Prediction of early recurrent myocardial ischemia and coronary reocclusion after successful thrombolysis: a qualitative and quantitative angiographic study

The American Journal of Cardiology
T C WallL Aronson

Abstract

To determine the association of qualitative and quantitative measurements of the myocardial infarct-related coronary narrowing with subsequent recurrent ischemia/reocclusion after successful thrombolysis, 47 patients treated with high-dose (150 mg) tissue plasminogen activator over 6 to 8 hours were studied in the setting of acute myocardial infarction. No patient underwent emergent coronary angioplasty. All patients had Thrombolysis in Myocardial Infarction (TIMI) grade 2 flow or higher at the baseline (90-minute) angiogram; 31 patients had a protocol 24-hour catheterization as well. Eighteen patients had recurrent ischemia/reocclusion whereas 29 had an uneventful hospital course. There was no significant difference in baseline clinical characteristics between the 2 groups. Twenty-five (86%) of those with an uneventful course had TIMI grade 3 flow at baseline angiogram compared with 56% of patients with recurrent events. No significant difference in angiographic morphologic characteristics was found between the 2 groups at baseline catheterization. At 24 hours, however, none of the patients who subsequently had recurrent events had a concentric narrowing, while 13 (58%) of them had a complex morphology. In contrast, quantitati...Continue Reading

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Citations

Feb 1, 1992·Catheterization and Cardiovascular Diagnosis·J B HermillerT M Bashore
Jun 1, 1994·International Journal of Cardiac Imaging·J LespéranceD Waters
May 1, 1993·Journal of the American College of Cardiology·A M Lincoff, E J Topol
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Mar 1, 1992·Journal of the American College of Cardiology·S G EllisE J Topol
Jan 15, 1990·The American Journal of Cardiology·T C WallD Whitcomb

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