Document Detail

Coronary angioscopic findings in the infarct-related vessel within 1 month of acute myocardial infarction: natural history and the effect of thrombolysis.
MedLine Citation:
PMID:  9443428     Owner:  NLM     Status:  MEDLINE    
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.
E Van Belle; J M Lablanche; C Bauters; N Renaud; E P McFadden; M E Bertrand
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation     Volume:  97     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:    1998 Jan 6-13
Date Detail:
Created Date:  1998-02-17     Completed Date:  1998-02-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  26-33     Citation Subset:  AIM; IM    
Service de Cardiologie B et Hémodynamique, Hôpital Cardiologique, Lille, France.
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MeSH Terms
Coronary Angiography
Coronary Thrombosis / drug therapy,  pathology
Coronary Vessels / pathology*
Middle Aged
Myocardial Infarction / drug therapy*,  pathology*
Thrombolytic Therapy*
Time Factors
Comment In:
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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