Document Detail

Angiographic characteristics of infarct-related and non-infarct-related stenoses in patients in whom stable angina progressed to acute myocardial infarction.
MedLine Citation:
PMID:  9736127     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: In patients with coronary artery disease, angiographic and postmortem studies have shown that coronary stenoses in infarct-related arteries often have complex morphology. It is not known whether in patients with multivessel disease stenosis morphology in non-infarct-related arteries is different from those of the infarct-related arteries. METHODS AND RESULTS: In 24 consecutive patients we examined the angiographic characteristics of both the infarct-related stenoses and non-infarct-related stenoses before and after spontaneous acute myocardial infarction, by visual inspection and computerized edge detection of coronary angiograms. Before myocardial infarction, the severity of the infarct-related stenoses was <50% in 14 patients and > or =50% in 10 patients (p=not significant) and of non-infarct-related stenoses was <50% in 16 and > or=50% in 13. A significantly greater proportion of infarct-related stenoses with severity > or =50% progressed to non-Q-wave than to Q-wave myocardial infarction (71% vs 50%, p < 0.05). Before myocardial infarction, the percentage of concentric, eccentric, and irregular infarct-related stenoses was 8%, 13%, and 50%, respectively, whereas in the non-infarct-related stenoses it was 62%, 17%, and 21%, respectively (p < 0.01). A similar proportion of irregular morphology progressed to Q-wave or non-Q-wave myocardial infarction. CONCLUSIONS: In patients with stable angina who had acute myocardial infarction develop, the infarct-related and non-infarct-related stenoses on average are similar in severity but different in morphology. Nonsevere stenoses more frequently progress to Q-wave than to non-Q-wave myocardial infarction.
D Tousoulis; G Davies; T Crake; D C Lefroy; S Rosen; A Maseri
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  136     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1998 Sep 
Date Detail:
Created Date:  1998-09-25     Completed Date:  1998-09-25     Revised Date:  2006-02-27    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  382-8     Citation Subset:  AIM; IM    
Cardiovascular Unit, Royal Postgraduate Medical School, Hammersmith Hospital, London, United Kingdom.
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MeSH Terms
Angina Pectoris / radiography*
Coronary Angiography*
Coronary Disease / radiography
Middle Aged
Myocardial Infarction / radiography*
Predictive Value of Tests
Severity of Illness Index
Comment In:
Am Heart J. 1998 Sep;136(3):368-70   [PMID:  9736124 ]

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