Can coronary angiography predict the site of a subsequent myocardial infarction in patients with mild-to-moderate coronary artery disease?

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 infarct...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 1988-11, Vol.78 (5), p.1157-1166
Main Authors: LITTLE, W. C, CONSTANTINESCU, M, APPLEGATE, R. J, KUTCHER, M. A, BURROWS, M. T, KAHL, F. R, SANTAMORE, W. P
Format: Article
Language:English
Subjects:
Adult
Aged
Biological and medical sciences
Cardiology. Vascular system
Coronary Disease - complications
Coronary Disease - diagnostic imaging
Coronary Disease - pathology
Coronary heart disease
Heart
Humans
Male
Medical sciences
Middle Aged
Myocardial Infarction - diagnostic imaging
Myocardial Infarction - etiology
Predictive Value of Tests
Radiography
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Summary: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.
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.78.5.1157