Coronary angiographic findings in infarct-related arteries following 1 month of medical treatment.
OBJECTIVE
We undertook the present study to determine first whether coronary angiographic (CAG) features, suggestive of ruptured atherosclerotic plaque, develop in infarct-related arteries of patients receiving conventional medical therapy without thrombolytic agents, and if they develop, what the incidence is, and second whether the sites where the CAG features develop are specific to infarct-related lesions.


METHODS
We reviewed the CAG findings of 127 consecutive patients one month after myocardial infarction (MI), including 72 consecutive patients who received medical therapy (Group I) and 55 patients who underwent intracoronary urokinase infusion (Group II).


RESULTS
Angiographic evidence of ruptured plaque was present in 24/44 (54.5%) patent infarct-related arteries in Group I and in 27/43 (62.8%) in Group II. Similar findings were only noted in 2/52 (3.8%) patent non-infarct-related arteries with significant stenosis in Group I, and in 0/45 (0.0%) in Group II.


CONCLUSIONS
On angiography, ruptured plaque was commonly found in patent infarct-related arteries in both groups, and was highly specific for the site of infarction. Thrombolytic therapy seemed to have no apparent effect on lesion morphology 1 month after MI.
Hanada
Y
Y
First Department of Internal Medicine, Miyazaki Medical College, Japan.
Koiwaya
Y
Y
Tanaka
K
K
D000925:Anticoagulants / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000453:epidemiology; D015912:Thrombolytic Therapy; D013988:Ticlopidine / Q000627:therapeutic use; D013997:Time Factors; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use
D000925:Anticoagulants; D014568:Urokinase-Type Plasminogen Activator; D013988:Ticlopidine; D001241:Aspirin