Copyright © 1988 by the European Society of Cardiology.
© 1988 The European Society of Cardiology
Pre-existing coronary stenoses in patients with first myocardial infarction are not necessarily severe
The Cardiovascular Research Unit, Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital Du Cane Road, London W120HS, U.K.
Received 27 January 1988; revised 4 July 1988; .
Abstract
The sudden, often unheralded, onset of symptoms in acute myocardial infarction suggests that pre-existing coronary stenoses susceptible to acute thrombosis in the infarct-related may not necessarily have been severe. We investigated the severity of residual coronary stenoses after successful thrombolytic recanalization and the relationship to previous symptoms, collateral vessels and the extent of coronary artery disease in 60 consecutive patients at the time of presentation of their first acute myocardial infarction by performing quantitative coronary arteriography before, during and after intracoronary thrombolytic therapy. Recanaliazation was achieved in 48 (80%) patients with a residual stenosis of 58.1±10.8% (mean±ISD; range 33–82%) obstruction diameter and a minimum lumen calibre of 1.10±0.3 mm (range 0.39–1.95 mm). A residual stenosis of less than 60% obstruction diameter was present in 28 (47%) patients. When residual stenoses were muld, no acute collateral filling of the occluded artery was observed.
After thrombolysis, residual infarct-related coronary stenoses in patients with their first acute myocardial infarction are not necessarily severly obstructive. This raises the problem of identifying which non-obstructive coronary stenoses are likely to occlude suddenly and why they do so.
Key Words: Acute myocardial infraction, • coronary stenoses, • thrombosis, • thrombolysis, • nitrates.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  J. L. Kelly, D. Thickman, S. D. Abramson, P. R. Chen, S. F. Smazal, M. J. Fleishman, and S. C. Lingam Coronary CT Angiography Findings in Patients Without Coronary Calcification Am. J. Roentgenol., July 1, 2008; 191(1): 50 - 55. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. R. S. Packard and P. Libby Inflammation in Atherosclerosis: From Vascular Biology to Biomarker Discovery and Risk Prediction Clin. Chem., January 1, 2008; 54(1): 24 - 38. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Valgimigli, G. A. Rodriguez-Granillo, H. M. Garcia-Garcia, P. Malagutti, E. Regar, P. de Jaegere, P. de Feyter, and P. W. Serruys Distance from the ostium as an independent determinant of coronary plaque composition in vivo: an intravascular ultrasound study based radiofrequency data analysis in humans Eur. Heart J., March 2, 2006; 27(6): 655 - 663. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Sano, M. Kawasaki, Y. Ishihara, M. Okubo, K. Tsuchiya, K. Nishigaki, X. Zhou, S. Minatoguchi, H. Fujita, and H. Fujiwara Assessment of Vulnerable Plaques Causing Acute Coronary Syndrome Using Integrated Backscatter Intravascular Ultrasound J. Am. Coll. Cardiol., February 21, 2006; 47(4): 734 - 741. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Libby Inflammation and cardiovascular disease mechanisms Am. J. Clinical Nutrition, February 1, 2006; 83(2): 456S - 460S. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. K. Hansson Inflammation, Atherosclerosis, and Coronary Artery Disease N. Engl. J. Med., April 21, 2005; 352(16): 1685 - 1695. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Madjid, A. Zarrabi, S. Litovsky, J. T. Willerson, and W. Casscells Finding Vulnerable Atherosclerotic Plaques: Is It Worth the Effort? Arterioscler. Thromb. Vasc. Biol., October 1, 2004; 24(10): 1775 - 1782. