Document Detail


A detailed angiographic analysis of patients with ambulatory electrocardiographic ischemia: results from the Asymptomatic Cardiac Ischemia Pilot (ACIP) study angiographic core laboratory.
MedLine Citation:
PMID:  8996298     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this Asymptomatic Cardiac Ischemia Pilot (ACIP) data bank study was to characterize angiographic features of coronary pathology of patients enrolled in the ACIP study. BACKGROUND: Ischemia during ambulatory electrocardiographic (AECG) monitoring is associated with increased morbidity and mortality. Reports relating AECG ischemia to severity or complexity of coronary artery disease are few in number and small in size and have produced conflicting results. METHODS: Coronary angiograms from patients with asymptomatic AECG ischemia enrolled in the ACIP study were reviewed at a central core laboratory. Quantitative measurement of percent stenosis and Thrombolysis in Myocardial Infarction flow grades were used to assess the severity of coronary artery disease. Lesions were also evaluated for the presence of intracoronary thrombus, ulceration and lumen contour as indicators of stenosis complexity. In addition, comparisons were made with 27 patients screened for the ACIP study, but who were found ineligible because they did not have AECG ischemia on 48-h Holter monitoring. RESULTS: A total of 329 (75%) of 439 patients with AECG ischemia had multivessel coronary artery disease. Proximal stenoses > or = 50% diameter reduction were common in patients with AECG ischemia (62.2%), as were proximal stenoses > or = 70% (38.7%). Features suggesting complex plaque were found in 50.1% of patients with AECG ischemia. CONCLUSIONS: Multivessel coronary artery disease, severe proximal stenoses and features of complex plaque were observed frequently in patients who exhibited AECG ischemia. The presence of severe and complex coronary artery disease may explain, in part, the increased risk for adverse outcome associated with ischemia during activities of daily life.
Authors:
B L Sharaf; D O Williams; N J Miele; R P McMahon; P H Stone; P Bjerregaard; R Davies; A D Goldberg; M Parks; C J Pepine; G Sopko; C R Conti
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  29     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1997 Jan 
Date Detail:
Created Date:  1997-02-11     Completed Date:  1997-02-11     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  78-84     Citation Subset:  AIM; IM    
Affiliation:
Maryland Medical Research Institute, Baltimore 21210, USA.
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MeSH Terms
Descriptor/Qualifier:
Coronary Angiography*
Coronary Disease / diagnosis,  epidemiology,  radiography
Electrocardiography, Ambulatory
Female
Humans
Logistic Models
Male
Middle Aged
Myocardial Ischemia / diagnosis,  epidemiology,  radiography*
Risk Factors
Severity of Illness Index
Grant Support
ID/Acronym/Agency:
HV-90-07/HV/NHLBI NIH HHS; HV-90-08/HV/NHLBI NIH HHS; HV-91-05/HV/NHLBI NIH HHS

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