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Coronary arteriographic lesion of unstable angina
J I Haft1, J E Goldstein, M L Niemiera
1Cardiology Department, St. Michael's Medical Center, Newark, NJ 07102.
Insights
Morphology of coronary arteriographic lesions, specifically "Type T" lesions, are strongly associated with unstable angina. These complex lesions suggest plaque rupture and thrombus formation are key factors in unstable angina development.
Area of Science:
- Cardiology
- Vascular Biology
Background:
- Unstable angina is a critical manifestation of coronary artery disease.
- Understanding the angiographic characteristics of lesions associated with unstable angina is crucial for diagnosis and treatment.
Purpose of the Study:
- To correlate the morphology of coronary arteriographic lesions with the clinical presentation of unstable angina.
- To identify specific lesion types associated with unstable angina.
Main Methods:
- Coronary arteriography was performed on 109 patients with coronary disease.
- Patients were divided into two groups: unstable angina (Group A, n=73) and stable angina (Group B, n=36).
- Lesion morphology was analyzed, focusing on "Type T" lesions characterized by eccentric narrowing, irregular borders, and intraluminal defects.
Main Results:
- "Type T" lesions were significantly more prevalent in patients with unstable angina (73%) compared to those without (47%, p < 0.01).
- These complex lesions were defined by specific morphological features visible on coronary arteriography.
Conclusions:
- The presence of "Type T" lesions on coronary arteriography is strongly associated with unstable angina.
- These findings suggest that atherosclerotic plaque rupture and/or thrombus formation are common underlying mechanisms in the etiology of unstable angina.
Abstract:
The morphology of the coronary arteriographic lesions in 109 patients with coronary disease was correlated with their clinical history. Unstable angina, characterized by new onset of angina, angina at rest, or an increase in frequency or ease of precipitation of attacks within the previous two months, was present in 73 patients (group A). The other 36 patients had no history of instability within two months (group B). "Type T" lesions, defined as eccentric narrowing with jagged irregular borders with overlapping or undermined areas, or intraluminal filling defects circumferentially outlined by contrast material were found in 73 percent of group 1 vs 47 percent of group B (p less than 0.01). The presence of these angiographic lesions suggests that a ruptured atherosclerotic plaque and/or thrombus commonly plays a role in the etiology of unstable angina.