Angiographic characteristics of infarct-related and non-infarct-related stenoses in patients in whom stable angina progressed to acute myocardial infarction☆,☆☆,★
Section snippets
Patients
We examined the preinfarction and postinfarction angiograms of 24 consecutive patients (19 men and 5 women, aged 36 to 74 years, Table I) admitted with acute myocardial infarction who had previously undergone coronary angiography for a history of stable angina. The previous arteriograms had been obtained a mean of 26 ± 4 months before the onset of myocardial infarction. Coronary arteriography was repeated 2.2 ± 0.5 weeks after acute myocardial infarction as part of the patient’s clinical
Results
Before myocardial infarction, 13 (54%) patients had a family history of coronary artery disease, 16 (67%) were smokers, 10 (42%) had hypercholesterolemia, and 6 (25%) had hypertension (Table I).
Discussion
Our study shows that the development of myocardial infarction cannot be predicted from the severity of preexisting stenosis, but it is related to the morphology and indicates that an irregular eccentric morphology is significantly more common in infarct-related than in non-infarct-related stenoses. Nonsevere stenoses more frequently progress to Q-wave than to non-Q-wave myocardial infarction.
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From the Cardiovascular Unit, Royal Postgraduate Medical School, Hammersmith Hospital, the Department of Cardiology, St. Bartholomew’s Hospital, and Istituto di Cardiologie Faculta di Medicina e Chirurgia “Agosfino Gemelli,”Universita Cattolica del Sacro Cuore.
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Reprint requests: Graham J. Davies, Division of Clinical Cardiology, Hammersmith Hospital, Ducane Rd., London W12 ONN, United Kingdom.
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