Introduction and purpose. The prognosis of patients with unstable angina ha
s improved in recent years resulting in a progressive reduction in hospital
stay and treatment. The aim of this study was to know the current prognosi
s of patients with unstable angina in a non-selected population followed fo
r up to 3 months.
Patients and methods. 478 consecutive patients with unstable angina were st
udied. They were treated following a strict protocol and a management polic
y guided by symptoms and the results of an exercise test or a pharmacologic
al stress test performed before hospital discharge.
Results. The mean age was 66 +/- 11 years with 30% being females. Thirty-fi
ve percent had a prior history of myocardial infarction, 61% presented isch
emic changes on the admission EGG, and 16% had elevation of the CKMB plasma
levels. An echocardiogram was performed in 80% of the patients, a stress t
est in 62%, coronary angiography in 51%, and a revascularization procedure
in 27% of the patients. During hospitalization, the incidence of mortality
or myocardial infarction, refractory angina or ischemic complications was o
f 3.6%, 11% and 13%, respectively. After hospital discharge and during a 3-
month follow-up, the incidence of these complications was of 3.3%, 9% and 1
0% (NS compared to the in-hospital period). Overall, from the time of hospi
tal admission to the 3-month follow-up, 4.2% of the patients died, 7% died
or had an infarction, 20% had refractory angina, and 26% had some ischemic
complication.
Conclusion. The in-hospital prognosis of unstable angina is currently good,
However, patients discharged from hospital after stabilization, present an
important number of ischemic complications during the following 3 months,
similar to that presented by all patients during the acute phase.