Coronary angiographic findings in unstable angina in relation to Braunwald's clinical classification and resting ECG.

Abstract

Background : Atherosclerotic coronary artery disease including unstable angina is a major cause of high morbidity and mortality all over the world .Among patients with unstable angina there are different clinical presentation and resting electrocardiogram pattern at presentations ,analysis of these provide a useful means to stratify a present risk and subsequent out come .Objectives : the objectives of this study were to study the angiographic findings of patients with unstable angina in relation to Braunwald's clinical classification and resting electrocardiogram pattern . Setting: Ibn-Albaitar hospital and Marjan teaching hospital.Method: Across-sectional study done,one hundred thirty patients with clinical presentation of unstable angina were classified according to Braunwald's clinical classification and resting electrocardiogram pattern and the results correlated with that of angiographic findings.Results: Triple vessel disease occurred in 44 patients (33.84%). Class I and class A showed higher proportion of single vessel disease (57.69% ,46.87% ) respectively. class II and class B showed higher proportion with triple vessel disease (44.87% , 42.37%) respectively. class III and class C showed higher proportion with double vessel disease (38.46%, 41.02% ) respectively. Patients with normal Electrocardiogram showed higher proportion with single vessel disease SVD (38.509%). Patients with electrocardiogram changes (ST-T segment changes and Q wave) showed higher proportion with triple vessel disease (40.27%).Conclusion: Patients with unstable angina have high incidence of triple vessel disease, mostly in patients who have primary unstable angina (class B) or have unstable angina that occurs at rest (class II). Single vessel disease occurs more in patients who have new or accelerated exertional angina (class I) and secondary unstable angina (class A).Single vessel disease mostly occurs in patients who have normal electrocardiogram patients with unstable angina who have more extensive disease usually have S.T.T changes.