The angiographic characteristics and extent of the coronary lesions in patients with residual ischemia following a myocardial infarct
Morais, J.; Faria, H.; Calisto, J.; Correia, F.; Maldonado, J.; Freitas, M.; Providência, L.
Revista Portuguesa de Cardiologia Orgao Oficial da Sociedade Portuguesa de Cardiologia 12(10): 819
1993
ISSN/ISBN: 0870-2551 PMID: 8286130 Document Number: 419652
The aim of the present study was to analyze the angiographic findings of patients with residual ischemia after acute myocardial infarction (spontaneous angina versus ischemia stress induced), testing the following theoretical hypothesis: those patients with early spontaneous angina after acute myocardial infarction have singular angiographic characteristics that justify their clinical instability. A consecutive group of 60 patients admitted in the Coronary Care Unit with acute myocardial infarction, all of them presenting signs or symptoms of residual ischemia, was divided into two subgroups: A--25 patients with spontaneous angina before discharge; B--35 patients with myocardial ischemia (symptomatic or not) during exercise test performed before discharge. The angiographic studies were analyzed according to following parameters: number of vessels with significant stenosis (more than 70%), involvement of the left anterior descending artery: "TIMI" score, presence of thrombi and morphology of the culprit lesion, presence of collaterals. We did not find any significant differences between the analyzed parameters. The present study does not disclose any significant differences related with coronary anatomy in patients with residual ischemia after acute myocardial infarction when we considered the two most frequent kinds of presentation: spontaneous angina or stress induced ischemia before discharge. Therefore the previous postulated hypothesis had not been confirmed.