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| The observation of culprit vessels in patients with acute myocardial infarction by coronary angioscopy |
| MA Shu-mei1, SUN Zhi-jun1, MIZUNO Kyoyichi2 |
| 1. Department of Cardiology, the Second Affiliated Hospital of China Medical University, Shenyang 110004, China;2. Nippon Medical School Chiba Hokusoh Hospital, Chiba 270-1694, Japan |
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Abstract Objective: To provide the clinical pathological basis for AMI by means of observation culprit vessels in acute myocardial infarction(AMI) patients with or without ST segment elevation by coronary angioscopy. Methods: Twenty-eight cases of AMI with ST elevation(STMI) and 18 cases AMI without ST elevation(NSTMI) were included. The criminal vessels were investigated by coronary angioscopy when these patients were accepting coronary interventional examination and therapy. Results: ①Yellow plaque was detected in all the culprit vessels of AMI patients. ②There were a higher rate of plaque rupture detection in the group of NSTMI than that of STMI(88.89% vs 57.14% respectively, P=0.022). ③The red or mixed plaque was more common in STMI group than in NSTMI(92.85% vs 55.56% respectively, P=0.003). Meanwhile the occlusive thrombus was more common in STMI group(78.57% vs 11.11% respectively, P<0.0001) while the non-occlusive thrombus was more common in NSTMI group(44.44% vs 14.29% respectively, P=0.054). Conclusion: Rupture of unstable yellow plaque and its accompanied thrombosis was the pathological basis of AMI. Red or unstable plaque was predominant in STMI while non-occlusive plaque was mostly seen in NSTMI. Thus, to stabilize the yellow plaque before its rupture is the key point to prevent the onset of AMI.
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Received: 28 February 2006
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2006, Vol. 17 
