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Intracoronary thrombus and complex morphology in unstable angina. Relation to timing of angiography and in-hospital cardiac events.

Publication ,  Journal Article
Freeman, MR; Williams, AE; Chisholm, RJ; Armstrong, PW
Published in: Circulation
July 1989

In 78 consecutive patients with unstable angina, we performed coronary angiography randomized to either the first day of presentation or later during the hospital admission to assess the frequency of intracoronary thrombus and complex coronary morphology relative to the time of symptomatic presentation and the impact of these angiographic features on outcome. Early angiography (17 +/- 6 hours) was performed in 42 patients and late angiography in 36 patients (5.7 +/- 2.1 days). Twelve patients randomized to late angiography required urgent cardiac catheterization 3.9 +/- 2.2 days after admission. Coronary thrombi were present in 43% (18 of 42) of early angiography patients and in 38% (14 of 36) of late angiography patients (p = NS). Only 21% (five of 24) late elective angiography patients had coronary thrombi, but 75% (nine of 12) of late urgent angiography patients had thrombi (p less than 0.05 vs. both early and late elective angiography patients). There was no difference in the frequency of complex coronary morphology among patients randomized to early angiography (42%, or 15 of 36), late urgent angiography (42%, or five of 12), and late elective angiography (38%, or nine of 24). Cardiac events (death, myocardial infarction, and urgent revascularization) were more frequent in the patients with coronary thrombus (73%, or 23 of 32), complex coronary morphology (55%, or 16 of 29), and multiple-vessel disease (58%, or 29 of 50) than in the patients without these angiographic features (17%, or eight of 46; 31%, or 15 of 49; and 7%, or two of 28, respectively; all p less than 0.05). Multiple regression analysis demonstrated that coronary thrombus was the best angiographic predictor of cardiac events. Thus, angiographic detection of intracoronary thrombi varies according to the temporal relation between angiography and chest pain at rest.

Duke Scholars

Published In

Circulation

DOI

ISSN

0009-7322

Publication Date

July 1989

Volume

80

Issue

1

Start / End Page

17 / 23

Location

United States

Related Subject Headings

  • Time Factors
  • Prospective Studies
  • Myocardial Revascularization
  • Myocardial Infarction
  • Middle Aged
  • Humans
  • Hospitalization
  • Coronary Thrombosis
  • Coronary Disease
  • Cardiovascular System & Hematology
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Freeman, M. R., Williams, A. E., Chisholm, R. J., & Armstrong, P. W. (1989). Intracoronary thrombus and complex morphology in unstable angina. Relation to timing of angiography and in-hospital cardiac events. Circulation, 80(1), 17–23. https://doi.org/10.1161/01.cir.80.1.17
Freeman, M. R., A. E. Williams, R. J. Chisholm, and P. W. Armstrong. “Intracoronary thrombus and complex morphology in unstable angina. Relation to timing of angiography and in-hospital cardiac events.Circulation 80, no. 1 (July 1989): 17–23. https://doi.org/10.1161/01.cir.80.1.17.
Freeman MR, Williams AE, Chisholm RJ, Armstrong PW. Intracoronary thrombus and complex morphology in unstable angina. Relation to timing of angiography and in-hospital cardiac events. Circulation. 1989 Jul;80(1):17–23.
Freeman, M. R., et al. “Intracoronary thrombus and complex morphology in unstable angina. Relation to timing of angiography and in-hospital cardiac events.Circulation, vol. 80, no. 1, July 1989, pp. 17–23. Pubmed, doi:10.1161/01.cir.80.1.17.
Freeman MR, Williams AE, Chisholm RJ, Armstrong PW. Intracoronary thrombus and complex morphology in unstable angina. Relation to timing of angiography and in-hospital cardiac events. Circulation. 1989 Jul;80(1):17–23.

Published In

Circulation

DOI

ISSN

0009-7322

Publication Date

July 1989

Volume

80

Issue

1

Start / End Page

17 / 23

Location

United States

Related Subject Headings

  • Time Factors
  • Prospective Studies
  • Myocardial Revascularization
  • Myocardial Infarction
  • Middle Aged
  • Humans
  • Hospitalization
  • Coronary Thrombosis
  • Coronary Disease
  • Cardiovascular System & Hematology