Association between angiographic coronary stenosis morphology and acute coronary syndrome manifestation in patients with ischemic heart disease.

ABSTRACT

AIM: Patients with acute coronary syndrome (ACS) often show complex morphology of coronary stenosis at angiography. In the present study we evaluated the association between different clinical forms of manifestation of acute coronary syndrome and the angiographic morphological patterns of coronary stenosis. PATIENTS AND METHODS: A total of 112 patients with angiographically verified single vessel coronary artery disease were divided into two groups a control group of 44 patients with simple coronary stenosis at angiography and a study group of 66 patients with complex coronary stenosis. Angiographic analysis was performed using a modified Ambrose classification. The two groups were compared according to the manifestation and distribution of the acute coronary syndrome based on Braunwald classification. RESULTS: There were no statistically significant differences between the mean values of stenosis severity in the group with simple stenosis (79.8% +/- 10.7%) and the group with complex stenosis (82.7% +/- 8.2%) (P > 0.05). The incidence of current acute coronary syndrome - unstable angina or myocardial infarction - was higher in the group with complex stenosis (30.00% +/- 8.37% vs. 52.00% +/- 7.07%, P < 0.05). Patients with previous ACS were prevailing in the group with simple stenosis (70.00% +/- 8.37% vs. 48.00% +/- 7.07%, P < 0.05). CONCLUSION: Complex coronary stenosis is associated with higher prevalence of acute coronary syndrome in acute clinical stage while simple coronary stenosis is associated with higher prevalence of previous acute coronary syndrome. A possible metamorphosis of coronary stenoses is taken into consideration.