The DOI matches its Crossref record; 2 of the 2 references it cites were found in a registry or an index.
Angioscopic Evaluation of Coronary-Artery Thrombi in Acute Coronary Syndromes
Abstract
BACKGROUND: Disruption of an atherosclerotic plaque in a coronary artery followed by the formation of a thrombus is believed to be the cause of both unstable angina and acute myocardial infarction. Although thrombolytic therapy is efficacious in patients with acute myocardial infarction, for unknown reasons it is far less effective in patients with unstable angina. We postulated that there might be differences in the composition of the coronary-artery thrombi in unstable angina and acute myocardial infarction. METHODS: To investigate the appearance of coronary-artery thrombi, we performed percutaneous transluminal coronary angioscopy in 15 patients with unstable angina and 16 with acute myocardial infarction. Angioscopy was performed within 48 hours after an episode of pain at rest in the patients with unstable angina and within 8 hours of onset in those with acute myocardial infarction. RESULTS: Angioscopy revealed coronary thrombi in all but two patients (one in each group). Of the 29 patients with thrombi, those with unstable angina were frequently observed to have grayish-white thrombi (10 of 14, 71 percent), but none were seen in the 15 patients with acute myocardial infarction (P less than 0.01). By contrast, reddish thrombi were observed in all 15 patients with acute myocardial infarction who had thrombi, but in only 4 of the 14 patients with unstable angina and thrombi (P less than 0.01). As assessed by coronary angiography, occlusive thrombi occurred frequently in patients with acute myocardial infarction (13 of 16 patients) but were not seen in any of the 15 patients with unstable angina (P less than 0.01). CONCLUSIONS: Coronary-artery thrombi play an important part in the pathogenesis of unstable angina and acute myocardial infarction. However, the appearance of the thrombi is different in the two conditions, possibly reflecting differences in the composition of age of the thrombi or the presence or absence of blood flow in the artery. This difference may account for the contrasting results of thrombolytic therapy.
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Citations
Cites
Thrombosis and Acute Coronary-Artery Lesions in Sudden Cardiac Ischemic Death
Davies, M. J., & Thomas, A. (1984) · New England Journal of Medicine · doi:10.1056/nejm198405033101801 · Cited by 1,694
Platelet Activation in Unstable Coronary Disease
Fitzgerald, D. J., Roy, L., Catella, F., & FitzGerald, G. A. (1986) · New England Journal of Medicine · doi:10.1056/nejm198610163151602 · Cited by 1,141
Cited by
Davies, M. J., Richardson, P. D., Woolf, N., Katz, D. R., & Mann, J. (1993) · Heart · doi:10.1136/hrt.69.5.377 · Cited by 1,127
Pathophysiology and clinical significance of atherosclerotic plaque rupture
Gutstein, D. (1999) · Cardiovascular Research · doi:10.1016/s0008-6363(98)00322-8 · Cited by 151
Magnetocardiography Predicts Coronary Artery Disease in Patients with Acute Chest Pain
Park, J., Hill, P. M., Chung, N., Hugenholtz, P. G., & Jung, F. (2005) · Annals of Noninvasive Electrocardiology · doi:10.1111/j.1542-474x.2005.00634.x · Cited by 109
Metadata
- Authors
- Mizuno, K., Satomura, K., Miyamoto, A., Arakawa, K., Shibuya, T., Arai, T., Kurita, A., Nakamura, H., & Ambrose, J. A.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1992-01-30
- Volume
- 326
- Issue
- 5
- Pages
- 287-291
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2340638737
- Cited by
- 591
- References
- 2
- FWCI
- 43.03
- Type
- journal article
- Language
- en
- Open access
- closed
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