What is the incidence of normal coronary arteriograms in young patients (≤35 years) with myocardial infarction?
A notable proportion (16%) of young patients (≤35 years) with myocardial infarction have normal coronary arteries, supporting the routine use of coronary angiography in this demographic to establish a favorable prognosis.
Over a 41 month period selective coronary arteriography was performed on all patients age 35 and under seen at our hospital with a documented myocardial infarction. In these 25 patients, 4 (16%) demonstrated no arteriographic evidence of coronary artery disease. One-hundred and fifty-two patients over age 35 with a documented myocardial infarction underwent selective coronary arteriography during the same period. In each of the 15 2 cases, obstructive coronary artery disease was demonstrated. The generally favorable prognosis of patients with myocardial infarction and normal coronary arteriograms has been previously documented. On the basis of our experience and a review of the literature, it is recommended that all patients age 35 and under sustaining a myocardial infarction should undergo selective coronary arteriography, in order to establish prognosis.
Thompson et al. (Sat,) studied this question.
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