Severity of coronary arterial stenoses responsible for acute coronary syndromes.
Details
Serval ID
serval:BIB_764C56671C26
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Severity of coronary arterial stenoses responsible for acute coronary syndromes.
Journal
American Journal of Cardiology
ISSN
1879-1913 (Electronic)
ISSN-L
0002-9149
Publication state
Published
Issued date
2009
Peer-reviewed
Oui
Volume
103
Number
9
Pages
1183-1188
Language
english
Notes
Publication types: Comparative Study ; Journal ArticlePublication Status: ppublish
Abstract
Acute myocardial infarctions were generally believed to result from plaque rupture and thrombosis at the site of a "mild to moderate" coronary stenosis. To assess the severity of coronary stenoses that predisposed to acute coronary syndrome, the 317 patients prospectively included were (1) 102 patients with acute ST-elevation myocardial infarction (STEMI) referred for primary percutaneous coronary intervention (PCI), (2) 135 patients with non-STEMI or unstable angina pectoris (UAP) referred for semiurgent PCI, and (3) 80 patients with stable angina pectoris (SAP) admitted for elective PCI. Patients with STEMI were included if thrombus aspiration could restore normal antegrade coronary blood flow. After aspiration (but before PCI), a high-quality angiogram was obtained and the reference diameter, minimal luminal diameter, and percentage of diameter stenosis of the culprit lesion were quantified. In patients with non-STEMI/UAP and SAP, aspiration was not performed. Average diameter of stenosis was similar in patients with STEMI and those with SAP (66 +/- 12% vs 65 +/- 10%, respectively; p = NS), but was slightly larger in patients with non-STEMI/UAP (71 +/- 12%; p <0.05 vs both STEMI and SAP). In patients with STEMI, only 11% of culprit stenoses were found to have diameter stenosis <50% after removal of the thrombus. In conclusion, most STEMIs occurred at the site of severe coronary stenosis. Diameter stenosis severity was <50% in a minority of cases.
Keywords
Acute Coronary Syndrome/epidemiology, Acute Coronary Syndrome/etiology, Age Distribution, Aged, Aged, 80 and over, Analysis of Variance, Angina, Unstable/complications, Angina, Unstable/mortality, Angioplasty, Balloon, Coronary/methods, Chi-Square Distribution, Cohort Studies, Coronary Angiography/methods, Coronary Stenosis/complications, Coronary Stenosis/mortality, Electrocardiography/methods, Female, Follow-Up Studies, Humans, Incidence, Male, Middle Aged, Myocardial Infarction/complications, Myocardial Infarction/mortality, Probability, Prospective Studies, Reference Values, Risk Assessment, Severity of Illness Index, Sex Distribution, Survival Analysis
Pubmed
Web of science
Create date
16/02/2015 19:02
Last modification date
20/08/2019 15:33