Open AccessThe underlying coronary lesion in myocardial infarction: Implications f coronary angiography
Author(s) -
Little William C.,
Downes Thomas R.,
Applegate Robert J.
Publication year - 1991
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960141103
Subject(s) - medicine , cardiology , myocardial infarction , angiography , lesion , occlusion , coronary occlusion , stenosis , coronary arteries , coronary angiography , coronary atherosclerosis , infarction , artery , radiology , coronary artery disease , surgery
Myocardial infarction is usually caused by sudden thrombotic occulusion of a coronary artery at the site of a fissured atherosclerotic plaque. Recent evidence suggests that coronary angiography may be insensitive in detecting and quantitaing atherosclerosis. Serial angiographic studies demonstrate that the majority of myocardial infarctions occur due to occlusion of arteries that previously did not contain angiographically significant (>50%) stenoses. Similarly, quantitative angiography performed after thrombolytic therapy indicates that the coronary lesion underlying the clot is frequently not severely stenotic. Thus, an angiographically apparent stenosis is not necessary for the development of a thrombotic occlusion resulting in an MI. These observations suggest that coronary angiography does not accurately predict the site of a subsequent, occlusion that will produce a myocardial infarction.