admitted to the Coronary Care Unit of Al‐Yarmouk Teaching Hospital during the period between the 1st of July and the 31st of December 2003. Each patients included in this study had been followed up for 72 hours to 2 weeks according to the period of admission in the hospital, searching for any mortality, new or recurrent myocardial infarction or recurrent ischemia that necessitate the referral to intervention cardiology center. Unfortunately there was no facility for catheterization in the hospital and no one of the included patients referred back to the hospital to knew the results of catheterization. All of the patients underwent thorough physical examination. All of them had been sent for ECG, chest X‐ray and echocardiographic examination.
Results: All cause mortality had been identified only in those patients whose age were 65 year old or older (6 patients, 6% of the whole sample). 66.7% of deaths (4 deaths) were observed among class III patients (only 26.3% of class III patients had relieved form chest pain) i.e. angina at rest and acute.
Conclusions: All cause mortality, frequency of new or recurrent myocardial infarction and recurrent ischemia were increased with the increase in the severity class. According to the clinical circumstances related to unstable angina, secondary unstable angina i.e. class A was the least frequent type (only 5 patients, 5% of the sample). According to the intensity of therapy, the worse outcome had been observed among those patients who are under the maximally tolerated doses of anti‐ischemic drugs.
