Angiographic coronary morphology in postinfarction angina

Ying‐Sui A. Lo*, Pierre Abi‐Mansour, Kerry J. Kaplan, Barry L. Kramer, Irene R. Hill, Sheridan Meyers, Michael Lesch

*Corresponding author for this work

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

To investigate the pathophysiologic relevance of angiographically irregular coronary stenoses in postinfarction angina (PIA), we analyzed the clinical course and coronary angiograms of 73 patients studied within 30 days of infarction. Coronary lesions were classified as smooth or irregular. Thirty‐six patients had PIA (Group 1) and 37 had an uncomplicated course (Group 2). Irregular lesion(s) in patent infarct‐related arteries were found in 77% of Group 1 vs. 24% of Group 2 patients (P < 0.005). Irregular lesion(s) in any coronary artery were found in 58% of Group 1 versus 19% of Group 2 patients (P < 0.002). Other univariate predictors of PIA included older age, hypertension, angina before myocardial infarct, lower peak creatine kinase, three‐vessel disease, and higher modified Gensini score. Multivariate analysis ranked lesion irregularity as the strongest predictor of PIA. Our data suggests that ruptured atherosclerotic plaques may be important in the pathogenesis of PIA. It is possible that lesion irregularity is associated with an active process and/or a residual thrombus, which may be responsible for postinfarction angina.

Original languageEnglish (US)
Pages (from-to)155-163
Number of pages9
JournalCatheterization and cardiovascular diagnosis
Volume16
Issue number3
DOIs
StatePublished - Mar 1989

Keywords

  • angina
  • coronary angiography
  • myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Lo, YS. A., Abi‐Mansour, P., Kaplan, K. J., Kramer, B. L., Hill, I. R., Meyers, S., & Lesch, M. (1989). Angiographic coronary morphology in postinfarction angina. Catheterization and cardiovascular diagnosis, 16(3), 155-163. https://doi.org/10.1002/ccd.1810160304