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Arteriographic Morphology and Intracoronary Thrombus in Patients with Unstable Angina, Non-Q Wave Myocardial Infarction and Stable Angina Pectoris

New York Methodist Hospital, Brooklyn, New York

L. Gould

New York Methodist Hospital, Brooklyn, New York

T. Bharathan

New York Methodist Hospital, Brooklyn, New York

M. Angirekula

New York Methodist Hospital, Brooklyn, New York

S. Choubey

New York Methodist Hospital, Brooklyn, New York

Yu. Karpov

New York Methodist Hospital, Brooklyn, New York

Coronary artery lesions were compared in 71 patients with unstable angina, 15 patients with non-Q wave myocardial infarction (MI), and 40 patients with stable angina. In the unstable angina group, 29 patients had new-onset angina, 31 had crescendo angina, and 11 had rest angina. In a subgroup of patients with unstable angina, three-vessel disease was less frequently (P < 0.05) seen in patients with new-onset angina (10.3%) than in the patients with crescendo angina (51.6%) or rest angina (54.5%). An angina-producing artery could be identified in 59 patients with unstable angina, in 11 with non-Q wave MI, and in 30 with stable angina. Type II eccentric stenosis (asymmetric narrowing with narrow neck and overhanging irregular edges) was present in 31 patients (52.5%; P < 0.01) with unstable angina, in 7 (63.6%; P < 0.01) with non-Q wave MI, and in only 2 (6.7%) with stable angina. Abrupt occlusion of a vessel was observed in 7 patients (11.9%) with unstable angina and in 2 (18.2%) with non-Q wave MI. None of the patients with stable angina had this type of occlusion. In the group of unstable angina and non-Q wave MI, angiographic evidence of intracoronary thrombi was present in 16 (27.1%) and 3 patients (27.3%), respectively, but in stable angina in only 1 patient (3.3%; P < 0.05). Intracoronary thrombi were most frequently found in rest angina (88%; P < 0.001) and crescendo angina (33.3%; P < 0.01) compared with new-onset angina (3.7%). These findings suggest that Type II eccentric lesions and intracoronary thrombi are frequent in patients with unstable angina and non-Q wave MI. Within the group of patients with unstable angina intracoronary thrombi are more frequently observed in patients with rest angina and crescendo angina.

Angiology, Vol. 46, No. 3, 181-189 (1995)
DOI: 10.1177/000331979504600301


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