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Scientific letters
Positive correlation between coronary arterial remodelling and prodromal angina in acute myocardial infarction
  1. Y Shimada1,
  2. M Yoshiyama2,
  3. Y Kobayashi2,
  4. H Tanaka1,
  5. S Jissho1,
  6. H Iida1,
  7. Y Nakamura2,
  8. S Ehara2,
  9. K Shimada2,
  10. K Takeuchi2,
  11. J Yoshikawa2
  1. 1Cardiology Department, Tsukazaki Memorial Hospital, Hyogo, Japan
  2. 2Department of Internal Medicine and Cardiology, Postgraduate School of Medicine, Osaka City University, Osaka, Japan
  1. Correspondence to:
    M Yoshiyama MD
    Department of Internal Medicine and Cardiology, Postgraduate School of Medicine, Osaka City University, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan; yoshiyamamed.osaka-cu.ac.jp

https://doi.org/10.1136/hrt.2003.015354

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    Recently, the relation between coronary arterial remodelling and ischaemic coronary disease has become a focus of investigation.1 Positive coronary arterial remodelling has been shown to be more frequent in acute coronary syndromes, including acute myocardial infarction (AMI), whereas negative remodelling has been shown to be more frequent in stable angina.2 However, in the case of AMI, preceding clinical presentations of the onset vary among patients and it is well known that patients often undergo episodes of unstable or stable angina.3 Furthermore, no studies have correlated remodelling and the presence of prodromal symptoms. In this study intravascular ultrasound (IVUS) was performed before coronary intervention to evaluate the possible correlation between the arterial remodelling at the culprit lesion site of AMI and the prodromal symptoms.

    METHODS

    Ninety four consecutive patients presenting with their first AMI were considered for entry into this study. AMI was diagnosed on the basis of coronary angiography, ECG, prolonged chest pain (> 30 minutes), and subsequent elevation of creatine kinase. Twenty two of these patients were excluded because of either an inability to make the IVUS catheter pass across the lesion before angioplasty (n  =  5), no proximal reference site defined due to a large side branch (n  =  4), or poor ultrasound image quality (n  =  13). Finally, 72 patients (60 men, …

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