| Coronary angioscopic findings in the infarct-related vessel within 1 month of acute myocardial infarction: natural history and the effect of thrombolysis. | |
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MedLine Citation:
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PMID: 9443428 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Limited angioscopic information is available on the natural history of infarct-related plaque after myocardial infarction (MI), in particular the effect of thrombolysis. METHODS AND RESULTS: We studied with angioscopy the morphological characteristics of the infarct-related lesion in 56 patients between 24 hours and 4 weeks after MI. Forty of these patients were initially treated with a thrombolytic agent. Most lesions were complex (complex + ulcerated shape = 54%). The predominant color of the plaque was yellow in 79% of cases; only 6% were uniformly white. Angioscopically visible thrombus was found in 77% of cases. Despite angioscopic evidence of instability, only 7% of the patients had post-MI angina. During the 1-month time window since the occurrence of MI, there was no significant difference in the angioscopic appearance of the plaque except for a slight increase in uniformly white plaques (P=.07). The use of a thrombolytic agent at the onset of MI was associated with a reduction in thrombus size and less protruding thrombi (P=.02) but not with a decreased frequency of plaque containing thrombi. Furthermore, a trend for more frequently ulcerated plaques (45% versus 16%, P=.06) was associated with the use of a thrombolytic agent. CONCLUSIONS: These results suggest that healing of the infarct-related lesion requires more than 1 month and that an "unstable" yellow plaque with adherent thrombus is common during that period. This finding may partly explain the unique behavior of recent infarct-related lesions, which are more prone to occlude than other lesions. |
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Authors:
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E Van Belle; J M Lablanche; C Bauters; N Renaud; E P McFadden; M E Bertrand |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Circulation Volume: 97 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1998 Jan 6-13 |
Date Detail:
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Created Date: 1998-02-17 Completed Date: 1998-02-17 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 26-33 Citation Subset: AIM; IM |
Affiliation:
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Service de Cardiologie B et Hémodynamique, Hôpital Cardiologique, Lille, France. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Angioscopy Coronary Angiography Coronary Thrombosis / drug therapy, pathology Coronary Vessels / pathology* Female Humans Male Middle Aged Myocardial Infarction / drug therapy*, pathology* Thrombolytic Therapy* Time Factors |
| Comments/Corrections | |
Comment In:
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Circulation. 1998 Jan 6-13;97(1):10-1
[PMID:
9443423
]
Circulation. 1999 Mar 30;99(12):1647-8 [PMID: 10096991 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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