Coronary artery stenting in unstable angina pectoris: a comparison with stable angina pectoris

Objective-To compare early complication rates in unselected cases of corona ry artery stenting in patients with stable v unstable angina. Setting-Tertiary referral centre. Patients-390 patients with stable angina pectoris (SAP) and 306 with unstab le angina (UAP). Patients treated for acute myocardial infarction (primary angioplasty) or cardiogenic shock were excluded. Interventions-268 coronary stents were attempted in 211 patients (30.3%). S tents used included AVE (63%), Freedom (14%), NIR (7%), Palmaz-Schatz (5%), JO (5%), and Multilink (4%). Intravascular ultrasound was not used in any of the cases. All stented patients were treated with ticlopidine and aspiri n together with periprocedural unfractionated heparin. Results-123 stents were successfully deployed in 99 SAP patients v 132 sten ts in 103 UAP patients. Failed deployment occurred with nine stents in SAP patients, v four in UAP patients (NS). Stent thrombosis occurred in four SA P patients and 11 UAP patients. Multivariate analysis showed no relation be tween stent thrombosis and clinical presentation (SAP v UAP), age, sex, tar get vessel, stent length, or make of stent. Stent thrombosis was associated with small vessel size (p < 0.001) and bailout stenting (p = 0.01) compare d with elective stenting and stenting for suboptimal PTCA, with strong tren ds toward smaller stent diameter (p = 0.052) and number of stents deployed (p = 0.06). Most stent thromboses occurred in vessels < 3 mm diameter. Conclusions-Coronary artery stenting in unstable angina is safe in vessels greater than or equal to 3 mm diameter, with comparable initial success and stent thrombosis rates to stenting in stable angina.