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lACC Vol. 6, No.6

December 19X5:1233-X

CLINICAL STUDIES

1233

Coronary Angiographic Morphology in Myocardial Infarction:

A Link Between the Pathogenesis

o

Unstable Angina and

Myocardial Infarction

JOHN A, AMBROSE, MD, FACC,* STEPHEN L.WINTERS, MD,* ROHIT

R,

ARORA, MD,*

JACOB I. HAFT, MD, FACC,t JONATHAN GOLDSTEIN, MD, FACC,t

K,

PETER RENTROP, MD, FACC,* RICHARD GORLIN, MD, FACC,*

VALENTIN FUSTER, MD, FACC*

New York, New York and Newark, New Jerse\

It has previously been shown that analysis of coronary

morphology can separate unstable from stable angina.

An eccentric stenosis with a narrow neck or irregular

borders,

or

both,

is

very common

in

patients who present

with acute unstable angina, whereas it

is

rare in patients

with stable angina. To extend these observations to myo

cardial infarction, the coronary morphology of 41 pa

tients with acute

or

recent infarction and nontotally

oc

cluded infarct vessels was studied. For all patients, 27

(66%) of

41

infarct vessels contained this eccentric nar

rowing, whereas only 2

(11

%) of 18 noninfarct vessels

with narrowing of

50

to less than 100% had this lesion

(p