Angiographic morphology and intraluminal coronary artery thrombus in patients with angina pectoris: clinical

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I Kranjec, J Delaye, B Didier

    European Heart Journal
    |February 1, 1987
    PubMed

    Insights

    Eccentric irregular lesions (EIL) are a strong indicator of unstable angina pectoris. These specific coronary artery lesions, identified during angiography, help predict and manage unstable angina.

    Area of Science:

    • Cardiology
    • Radiology
    • Vascular Biology

    Background:

    • Angina pectoris (AP) management relies on accurate diagnosis of coronary artery disease.
    • Differentiating stable from unstable AP is crucial for timely and appropriate treatment.
    • Angiographic assessment of coronary lesions provides key morphological information.

    Purpose of the Study:

    • To investigate the association between specific coronary lesion morphologies and the clinical presentation of angina pectoris.
    • To determine if eccentric irregular lesions (EIL) are a specific angiographic marker for unstable angina.
    • To explore the relationship between EIL and spontaneous angina episodes.

    Main Methods:

    • Prospective study of 104 patients undergoing coronary angiography for angina evaluation.
    • Comparison of coronary lesions (≥50% luminal diameter reduction) between stable and unstable angina groups.
    • Analysis of lesion characteristics: localization, grade, length, type (eccentric irregular vs. concentric), and collateralization.

    Main Results:

    • Eccentric irregular lesions (EIL) were significantly more frequent in the unstable angina group (27% vs. 3%, P<0.01).
    • Concentric lesions were more common in the stable angina group (45% vs. 26%, P<0.02).
    • EIL were identified as spontaneous angina-producing lesions in 55% of unstable patients and were associated with thrombi in 86% of cases.

    Conclusions:

    • Eccentric irregular lesions (EIL) are a sensitive and specific angiographic marker for unstable angina pectoris.
    • The morphology of EIL, particularly narrow neck or wall irregularity, may indicate lesion evolution.
    • Angiographic identification of EIL can aid in therapeutic decision-making for unstable angina.

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