[Myocardial infarct before 45 years of age: significance of the coronarographic study in asymptomatic patients].
The aim of our study was to evaluate the significance of coronary arteriography in young asymptomatic patients after myocardial infarction. Among a total of 586 consecutive patients who underwent left ventriculography and coronary angiography because of coronary heart disease during the period from January 1984 to June 1986, we selected 51 patients (8.7%) under 45 years of age (range 28-45 years) and without angina, dyspnea or electrocardiographic signs of myocardial ischemia during bicycle ergometric stress test. These patients, 50 males (98.0%) and 1 female (2.0%) were angiographically evaluated from 1 to 12 months after a first myocardial infarction. Coronary occlusions greater than or equal to 70% were found in 44 patients (86.3%): 36 of them (70.6%) had single-vessel disease, 6 (11.8%) double-vessel disease and only 2 (3.9%) triple-vessel disease; no coronary obstructions greater than or equal to 50% of the left main coronary artery were found. Among the 7 patients without critical stenoses (13.7%) 3 had "normal" coronary arteries, 3 noncritical stenoses and one presented an anomalous origin of the left circumflex artery from the right sinus of Valsalva. Only 1 patient underwent surgery. In conclusion, in young asymptomatic patients after a myocardial infarction coronary arteriography may identify a small group either without or with minor atherosclerotic involvement of the coronary tree, while the presence of a localized disease is confirmed in most patients. Therefore, in this selected subgroup, coronary angiography has a limited usefulness in defining high-risk patients possibly requiring surgical treatment.
Di Mario
C
C
Divisione di Cardiologia del Presidio Ospedaliero, U.L.S.S. n. 19, Cittadella.
Zanchetta
M
M
Carlon
R
R
Al Bunni
M
M
Allegri
P
P
Maiolino
P
P
D000328:Adult; D000367:Age Factors; D017023:Coronary Angiography; D005260:Female; D006334:Heart Function Tests; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005082:Physical Exertion; D011379:Prognosis; D012907:Smoking / Q000009:adverse effects
Infarto miocardico sotto i 45 anni: significato dello studio coronarografico in pazienti asintomatici.