CORONARY ANGIOGRAPHY AFTER NON-Q-WAVE MYO CARDIAL-INFARCTION - RESULTS OF A PROSPECTIVE ANGIOGRAPHY STUDY

Non-Q wave myocardial infarction is associated with a high recurrence rate of ischaemic events (angina and infarction). The artery responsib le for the infarction is usually patent but stenosed and seems to be t he cause of these complications. This prospective multicenter series o f 66 patients treated by Heparin, Aspirin, Diltiazem and undergoing co ronary angiography during the hospital period studied the artery respo nsible for the infarction and the value of coronary angiography in thi s setting. Several conclusions were drawn from the results: the precis e diagnosis of the artery responsible for the infarct may be difficult (14 %) ; the left circumflex artery or one of its branches is often i mplicated (47 %) ; non-Q wave infarction is a various and heterogenous group, including : infarctions located on small branch arteries, ''wa rning'' ischaemic episodes in the left anterior descending artery terr itory. definitive infarction of the left circumflex artery territory n evertheless, this group is an intermediate state between Q wave infarc tion and unstable angina (low occlusion rate 26 % and angiographic les ional appearances similar to those of unstable angina) ; early coronar y angiography (48-72 h) seems to be useful to improve prevention of is chaemic recurrences by adequate revascularisation.