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Comparison of the clinical and morphologic characteristics of culprit lesions in
unstable angina and non-ST-elevation myocardial infarction
#MMPMID27326024
Kiani R
; Sanati HR
; Abdi S
; Shakerian F
; Firoozi A
; Zahedmehr A
Heart Asia
2012[]; 4
(1
): 32-6
PMID27326024
show ga
OBJECTIVE: The aim of the study was to assess the differences in clinical and
morphologic characteristics of culprit lesions among patients with unstable
angina (UA) and non-ST-elevation myocardial infarction (NSTEMI). METHODS: The
authors included 174 consecutive patients who have been admitted due to UA or
NSTEMI. All patients underwent coronary angiography during hospitalisation and
angiographic characteristics were determined. RESULTS: The mean age of study
patients was 57±9?years, and the majority were men. The frequency of single, two
and three vessel disease was 35.6%, 28.7% and 28.1%, respectively. There was no
significant difference between UA and NSTEMI patients in terms of the extent of
coronary artery involvement and culprit lesion morphologic features (p value:
0.99 and 0.67, respectively). The only significant difference was the incidence
of definite and possible thrombus in culprit lesion (40.7% vs 16.5%, p
value<0.001). The authors also did not find any association between Braunwald
clinical/severity classification and lesion morphology in the studied population.
In multivariate analysis there was a significant association between Braunwald
class II-III and increased risk of NSTEMI (OR (95% CI): 13.43 (1.12 to 160.63),
p=0.04, OR (95% CI): 14.08 (1.21 to 163.11), p=0.03, for Braunwald severity class
II and III, respectively). CONCLUSION: Clinical characteristics of patients with
acute coronary syndrome including enzyme rising cannot predict the extent of
coronary artery involvement and the morphology of culprit lesions. The only
exception was the higher incidence of intracoronary thrombus in patients with
NSTEMI as compared with UA.
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