PREDICTORS OF MULTIVESSEL DISEASE IN CASES OF ACUTE CHEST PAIN

Background: Patients with unstable angina not showing ischemia at the exercise treadmill test after medical stabilization usually have a low -risk coronary anatomy. However, some of them have multivessel disease , and it is not known what characteristics are associated with the ext ension of the coronary artery disease in this subset of patients. Obje ctive: To determine clinical and exertional characteristics associated with multivessel disease in patients with unstable angina and a negat ive exercise test. Methods: 312 hospitalised patients with unstable an gina and a negative exercise test who had undergone cardiac catheteriz ation were reviewed. The relationship between coronariographic finding s (presence of multivessel disease) and clinical characteristics, exer cise parameters and left ventricular function was studied. Results: Mu ltivessel disease was present in 97 patients (31%). The following vari ables were associated with the presence of multivessel disease: age mo re than 65 years old, previous myocardial infarction, previous admissi ons because of unstable angina, peripheral artery disease, presence of mon than two coronary risk factors, left ventricular dysfunction, fun ctional capacity less than 6 METS, duration of exercise less than 8 mi n and less than 85% of the maximum heart rate. Multivariate analysis s howed, as independent predictors of multivessel disease: previous myoc ardial infarction, previous admissions because of unstable angina, pre sence of more than two coronary risk factors and peripheral artery dis ease. Conclusions: In patients with medically stabilized unstable angi na and a negative exercise test, previous myocardial infarction, previ ous admissions because of unstable angina, presence of more than two c oronary risk factors and peripheral artery disease, but not exercise p arameters, are independent predictors of multivessel disease. (C) 1998 Elsevier Science Ireland Ltd.