[Which medical treatment can minimize late complications after pharmacologic treatment of unstable angina?].

UNLABELLED: Current pharmacological treatment of unstable coronary diseases has significantly reduced the rate of early and late complications. Aim of this study was to investigate the impact of in-hospital and ambulatory treatment on the occurrence of late complications in patients with unstable angina treated conservatively. The study group consisted of consecutive 79 patients hospitalized in our Department on the turn of years 1998-1999 (48 men--age 62 +/- 11 years), followed up by at least 1 year. We analyzed the administered agents on the first day of hospitalization: acetylsalicylic acid, heparin, nitroglycerin, beta-adrenergic agents, calcium channels blockers, statins and ACE inhibitors, as well these drugs prescribed for ambulatory management. At least one complication (recurrent hospitalization due to coronary artery disease, unstable angina pectoris, myocardial infarction, need for revascularization or death) occurred in 57 patients (72%) in a follow-up of 16 +/- 3 months. The following drugs significantly reduced rate of late complications (OR--odds ratio, CI--confidence interval, p--significance level):--intravenous heparin during hospitalization: OR = 0.22; CI = 0.12-0.42; p = 0.007;--acetylsalicylic acid administration during hospitalization: OR = 0.42; CI = 0.22-0.77; p = 0.03;--acetylsalicylic acid prescribed for ambulatory treatment: OR = 0.24; CI = 0.13-0.46; p = 0.05.

CONCLUSIONS

Heparin and acetylsalicylic acid treatment seems to reduce the number of late complications in patients treated conservatively for the episode of unstable angina.