Optimal timing of coronary stenting in unstable angina patients.

OBJECTIVE To assess the efficacy and safety of intracoronary stenting in the acute phase of unstable angina pectoris (UAP). METHODS Fifty-five patients with UAP were randomized to early (Group I, n = 29) and delayed interventional treatment (Group II, n = 26). Coronary angiography and stenting were performed within 48 hours in Group I and 7-10 days later in Group II. Procedural success rate, time interval from admission to angina relief and duration of hospitalization were recorded. Cardiac events within 30 days were observed as well. RESULTS Clinical characteristics and angiographic features were similar between the two groups. There was no significant difference in the procedural success rate (93% versus 96%), but the cardiac event rate within 30 days was significantly lower in Group I than in Group II (0% versus 9.2%, P < 0.05). The time interval from admission to angina relief (4.4 +/- 3.1 days versus 5.7 +/- 2.9 days) and the duration of hospitalization (8.8 +/- 3.2 days versus 13.5 +/- 3.1 days) were significantly reduced in Group I (both P < 0.05). CONCLUSIONS Intracoronary stent implantation is effective and safe in the acute phase of UAP. Early percutaneous coronary intervention results in rapid improvement in symptomatology and a shorter hospitalization. Its long-term effect has to be confirmed in a future randomized study.