Angiographic morphology in unstable angina pectoris

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Biology

Background:

• Unstable angina frequently presents with complex coronary artery morphology.
• The relationship between complex morphology, clinical presentation, angiography timing, and hospital outcomes in unstable angina remains under-investigated.

Purpose of the Study:

• To investigate the association between complex coronary artery morphology and symptomatic presentation.
• To explore the link between complex morphology, angiography timing, and hospital outcomes in patients with acute coronary syndromes.

Main Methods:

• Coronary angiography was performed in 101 consecutive patients with acute coronary insufficiency or crescendo angina.
• Complex morphology was defined as stenosis with irregularity, overhang, or thrombus.
• Clinical presentation, need for urgent catheterization, and in-hospital cardiac events were assessed.

Main Results:

• Complex morphology was observed in 61% of patients.
• Intraluminal thrombi were found in 27% of patients without myocardial infarction and 78% of those with myocardial infarction.
• Urgent catheterization was associated with intraluminal thrombus (46%) and complex morphology (83%).
• Complex morphology and thrombus presence correlated with increased in-hospital cardiac events (revascularization, myocardial infarction, death).

Conclusions:

• Complex coronary morphology and intraluminal thrombus are prevalent in unstable angina.
• These findings are linked to urgent intervention needs and a higher risk of adverse in-hospital cardiac events, independent of multivessel disease.