FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Volume 302:1157-1162 May 22, 1980 Number 21 Next

	Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Abstract

We used angiography in a prospective study of the coronary circulation in patients with acute coronary insufficiency. Reversible ST-T changes during the acute illness corresponded anatomically with severely narrowed coronary arteries (80 to 95 per cent stenosis). Angiograms repeated four months later showed new complete occlusions in nine of 30 severely stenotic arteries. Eight of the new occlusions occurred in severely narrowed arteries previously correlated with regional ST-T changes. Six patients had myocardial infarctions, five of which corresponded with the site of a new occlusion. These results provide indirect evidence that the acute coronary-insufficiency syndrome commonly represents intermittent transient coronary-artery occlusion and a threat of new permanent occlusion of the same artery. Myocardial infarction in these patients appeared to occur as a complication of the new occlusion.

This article has been cited by other articles:

• Kaski, J. C., Chester, M. R., Chen, L., Katritsis, D. (1995). Rapid Angiographic Progression of Coronary Artery Disease in Patients With Angina Pectoris : The Role of Complex Stenosis Morphology. Circulation 92: 2058-2065 [Abstract] [Full Text]  
• Chen, L., Chester, M. R., Redwood, S., Huang, J., Leatham, E., Kaski, J. C. (1995). Angiographic Stenosis Progression and Coronary Events in Patients With `Stabilized' Unstable Angina. Circulation 91: 2319-2324 [Abstract] [Full Text]  
• Johnson, E., Ports, T. (1988). Unstable Angina Pectoris: An Interventional Approach to Management. J Intensive Care Med 3: 202-214 [Abstract]  
• Hirsh, J., Cairns, J. A. (1987). Analytic Reviews : Antithrombotic Tberapy in Acute Myocardial Infarction and Unstable Angina. J Intensive Care Med 2: 299-312  
• SPODICK, D. H. (1985). Inflammation and the Onset of Myocardial Infarction. ANN INTERN MED 102: 699-702 [Abstract]  
• Eugene, J., Ott, R. A., Piters, K. M., Stemmer, E. A. (1985). Operative Risk Factors Associated With Unstable Angina Pectoris. Arch Surg 120: 279-282 [Abstract]  
• OLIVA, P. B. (1984). Unstable Rest Angina with ST-Segment Depression: Pathophysiologic Considerations and Therapeutic Implications. ANN INTERN MED 100: 424-440 [Abstract]  
• OLIVA, P. B. (1981). Pathophysiology of Acute Myocardial Infarction, 1981. ANN INTERN MED 94: 236-250 [Abstract]