CORONARY ANGIOGRAPHIC FINDINGS IN INFARCT-RELATED ARTERIES FOLLOWING 1 MONTH OF MEDICAL-TREATMENT

Purpose: We undertook the present study to determine first whether cor onary angiographic (CAG) features, suggestive of ruptured atherosclero tic plaque, develop in infarct-related arteries of patients receiving conventional medical therapy without thrombolytic agents, and if they develop, what the incidence is, and second whether the sites where the CAG features develop are specific to infarct-related lesions. Methods : We reviewed the CAG findings of 127 consecutive patients one month a fter myocardial infarction (MI), including 72 consecutive patients who received medical therapy (Group I) and 55 patients who underwent intr acoronary urokinase infusion (Group II). Results: Angiographic evidenc e of ruptured plaque was present in 24/44 (54.5%) patent infarct-relat ed arteries in Group I and in 27/43 (62.8%) in Group II. Similar findi ngs were only noted in 2/52 (3.8%) patent non-infarct-related arteries with significant stenosis in Group I, and in 0/45 (0.0%) in Group II. Conclusion: On angiography, ruptured plaque was commonly found in pat ent infarct-related arteries in both groups, and was highly specific f or the site of infarction. Thrombolytic therapy seemed to have no appa rent effect on lesion morphology 1 month after MI.