CAN CORONARY ANGIOGRAPHY PREDICT THE SITE OF A SUBSEQUENT MYOCARDIAL-INFARCTION IN PATIENTS WITH MILD-TO-MODERATE CORONARY-ARTERY DISEASE
CAN CORONARY ANGIOGRAPHY PREDICT THE SITE OF A SUBSEQUENT MYOCARDIAL-INFARCTION IN PATIENTS WITH MILD-TO-MODERATE CORONARY-ARTERY DISEASE
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DOI：
10.1161/01.cir.78.5.1157
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发表时间：
1988-11-01
期刊：
影响因子：
37.8
通讯作者：
SANTAMORE, WP
中科院分区：
文献类型：
--
作者：
LITTLE, WC;CONSTANTINESCU, M;SANTAMORE, WP
为了帮助确定冠状动脉造影术是否可以预测未来将导致心肌梗死的冠状动脉闭塞的位置，对42名连续接受冠状动脉造影术的患者进行了评估，这些患者在急性心肌梗死发生前和发病后一个月内都接受了冠状动脉造影术。29名患者有新的冠状动脉闭塞。在这29名患者中，有25名患者在最初的血管造影中至少有一条动脉的狭窄程度超过50%。然而，在29名患者中，有19名(66%)在第一次血管造影中，随后闭塞的动脉狭窄程度低于50%，而在29名患者中，有28名(97%)的狭窄程度低于70%。在每个患者中，在随后的冠脉阻塞部位的第一次血管造影中，至少有一些冠脉壁的不规则性。在29例中，只有10例(34%)的梗塞是由于先前包含最严重狭窄的动脉闭塞所致。此外，初次冠状动脉狭窄的严重程度与从首次插管到梗塞的时间无相关性(R2=0.0005，p=NS)。这些数据表明，对冠状动脉狭窄的血管造影严重程度的评估可能不足以准确预测随后将导致心肌梗死的冠状动脉闭塞的时间或位置。
To help determine if coronary angiography can predict the site of a future coronary occlusion that will produce a myocardial infarction, the coronary angiograms of 42 consecutive patients who had undergone coronary angiography both before and up to a month after suffering an acute myocardial infarction were evaluated. Twenty-nine patients had a newly occluded coronary artery. Twenty-five of these 29 patients had at least one artery with a greater than 50% stenosis on the initial angiogram. However, in 19 of 29 (66%) patients, the artery that subsequently occluded had less than a 50% stenosis on the first angiogram, and in 28 of 29 (97%), the stenosis was less than 70%. In every patient, at least some irregularity of the coronary wall was present on the first angiogram at the site of the subsequent coronary obstruction. In only 10 of the 29 (34%) did the infarction occur due to occlusion of the artery that previously contained the most severe stenosis. Furthermore, no correlation existed between the severity of the initial coronary stenosis and the time from the first catheterization until the infarction (r2 = 0.0005, p = NS). These data suggest that assessment of the angiographic severity of coronary stenosis may be inadequate to accurately predict the time or location of a subsequent coronary occlusion that will produce a myocardial infarction.