Pathogenesis, Treatment and Prognosis of Impending Myocardial Infarction and Early Post-Infarction Angina : Relation between ST-segment shift during myocardial ischemia and the pathogenesis : PATHOGENESIS AND MANAGEMENT OF IMPENDING MYOCARDIAL INFARCTION
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概要
- 論文の詳細を見る
We studied 141 patients to evaluate the pathogenesis and clinical picture of high-risk unstable angina (UA), designated as impending myocardial infarction (IMI) in this study, or severe early post-infarction angina (PIA). IMI and PIA were diagnosed when chest pain appeared at rest and lasted 15 min or more de-spite extensive pharmacological therapy during hospital stay among consecutive 510 patients with UA. All patients underwent coronary angiography urgently within 72 h after chest pain, and were divided into 2 subgroups according to ST segment shifts during chest pain. In IMI, 42 patients with ST depression had higher incidences of prior myocardial infarction (MI), worsening UA, mul-tivessel disease and complex lesions such as eccentric irregular lesion or ulceration. On the contrary, in 44 with ST elevation, new onset UA, single vessel disease and coronary thrombus (CT) were dominant. In PIA, 32 patients with ST elevation revealed higher incidences in Q wave MI, ST elevation at the MI onset, single vessel disease and CT, compared to 23 with ST depression who showed a high proportion of complex lesions. Thus, it was evident that there was a common link between the pathogenesis of IMI and PIA. The therapeutic options were also different in the groups according to ST segment shift. We conclude that ST segment shifts during chest pain may be useful for determining the pathogenesis and clinical features of high-risk UA.
- 社団法人日本循環器学会の論文
- 1992-11-20
著者
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NONOGI Hiroshi
Division of Cardiology, National Cardiovascular Center
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MIYAZAKI Shunichi
Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, Fujishiroda
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DAIKOKU Satoshi
Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, Fujishiroda
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Daikoku Satoshi
Division Of Cardiology Department Of Internal Medicine National Cardiovascular Center
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Nonogi Hiroshi
Division Of Cardiology And Emergency Medicine National Cardiovascular Center
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Ito Akira
Division of Cardiology, Osaka City General Hospital
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Haze Kazuo
Department Of Cardiology Osaka City General Hospital
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Haze Kazuo
Division Of Cardiology Department Of Medicine National Cardiovascular Center
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Itoh Akira
Division Of Cardiology Department Of Internal Medicine National Cardiovascular Center
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Ito Akira
Division Of Cardiology Osaka City General Hospital
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Haze Kazuo
Heart Institute Japan Tokyo Women's Medical College
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Miyazaki Shunichi
Division Of Cardiology Department Of Internal Kinki University School Of Medicine
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Nonogi Hiroshi
Division Of Cardiac Care Unit Department Of Cardiovascular Medicine National Cerebral And Cardiovasc
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