Key Points
- To examine coronary artery anatomy during acute coronary insufficiency and evaluate the subsequent risk of complete coronary occlusion and myocardial infarction.
- Conducted a prospective angiographic study evaluating coronary circulation in patients presenting with acute coronary insufficiency and reversible ST-T changes.
- Performed baseline angiography identifying 30 severely stenotic arteries (80% to 95% stenosis) and repeated angiograms 4 months later.
- Repeat angiography at 4 months revealed new complete occlusions in 9 of 30 severely stenotic arteries (30.0%), with 8 of these 9 occlusions occurring in arteries corresponding to prior regional ST-T changes.
- Myocardial infarction occurred in 6 patients, with 5 of the 6 cases anatomically matching the location of a newly identified complete arterial occlusion.
Structured PICO
PPopulationPatients with acute coronary insufficiency
IInterventionAngiography at baseline and repeated at four months
OOutcomeNew complete coronary occlusionssurrogate
Acute coronary insufficiency syndrome commonly represents intermittent transient coronary-artery occlusion and carries a high risk of progression to permanent occlusion and myocardial infarction.