Comparative analysis of the X-ray morphology of coronary atherosclerosis and the results of endovascular interventions performed in the subacute period and 6 months after prior myocardial infarction
Savchenko, A.P.; Nudnov, N.V.; Bolotov, P.A.; Rudenko, B.A.
Vestnik Rentgenologii i Radiologii 3: 13-18
2006
ISSN/ISBN: 0042-4676 PMID: 17407959 Document Number: 604849
The study was undertaken to analyze the morphology of coronary lesion and the angiographic results of interventions made in the subacute period and 6 months after prior myocardial infarction. It included 593 patients with and without prior Q-wave myocardial infarction. The X-ray morphological parameters of the coronary bed were analyzed in the patients who had undergone invasive studies within a month (n = 362) and 6 months (n = 231) after sustained myocardial infarction. In both groups, the successful intervention rate was also estimated during endovascular treatment. The study showed that the number of stenoses with the complicated morphology (type B) was significantly more 6 months after sustained myocardial infarction than that in the subacute period. The number of occluded segments with the characteristics that were unfavorable for endovascular intervention (bridge collaterals, extended occlusions) was also significantly more in the late periods. In the subacute period, the angiographic success rate of endovascular recanalizations of chronic occlusions was 83.4%, which was significantly higher than that (62.6%) 6 months following infarction. The findings have led us to the conclusion that it is necessary to make routine coronary angiography in all postinfarction patients during their hospital stay in order to define the potentialities of early revascularization.