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R Bigi, L Cortigiani, P Colombo, A Desideri, J J Bax, and O Parodi Prognostic and clinical correlates of angiographically diffuse non-obstructive coronary lesions Heart, September 1, 2003; 89(9): 1009 - 1013. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. S. Blumenthal and T. J. Gluckman New insights into the relationship between myocardial perfusion and lipid-lowering J. Am. Coll. Cardiol., August 20, 2003; 42(4): 611 - 613. [Full Text] [PDF]
|
|
|
|
 |
|
 H. Tomoda and N. Aoki Clinical Evaluation of Coronary Lesion Characteristics in Acute Myocardial Infarction Angiology, May 1, 2003; 54(3): 277 - 285. [Abstract] [PDF]
|
|
|
|
|
|
P. K. Shah Mechanisms of plaque vulnerability and rupture J. Am. Coll. Cardiol., February 19, 2003; 41(4_Suppl_S): 15S - 22S. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Gidron, H. Gilutz, R. Berger, and M. Huleihel Molecular and cellular interface between behavior and acute coronary syndromes Cardiovasc Res, October 1, 2002; 56(1): 15 - 21. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Beckman, J. Ganz, M. A. Creager, P. Ganz, and S. Kinlay Relationship of Clinical Presentation and Calcification of Culprit Coronary Artery Stenoses Arterioscler. Thromb. Vasc. Biol., October 1, 2001; 21(10): 1618 - 1622. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E.G. Zouridakis, R. Schwartzman, X. Garcia-Moll, I.D. Cox, S. Fredericks, D.W. Holt, and J.C. Kaski Increased plasma endothelin levels in angina patients with rapid coronary artery disease progression Eur. Heart J., September 1, 2001; 22(17): 1578 - 1584. [Abstract] [PDF]
|
|
|
|
|
|
A Jeremias, C Spies, N A Herity, E Pomerantsev, P G Yock, P J Fitzgerald, and A C Yeung Coronary artery compliance and adaptive vessel remodelling in patients with stable and unstable coronary artery disease Heart, September 1, 2000; 84(3): 314 - 319. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Longobardi, P. Abete, N. Ferrara, A. Papa, R. Rosiello, G. Furgi, C. Calabrese, F. Cacciatore, and F. Rengo "Warm-Up" Phenomenon in Adult and Elderly Patients With Coronary Artery Disease: Further Evidence of the Loss of "Ischemic Preconditioning" in the Aging Heart J. Gerontol. A Biol. Sci. Med. Sci., March 1, 2000; 55(3): 124M - 129. [Abstract] [Full Text]
|
|
|
|
|
|
R A Coulden, H Moss, M J Graves, D J Lomas, D S Appleton, and P L Weissberg High resolution magnetic resonance imaging of atherosclerosis and the response to balloon angioplasty Heart, February 1, 2000; 83(2): 188 - 191. [Abstract] [Full Text]
|
|
|
|
|
|
M. Yamagishi, M. Terashima, K. Awano, M. Kijima, S. Nakatani, S. Daikoku, K. Ito, Y. Yasumura, and K. Miyatake Morphology of vulnerable coronary plaque: insights from follow-up of patients examined by intravascular ultrasound before an acute coronary syndrome J. Am. Coll. Cardiol., January 1, 2000; 35(1): 106 - 111. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Rabbani and E. J. Topol Strategies to achieve coronary arterial plaque stabilization Cardiovasc Res, February 1, 1999; 41(2): 402 - 417. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Ishii, N. Yokoyama, M. Yanagimachi, N. Ashikawa, M. Hata, S. Murakami, Y. Asami, N. Morisaki, Y. Saito, S. Ohmori, et al. Stimulation of Cholesterol Release from Rabbit Foam Cells by the Action of a New Inhibitor for Acyl CoA:Cholesterol Acyltransferase (ACAT), HL-004 J. Pharmacol. Exp. Ther., October 1, 1998; 287(1): 115 - 121. [Abstract] [Full Text]
|
|
|
|
|
|
