title: Angiographic coronary artery lesion morphology and pathogenetic mechanisms of myocardial ischemia in stable and unstable coronary artery disease syndromes.
abstract: The angiographic morphology of coronary artery stenoses was studied in 160 patients referred for diagnostic coronary arteriography. Three groups of patients were studied: 60 patients with stable angina, 78 patients with unstable angina and 22 patients with a recent myocardial infarction. Complex lesions were more frequently observed in patients with unstable angina (59%, p less than 0.001) and in patients with a recent myocardial infarction (54%, p less than 0.05) then in patients with stable angina (25%). Angiographic signs suggestive for the presence of intravascular thrombi were almost exclusively observed in the patients with unstable angina (34%, p less than 0.001) and in the patients with a recent myocardial infarction (27%, P less than 0.001) and were almost completely absent in the patients with stable angina (1.5%). The high prevalence of complex coronary artery lesion morphology and of intravascular thrombi observed in patients with unstable angina or with a recent myocardial infarction emphasizes the important role of intima disruption and of subsequent thrombosis in the pathogenesis of myocardial ischemia in those unstable syndromes of ischemic heart disease.
authors.affiliation: Department of Cardiology, University Hospital of Antwerp, Edegem, Belgium.
authors.forename: F J
authors.initials: FJ
authors.lastname: Cools
authors.forename: C J
authors.initials: CJ
authors.lastname: Vrints
authors.forename: J P
authors.initials: JP
authors.lastname: Snoeck
mesh_terms: D000787:Angina Pectoris / Q000000981:diagnostic imaging* / Q000473:pathology; D000789:Angina, Unstable / Q000000981:diagnostic imaging* / Q000473:pathology; D003251:Constriction, Pathologic; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D003328:Coronary Thrombosis / Q000150:complications; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies