© 2003 by BMJ Publishing Group & British Cardiac Society
EDITORIAL
The elusive link between stenosis severity and prognosis in stable ischaemic heart disease
Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Roma, Italy
Correspondence to:
Correspondence to:
Professor Filippo Crea, Istituto di Cardiologia, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 8, 00168 – Roma, Italy;
f.crea@tiscali.it
When assessing patients with stable ischaemic heart disease, cardiologists should not just take into account the number of critical stenoses detected at angiography, but should also consider patient symptoms, left ventricular function, the extent of myocardium at risk of ischaemia, and the extent of coronary atherosclerosis
Keywords: coronary stenosis; inflammation; myocardial infarction; stable angina; unstable angina
| The first 150 words of the full text of this article appear below. |
It is well recognised that the number of coronary artery branches with a "critical stenosis" at angiography is a predictor of future cardiac events.1 Accordingly, the major scope of invasive cardiology is the identification and subsequent treatment of critical stenoses.
Yet a large body of evidence challenges the notion that critical stenoses are the most frequent site of future subtotal or total occlusions resulting in acute coronary syndromes. Indeed, serial angiographic studies have consistently shown that in about 85% of patients, coronary occlusion resulting in acute myocardial infarction occurs at the site of non-critical stenoses.2 Furthermore, severe stenoses often remain unchanged over time, whereas new critical obstructions may develop, even after a short follow up, in segments which had previously been found normal or near normal at angiography.3,4 Accordingly, cross-sectional angiographic studies have shown that patients who present with stable angina as the first manifestation of ischaemic heart disease (IHD),
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This article has been cited by other articles:
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Crea, F., Camici, P. G., De Caterina, R., Lanza, G. A.
(2009). CHAPTER 17 Chronic Ischaemic Heart Disease. ESC Textbook of Cardiovascular Medicine
2: med-9780199566990-chapter-med-9780199566990-chapter
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