INTRODUCTION : UA is a clinical syndrome caused by atherosclerotic plaque rupture
and thrombosis within a coronary artery . It is defined as angina that is new onset or
abruptly increased in intensity ,duration or frequency within the past 60 days. It may
present as rest angina,new onset severe angina or increasing angina .Initial evaluation
includes risk stratification based on history ,clinical exam , ECG , cardiac enzymes .
Among patients with UA who undergo angiogram ,85% will have significant CAD.
CABG confers a survival benefit in patients with > 50% LM stenosis or triple vessel
disease with LV dysfunction, Importantly patients with no significant lesions at
angiography benefit from reorientation of their management.Symptomatic patients with
normal coronaries may have significant atherosclerosis by IVUS secondary to coronary
artery remodeling
AIM : 1. Risk stratification based on clinical history & presentation, ECG, Enzymes, 2. To
Correlate the clinical profile with Coronary angiographic profile 3. To identify the high risk
predictors for early intervention
MATERIALS AND METHODS : Study design : Observational and Cross sectional StudyStudy
population:Unstable angina patients admitted for coronary angiogram in cardiology
ward GRH, Madurai. Inclusion Criteria Patients admitted with a history of chest pain
diagnosed as unstable angina and subsequently underwent CAG in cardiology ward.
RESULTS AND CONCLUSION : Unstable angina commonly affects the age group 45-60yrs in
both sexes. 30% of patients in our study was women. Women have normal coronaries
compared to men in patients with unstable angina, (30% vs 20%) which suggests a
different patho physiological mechanism for their symptoms which leads to difficulty in
making a firm diagnosis of UA. Smoking, diabetes, Hyperlipidemia, Hypertension are
major risk factors for unstable angina in this study Braunwald class III angina (Rest
angina) predicted severity of lesion ( left main & triple vessel disease) in our study.
Patients who had High TIMI risk scoring had more severe coronary lesions compared to
low TIMI risk score which helps in risk stratification and early intervention.
Significant ST-T changes in ECG predicted more extensive disease which helps
in decision making regarding treatment strategy (conservative vs invasive) aVR ST
elevation in background of unstable angina predicts left main disease &Triple vessel
disease in our study which helps risk stratification and early intervention. ECHO
evidence of LV dysfunction predicted Triple vessel disease /LM disease. Out of the 100
pts who underwent coronary angiogram in our study 27 pts had Single Vessel disease (
type A lesions predominantly) 24 pts had two Vessel disease .( type B lesions
predominantly) 26% had three vessel disease. (type B lesions predominantly) 14 patients
had Left Main Coronary artery disease. 23 patients had normal or insignificant coronary
artery lesions. 9 patients had thrombus containing lesion who had rest angina, out of
whom 6 patients had SVD and 3 patients had multivessel disease. 3 patients had total
occlusion with TIMI β0β flow
