[The prognostic significance of bicycle ergometry data in patients with unstable angina]. / Prognosticheskoe znachenie dannykh veloérgometrii u bol'nykh s nestabil'noi stenokardiei.

A total of 179 patients with unstable angina were studied. There were no complications after bicycle ergonomic tests performed after the patient's condition improvement. An analysis of bicycle ergonometric data and long-term outcomes in 169 patients revealed that the outcome was significantly worse in case of positive test (p = 0.007). The validity of this assessment was confirmed over 49 months. The criterion of test cessation was the most predictor in the assessment of a long-term outcome. In pain development accompanied by ECG changes, only 20% of patients had an uncomplicated course 48 months later. Deaths were more frequently observed in the late period if there was 2 mm or more ST segment depression on exercise testing (p = 0.001).

[Comparison of the data of 24-hour ECG monitoring and the condition of the coronary bed in patients with the variants of the course of unstable stenocardia]. / Sopostavlenie dannykh sutochnogo monitorirovaniia EKG i sostoianiia koronarnogo rusla u bol'nykh s razlichnymi variantami techeniia nestabil'noi stenokardii.

A total of 232 patients with various clinical types of unstable angina pectoris were examined. All the patients underwent coronary angiographic studies, 24-hour ECG monitoring. In 40.5% of the patients, 24-hour monitoring revealed transient ST segment changes which were not accompanied by pain in 47% of the cases. ST segment changes were equally encountered in patients with one-, two-, and three-vessel disease in the presence or absence of pain. Ischemic ST segment changes generally occurred with an anginal episode in patients with crescendo unstable angina, whereas in those with more prolonged and intensified pain and angina at rest in particular, silent myocardial ischemic episodes were significantly more frequently recorded, which were more common in these patients with multivessel disease.

[Bicycle ergometry in patients with unstable stenocardia: its performance potentials and diagnostic and prognostic significance]. / Veloérgometriia u bol'nykh nestabil'noi stenokardiei: vozmozhnosti provedeniia, diagnosticheskaia i prognosticheskaia znachimost'.

As many as 175 patients with unstable angina pectoris were examined. After the patients' status was stabilized by drug therapy on days 3-31 (after 12.5 days on the average) bicycle ergometry was performed in accordance with a standard technique. In all the cases, the exercise test produced no complications. 134 patients underwent coronary angiography to define the long-term outcome. The patients with ECG changes seen during the test and those with angina pectoris attacks alone without any changes on the ECG manifested multiple vascular lesions significantly more often than those with negative exercise results. If there were changes in the ST segment during exercise, the complications (myocardial infarction, coronary death, unstable angina pectoris relapses) common to the long-term period which lasted 25.7 months on the average were recorded significantly more often (p less than 0.01) as compared to the patients with negative exercise results.

[Prognostic significance of various qualitative and quantitative indicators of coronary angiography in patients with unstable stenocardia]. / Prognosticheskoe znachenie nekotorykh kachestvennykh i kolichestvennykh pokazatelei koronarnoi angiografii u bol'nykh s nestabil'noi stenokardiei.

The coronary bed was qualitatively and quantitatively examined in 41 patients with unstable angina pectoris. The patients were divided into two groups: (1) those with uncomplicated angina and (2) those with complicated angina in relation of follow-up (mean 3.1 +/- 0.8 years) findings. In patients with a poor coronary heart disease outcome a symptom-related lesion was more frequently located mainly in the left coronary trunk during clinical manifestations of unstable angina pectoris, along with more severe overall lesion in the coronary bed. They had also higher incidence rates of complicated lesions and higher values of three quantitative parameters (stenosis extent, the mean and proper diameters of a stenotic segment in the symptom-related vessel) determined by semiautomatic stenosis configuration analysis.

[Unstable stenocardia: prognostic significance of painless forms of myocardial ischemia during hospitalization and in the remote period]. / Nestabil'naia stenokardiia: prognosticheskoe znachenie bezbolevykh form ishemii miokarda vo vremia gospitalizatsii i v otdalennom periode.

Variants of unstable angina pectoris were compared upon examination of 366 relevant patients. 24-h ECG monitoring registered painless ST shifts in 75 of them. Treatment at hospital produced results independent of ischemia form (painful or painless). However, the analysis of long-term response for 10 patients demonstrating episodes of ischemia at discharge suggests that in spite of numerous adjustments of treatment in 70% of the patients the risk of unfavorable outcome seems great.

[Immediate and late prognosis in patients with unstable angina under medical treatment]. / Blizhaishii i otdalennyi prognoz u bol'nykh s nestabil'noi stenokardiei pri medikamentoznom lechenii.

The study was undertaken to examine 221 patients with unstable angina (UA) in the acute period and repeatedly on average of 5.3 years later. Myocardial infarction and sudden coronary death were regarded as unfavorable outcomes of UA. Out of all the patients included into the study, 33 (15%) developed myocardial infarction on days 2-28 of hospital stay, which resulted in death in 7 patients; 6 more patients died suddenly. The hospital mortality rate was 5.8%. Of 175 patients discharged from the unit, 31 developed myocardial infarction in the late period, 1 case ended with a fatal outcome, sudden coronary death was observed in 32 cases. The mortality rates by years were the following: 10.2% within the first year, 17.4% for 3 years, and 28.2% for 5 years. The choice of a complex of initial signs mostly significant for defining the risk for complications with the use of Cox's model of proportional risks indicated that the outcome of UA was affected by the following significant factors: 1) ST segment depression in the leads V4-V6; 2) duration of aggravated condition; 3) duration of coronary heart disease; 4) the number of resting anginal episodes; 5) a patient's fitness on his admission to hospital; 6) a history of arterial hypertension; 7) negative T waves in the leads V4-V5.

[Results of repeated coronary angiography in patients with unstable angina pectoris in a long-term follow-up]. / Rezul'taty povtornoi koronarnoi angiografii u bol'nykh s nestabil'noi stenokardiei pri dlitel'noi nabliudenii.

A total of 27 patients with unstable angina pectoris were examined in the acute period of the disease and 3.4 years later (from 30 to 51 months). A group of patients with a favorable outcome of unstable angina comprised 13 patients who had displayed no recurrences of disease exacerbation, but that of patients with an unfavorable outcome of unstable angina consisted of 14 patients who had had recurrences of symptoms of progressive angina until myocardial infarction (in 6 patients). Coronary angiography made during the first hospitalization showed that 40% of the patients exhibited a "complicated lesion" of the symptom-related artery, which further transformed to an uncomplicated one (Type I stenosis according to the classification by J. Ambrose et al.), the remaining developed coronary occlusion. Comparison of the specific features of a course of the disease and coronary angiographic findings revealed no relationship between the degree of symptom-related artery stenosis and the long-term outcome of unstable angina.