Does Coronary Artery Morphology Predict Favorable Results of Intracoronary Thrombolysis in Patients With Unstable Angina Pectoris?
スポンサーリンク
概要
- 論文の詳細を見る
The efficacy of intracoronary thrombolysis (ICT) for unstable angina pectoris (UAP) has been limited, despite the similar pathogenesis between UAP and acute myocardial infarction. To ascertain the subset of UAP suitable for ICT, the clinical responses to ICT were assessed in patients with UAP. Eighty-2 patients with medically refractory angina were divided into 2 groups according to the coronary artery morphology of the culprit lesion before ICT: (1) lesions with acute cut off and/or filling defects (AC) and (2) lesions with a tapered shape (TA). The TIMI flow grade was determined from coronary angiograms before and immediately after ICT. The diameter stenosis (%DS) and minimal lumen diameter (MLD) of the culprit lesion were determined using quantitative coronary angiographic analysis before and immediately after ICT. In addition, inhospital cardiac event rates including urgent / emergency coronary angioplasty or bypass surgery, nonfatal myocardial infarction or cardiac death were compared between the 2 groups. Multivariate logistic regression analysis was performed using 13 clinical factors contributing to successful ICT. The results showed that all 3 coronary angiographic parameters (TIMI flow, %DS, and MLD) significantly improved in the AC group (p<0.01, p<0.01 and p<0.05, respectively), whereas none of these parameters improved in the TA group. The inhospital cardiac event rate after ICT was significantly higher in the TA group (76%) than in the AC group (48%; p=0.016). Odds ratio predicting successful ICT was 7.09 (p<0.01) for the AC lesion, and 2.54 (p<0.01) for new angina. In conclusion the AC lesions are more commonly associated with coronary thrombosis that responds to ICT than are the TA lesions. Thus, the coronary angiographic morphology may be an important predictor for a successful ICT in patients with medically refractory UAP. (Jpn Circ J 1999; 63: 13 - 18)
- 社団法人 日本循環器学会の論文
社団法人 日本循環器学会 | 論文
- Adenosine Triphosphate Exposes Dormant Pulmonary Vein Conduction Responsible for Recurrent Atrial Tachyarrhythmias : Importance of Evaluating the Dormant Conduction During the Re-Do Ablation Procedure
- Impact of Diabetes Mellitus on Rehospitalization for Heart Failure Among Survivors of Acute Myocardial Infarction in the Percutaneous Coronary Intervention Era
- N-Acetylcysteine Reduces the Severity of Atherosclerosis in Apolipoprotein E-Deficient Mice by Reducing Superoxide Production
- Incremental Effects of Eicosapentaenoic Acid on Cardiovascular Events in Statin-Treated Patients With Coronary Artery Disease : Secondary Prevention Analysis From JELIS
- Risk of Smoking and Metabolic Syndrome for Incidence of Cardiovascular Disease : Comparison of Relative Contribution in Urban Japanese Population : The Suita Study