Atherosclerotic coronary artery disease progression after Acute Myocardial Infarction:An angiographic study.

Abstract

An acute myocardial infarction (AMI) may be the first and, at the same time, the most dangerous complication of CAD. There are compelling reasons to believe that rupture of atheromatous plaques play an important role in the pathophysiology of AMI, as well as lesion progression Episodes of plaque disruption with local thrombin activation and subsequent re-sealing, with incorporation of the thrombus into the vessel wall, may be one of the major reasons for the rapid progression of atherosclerotic lesions . The aim of this study is to assess the atherosclerotic coronary artery disease progression in non-infarct-related arterial segments in patients with acute myocardial infarction using coronary angiographic data. The study included 140 patients with acute myocardial infarction and chronic stable angina in Killip Class 1 or 2 who were referred to the CCU at Ain-Shams University Hospital and National Heart Institute. They were divided into 2 groups: Group A: Included 70 patients who were managed with invasive approach, the hospital course was the standard care for MI patients treated with primary percutaneous coronary interventions (PCI). Group B: Included 70 patients with chronic stable angina undergoing elective (PCI). Six months later , a control noninvasive assessment as well as coronary angiography procedure were done for all patients. During hospitalization of both groups, all clinical, laboratory and angiographic parameters were collected. Coronary angiography were performed during the acute phase of AMI and after 6 months. Atherosclerotic coronary artery disease progression was evaluated offline with quantitative coronary angiography (QCA) by applying the Automated Coronary Analysis system.