M. Previtali, R. Fetiveau, L. Lanzarini, C. Cavalotti, and C. Klersy Prognostic value of myocardial viability and ischemia detected by dobutamine stress echocardiography early after acute myocardial infarction treated with thrombolysis J. Am. Coll. Cardiol., August 1, 1998; 32(2): 380 - 386. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. K. Liao Endothelium and acute coronary syndromes Clin. Chem., August 1, 1998; 44(8): 1799 - 1808. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. S. Rosenson and C. C. Tangney Antiatherothrombotic Properties of Statins: Implications for Cardiovascular Event Reduction JAMA, May 27, 1998; 279(20): 1643 - 1650. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Iwai, S. Tamaki, N. Ohmichi, and M. Kinoshita The II Genotype of the Angiotensin-Converting Enzyme Gene Delays the Onset of Acute Coronary Syndromes Arterioscler. Thromb. Vasc. Biol., September 1, 1997; 17(9): 1730 - 1733. [Abstract] [Full Text]
|
|
|
|
 |
|
 M. D. Guazzi, M. Bussotti, L. Grancini, N. De Cesare, M. Guazzi, I. L. Pera, and A. Loaldi Evidence of Multifocal Activity of Coronary Disease in Patients With Acute Myocardial Infarction Circulation, August 19, 1997; 96(4): 1145 - 1151. [Abstract] [Full Text]
|
|
|
|
|
|
J. M. Mann and M. J. Davies Vulnerable Plaque: Relation of Characteristics to Degree of Stenosis in Human Coronary Arteries Circulation, September 1, 1996; 94(5): 928 - 931. [Abstract] [Full Text]
|
|
|
|
|
|
D. A. Kass, A. Saeki, R. S. Tunin, and F. A. Recchia Adverse Influence of Systemic Vascular Stiffening on Cardiac Dysfunction and Adaptation to Acute Coronary Occlusion Circulation, April 15, 1996; 93(8): 1533 - 1541. [Abstract] [Full Text]
|
|
|
|
|
|
R. S. Blumenthal, D. M. Becker, T. F. Moy, J. Coresh, L. B. Wilder, and L. C. Becker Exercise Thallium Tomography Predicts Future Clinically Manifest Coronary Heart Disease in a High-Risk Asymptomatic Population Circulation, March 1, 1996; 93(5): 915 - 923. [Abstract] [Full Text]
|
|
|
|
|
|
J. C. Kaski, M. R. Chester, L. Chen, and D. Katritsis Rapid Angiographic Progression of Coronary Artery Disease in Patients With Angina Pectoris : The Role of Complex Stenosis Morphology Circulation, October 15, 1995; 92(8): 2058 - 2065. [Abstract] [Full Text]
|
|
|
|
|
|
H. C. Stary, A. B. Chandler, R. E. Dinsmore, V. Fuster, S. Glagov, W. Insull Jr, M. E. Rosenfeld, C. J. Schwartz, W. D. Wagner, and R. W. Wissler A Definition of Advanced Types of Atherosclerotic Lesions and a Histological Classification of Atherosclerosis : A Report From the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association Arterioscler. Thromb. Vasc. Biol., September 1, 1995; 15(9): 1512 - 1531. [Abstract] [Full Text]
|
|
|
|
|
|
H. C. Stary, A. B. Chandler, R. E. Dinsmore, V. Fuster, S. Glagov, W. Insull Jr, M. E. Rosenfeld, C. J. Schwartz, W. D. Wagner, and R. W. Wissler A Definition of Advanced Types of Atherosclerotic Lesions and a Histological Classification of Atherosclerosis : A Report From the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association Circulation, September 1, 1995; 92(5): 1355 - 1374. [Abstract] [Full Text]
|
|
|
|
|
|
P. Libby Molecular Bases of the Acute Coronary Syndromes Circulation, June 1, 1995; 91(11): 2844 - 2850. [Full Text]
|
|
|
|
|
|
A. A. Maggioni, A. Maseri, C. Fresco, M. G. Franzosi, F. Mauri, E. Santoro, G. Tognoni, and The Investigators of the Gruppo Italiano por lo St Age-Related Increase in Mortality among Patients with First Myocardial Infarctions Treated with Thrombolysis N. Engl. J. Med., November 11, 1993; 329(20): 1442 - 1448. [Abstract] [Full Text]
|
|