Angiographic study of the infarct-related coronary artery in the chronic stage of acute myocardial infarction.
We and others have demonstrated a high prevalence of total coronary occlusion during the acute phase of myocardial infarction (MI). This study reports the angiographic appearance of the infarct-related artery (IRA) in 130 patients with a history of MI, who underwent cardiac catheterization 2 weeks to more than 12 months afterwards. The IRA was the left anterior descending in 47%, the right coronary artery in 50%, and the circumflex in 3% of cases. Total coronary occlusion was found in 80% of patients studied 2 to 4 weeks after MI, and decreased gradually reaching 40% of those studied after 12 months of MI. In those patients with a patent IRA, severe stenosis remained: 99% obstruction at 2 to 4 weeks, decreasing to 85.9% obstruction after 12 months (p less than 0.005). The prevalence of total coronary occlusion (TCO) and the severity of stenosis in those without TCO was similar in those with transmural or nontransmural MI and in those with one-, two- or three-vessel disease. This study suggests that endogenous lysis is probably a slow process, and that severe coronary narrowing persists in those with recanalization.
D000328:Adult; D000368:Aged; D003251:Constriction, Pathologic; D017023:Coronary Angiography; D003327:Coronary Disease / Q000150:complications; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000473:pathology; D012189:Retrospective Studies; D013997:Time Factors