Y Hanada1, Y Koiwaya, K Tanaka. 1. First Department of Internal Medicine, Miyazaki Medical College, Japan.
Abstract
PURPOSE: We undertook the present study to determine first whether coronary angiographic (CAG) features, suggestive of ruptured atherosclerotic plaque, develop in infarct-related arteries of patients receiving conventional medical therapy without thrombolytic agents, and if they develop, what the incidence is, and second whether the sites where the CAG features develop are specific to infarct-related lesions. METHODS: We reviewed the CAG findings of 127 consecutive patients one month after myocardial infarction (MI), including 72 consecutive patients who received medical therapy (Group I) and 55 patients who underwent intracoronary urokinase infusion (Group II). RESULTS: Angiographic evidence of ruptured plaque was present in 24/44 (54.5%) patent infarct-related arteries in Group I and in 27/43 (62.8%) in Group II. Similar findings were only noted in 2/52 (3.8%) patent non-infarct-related arteries with significant stenosis in Group I, and in 0/45 (0.0%) in Group II. CONCLUSION: On angiography, ruptured plaque was commonly found in patent infarct-related arteries in both groups, and was highly specific for the site of infarction. Thrombolytic therapy seemed to have no apparent effect on lesion morphology 1 month after MI.
PURPOSE: We undertook the present study to determine first whether coronary angiographic (CAG) features, suggestive of ruptured atherosclerotic plaque, develop in infarct-related arteries of patients receiving conventional medical therapy without thrombolytic agents, and if they develop, what the incidence is, and second whether the sites where the CAG features develop are specific to infarct-related lesions. METHODS: We reviewed the CAG findings of 127 consecutive patients one month after myocardial infarction (MI), including 72 consecutive patients who received medical therapy (Group I) and 55 patients who underwent intracoronary urokinase infusion (Group II). RESULTS: Angiographic evidence of ruptured plaque was present in 24/44 (54.5%) patent infarct-related arteries in Group I and in 27/43 (62.8%) in Group II. Similar findings were only noted in 2/52 (3.8%) patent non-infarct-related arteries with significant stenosis in Group I, and in 0/45 (0.0%) in Group II. CONCLUSION: On angiography, ruptured plaque was commonly found in patent infarct-related arteries in both groups, and was highly specific for the site of infarction. Thrombolytic therapy seemed to have no apparent effect on lesion morphology 1 month after MI.
Authors: W C Little; M Constantinescu; R J Applegate; M A Kutcher; M T Burrows; F R Kahl; W P Santamore Journal: Circulation Date: 1988-11 Impact factor: 29.690