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Comparison of the clinical and morphologic characteristics of culprit lesions in unstable angina and non-ST-elevation myocardial infarction
  1. Reza Kiani,
  2. Hamid Reza Sanati,
  3. Seifollah Abdi,
  4. Farshad Shakerian,
  5. Ata Firoozi,
  6. Ali Zahedmehr
  1. Department of Interventional Cardiology, Rajaie Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Tehran, IRAN
  1. Correspondence to Dr Hamid Reza Sanati, Assistant Professor, Interventional Cardiologist, Department of Interventional Cardiology, Rajaei Cardiovascular Medical and Research Center, Tehran University of Medical Sciences, Tehran PO.Box:1996911151, Iran; sanati.md{at}gmail.com

Abstract

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.

  • Culprit lesion
  • coronary angiography
  • acute coronary syndrome
  • coronary artery disease
  • coronary physiology
  • coronary flow
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Footnotes

  • Competing interest None declared.

  • Patient consent Obtained.

  • Ethics approval This study has been approved by the ethical committee of Rajaie cardiovascular medical and research center.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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