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Limits: Publication Date from 2003/10/01 to
2005/02/01

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1: Am
Heart J. 2004 Feb;147(2):281-6.

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Change of multiple
complex coronary plaques in patients with acute myocardial infarction: a
study with coronary angiography.

Lee SG, Lee CW,
Hong MK, Kim JJ, Park SW, Park SJ.

Department of Medicine,
Ulsan University Hospital, University of Ulsan College of Medicine,
Ulsan, South Korea.

BACKGROUND: Patients with acute myocardial
infarction (AMI) may have multiple complex coronary plaques that are not
limited to the culprit lesions. However, it is unknown whether they tend
to progress in severity, regress, or remain stable. The aim of this
angiographic study is to evaluate the natural history of these lesions.
METHODS: We consecutively enrolled 229 patients who underwent coronary
angiography at the time of their hospitalization to treat AMI with
primary angioplasty. Baseline and follow-up (mean follow-up duration,
192 +/- 33 days) coronary angiographic data in patients with multiple
complex coronary plaques characterized by thrombus, ulceration, plaque
irregularity, and impaired flow were compared. RESULTS: Single complex
coronary plaques were identified in 167 patients (73%), and multiple
complex plaques were identified in the other 62 patients (27%). Among
the patients with multiple complex plaques (62 patients, 83 non-culprit
complex plaques), the angiographic examinations were reviewed
simultaneously in 43.5% (27 patients, 35 non-culprit complex plaques).
Of 35 non-culprit complex lesions, 29 lesions (82%) remained complex
without changing into smooth lesions, 1 lesion became totally occluded,
and 4 lesions regressed. The severity of non-culprit complex lesions
between baseline and follow-up angiography is equal (maximal diameter
stenosis, 74% +/- 15% vs 72% +/- 15%, P =.4). Long-term cardiac events
after discharge were more likely to develop in patients with multiple
complex plaques than in patients with single complex plaques (24% vs
10%, respectively; P <.01). CONCLUSIONS: In patients with AMI, little
angiographic change occurred during 6 months of follow-up in the
non-culprit complex plaques.

PMID: 14760326 [PubMed - indexed for
MEDLINE]

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