Indications for coronary arteriography after myocardial infarction

The prognosis of patients after an acute myocardial infarction depends on the extent of the myocardial damage, its resulting left ventricular dysfunction and on the number and degree of narrowing of diseased coronary arteries. Patients with a severe multivessel disease constitute a high-risk group with an important morbidity and mortality during the first few months after hospitalization for a myocardial infarction. They could benefit from early revascularization therapy, whether by coronary artery bypass surgery, whether by percutaneous transluminal coronary angioplasty. Although early coronary revascularization is still controversial, management of patients after a myocardial infarction certainly will improve from a more accurate risk profiling by a careful diagnostic evaluation--including coronary arteriography in some subsets of patients--during the in-hospital period.