Coronary artery thrombosis in patients with unstable angina.
Population
16 patients with an unstable clinical course in whom coronary artery thrombosis was detected at the time of…
Design
Case_series
Authors
Discussion
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Implication
Should not change practice in unstable angina; leaves open whether thrombus patterns predict outcomes or warrant targeted therapy.
Key Points
- To characterize the clinical course, coronary anatomy, and left ventricular function in patients presenting with angiographically verified coronary artery thrombosis.
- Evaluated clinical histories, coronary angiograms, and ventriculograms in a consecutive series of 16 patients with coronary artery thrombosis identified during cardiac catheterisation.
- Categorized arterial thrombus location relative to coronary stenosis and assessed regional left ventricular wall motion.
- All 16 patients had severe coronary artery disease following an accelerated angina course starting a mean of 4 weeks (range: 4 days to 12 weeks) pre-catheterisation, with 4 having recent subendocardial myocardial infarction.
- Segmental left ventricular wall motion abnormalities were present in 15 of 16 patients (93.8%), specifically localized to the territory supplied by the thrombosed vessel.
- Thrombi displayed three distinct anatomical configurations: proximal to high-grade stenosis, distal to high-grade stenosis, and within arterial segments lacking high-grade stenosis.
Structured PICO
P
Population
16 patients with an unstable clinical course (accelerated angina) in whom coronary artery thrombosis was detected at the time of cardiac catheterisation.
O
Outcome
Clinical course, coronary artery anatomy, and ventricular function
Corary artery thrombosis in unstable angina presents in distinct angiographic patterns and is frequently associated with regional ventricular dysfunction, suggesting it may contribute to abrupt clinical deterioration.
Cite This Study
Holmes et al. (1981) studied this question.