[The problem of chronic refractory angina pectoris].

Prognosis in the case of refractory angina pectoris is poor in comparison with stable angina. Patients with refractory angina are more likely to have an acute coronary attack as a result of more diffuse coronary artery lesions and a high prevalence of cardiac risk factors. The quality of life of these patients is also poor. 36 patients 35-70 years of age with chronic stable angina were studied (34-males and 2-females). In all patients the stable angina was diagnoses based on the results of coronary angiography, medical record, ECG, echocardiography, stress-test, blood glucose, coagulation and lipid spectrum tests results. All patients were divided into 2 groups. By coronary angiography in 5 cases severe stenosis (80-95%) and occlusion of left main coronary artery was founded. In 10 cases significant stenosis of main coronary artery was not found and the patients were referred for conventional anti-ischemic therapy. 11 patients were treated by revascularization procedures (4 coronary artery bypass grafting and 7 coronary angioplasty). 15 cases ( 41,6%) were considered as refractory angina pectoris as far as they were suffering from ischemic heart disease and symptoms were present despite optimal medical therapy. They had been considered not suitable for any interventional procedure due to several reasons (distal localization of stenosis, diffuse lesions of arteries, etc.).