Relation of the site of acute myocardial infarction to the most severe coronary arterial stenosis at prior angiography

Reabilitação cardiovascular de portadores de cardiopatia isquêmica submetidos a tratamento clínico, angioplastia coronariana transluminal percutânea e revascularização cirúrgica do miocárdio

“…The lack of relation between major coronary events and the number of stenotic arteries demonstrated in the comparison of the group comprised of patients with single-vessel stenosis versus the group comprised of patients with multivessel stenosis (OR 0.824, 95%CI; 0.377-1.798) corroborates the results found in other studies that show lack of a positive correlation between the occurrence of these events and the higher degree of stenosis and number of coronary arteries affected [19][20][21] . Fissure with atherosclerotic plaque rupture and thrombosis, responsible for the great majority 22,23 .…”

“…The occurrence of a greater number or coronary stenoses has been verified in patients with stable angina than in patients with unstable angina or myocardial infarction, thus demonstrating the human body's natural adaptation mechanism that could be optimized by a full medical treatment including rehabilitation resources, especially physical exercises 24,25 . In addition to the patients' choice not to undergo intervention treatment, with or without their physician's support, since patients frequently refused the intervention treatment proposed, the results of the studies mentioned [19][20][21][22][23][24][25] allowed us to keep these patients with hemodynamically significant chronic coronary stenoses subject to intervention treatment from the anatomic point of view in the rehabilitation program.…”

Ischemia and No Obstructive Coronary Artery Disease (INOCA): What Is the Risk?

“…Even mild degrees of atherosclerosis or abnormal coronary vasoreactivity are related to increased health risk 4, 26, 83, 84. Furthermore, the majority of MIs result from rupture of nonobstructive plaque, highlighting the importance of optimizing therapy in these patients 85, 86. To date, limited data exist about the effectiveness of therapy in stable patients with no CAD and high prevalence of CMD.…”

The Coronary Angiogram and Its Seminal Contributions to Cardiovascular Medicine Over Five Decades

“…Subsequent studies by Little et al, 38 Ambrose et al, 39 and Giroud et al 40 that identified the lesions responsible for acute myocardial infarctions and then sized these same lesions measured at an earlier catheterization indicate that approximately 70% of such lesions had an earlier stenosis diameter less than 50%. These arteriographic observations that acute coronary occlusion results more often from young, non-obstructing atheromatous lesions than from high grade obstructive lesions has significantly influenced our present day understanding of the pathogenesis of acute myocardial infarction.…”