Myocardial infarction with normal coronary arteries: A prospective clinical-angiographic study

Betriu, Amadeo; Jc, Paré; Sanz, Ginés; Casals, F J; Magriñá, J; Castañer, Angel; Navarro-López, F

doi:10.1016/0002-9149(81)90568-3

Cited by 113 publications

(39 citation statements)

References 38 publications

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“…In accordance with data in the literature 11,12 , in our study, Some studies have shown contradictory results regarding the clinical and demographic characteristics in patients with acute coronary syndrome and coronary arteries without significant obstructive lesions. In regard to demographic characteristics in our case series, women predominated (58.8%) among the patients without an elevation in the ST segment, differing from individuals with an elevation in the ST segment, in whom no difference in sex distribution was observed in the groups with and without a significant obstructive lesion.…”

Section: Discussionsupporting

confidence: 89%

“…Some researchers 11,12 , studying patients who evolve with acute coronary syndrome without an elevation in the ST segment, have reported a low incidence of complications in the acute phase of the ischemic event, such as arrhythmias, congestive heart failure, and hypotension, as compared with that of individuals with acute coronary syndrome and an elevation in the ST segment. In our case series, the patients with acute coronary syndrome and nonsignificant obstructive coronary lesion, with or without an elevation in the ST segment, had a shorter length of hospital stay as compared with that of patients with significant obstructive coronary lesions, probably due to the low incidence of complications.…”

Section: Discussionmentioning

confidence: 99%

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Síndromes coronarianas agudas na ausência de doença arterial coronariana significativa

Pinheiro

et al. 2005

Arq. Bras. Cardiol.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Síndromes coronarianas agudas na ausência de doença arterial coronariana significativa

Pinheiro

et al. 2005

Arq. Bras. Cardiol.

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“…[1][2][3][4] Acute myocardial infarction can occur at the site of atherosclerotic plaques that do not narrow the coronary artery lumen. 5 Plaque rupture followed by thrombosis, and vasoconstriction at the site of the plaque, are involved in coronary artery occlusion. 6,7 Coronary vasospasm has been suggested to occur as a result of reduced endotheliumdependent vasodilatation and hyperactivity of vascular smooth muscle cells.…”

mentioning

confidence: 99%

Coronary Artery Spasm and the Polymorphisms of the Endothelial Nitric Oxide Synthase Gene

Kaneda

Taguchi

Kuwada

et al. 2006

Circ J

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oronary spasm plays an important role in the pathogenesis of vasospastic angina. It may also contribute to the development of other acute coronary syndromes. [1][2][3][4] Acute myocardial infarction can occur at the site of atherosclerotic plaques that do not narrow the coronary artery lumen. 5 Plaque rupture followed by thrombosis, and vasoconstriction at the site of the plaque, are involved in coronary artery occlusion. 6,7 Coronary vasospasm has been suggested to occur as a result of reduced endotheliumdependent vasodilatation and hyperactivity of vascular smooth muscle cells. [8][9][10][11] Kugiyama et al demonstrated a deficiency in the vasodilatory activity of endothelial nitric oxide (NO) in spastic arteries. 12 NO is biosynthesized from L-arginine by a family of NO synthases (NOSs). [13][14][15] Endothelial NOS (ecNOS), or NOS3, is constitutively expressed in the endothelium and catalyzes the synthesis of NO that regulates vascular tone. Wang et al reported that a polymorphism of intron 4 of the ecNOS gene (27-bp tandem repeats: a allele (4 repeats, rare, NOS4a), b allele (5 repeats, common)) is associated with the smoking-dependent risk for coronary artery disease. 16 The same research group also reported that these genotypes account for over 25% of the basal plasma NO production. 17 Other polymorphisms, Circulation Journal Vol.70, April 2006G894T (Glu298Asp) in exon 7 and T-786C in the 5' flanking region of the ecNOS gene, have been reported to be a risk factor for coronary artery disease, including coronary spasm. [18][19][20][21][22][23] The aim of this study is to assess the relationship between the polymorphisms of ecNOS genes, especially NOS4a, and coronary vascular behavior at spasm provocation tests in detail, by using quantitative coronary angiography (QCA). Methods Study PatientsOf 1,094 Japanese patients who underwent coronary angiography at the Cardiovascular Institute Hospital, Tokyo, Japan, 165 patients were clinically suspected of having angina and did not have fixed stenoses in their coronary arteries. Spasm provocation by serial infusions of acetylcholine (Ach) was performed on these 165 patients according to the method of Yasue et al. 24 In brief, Ach chloride (Daiichi Seiyaku) dissolved in 5 ml of warmed 0.9% saline in incremental doses of 25, 50 and 100 g was injected into the left coronary artery and then 25 and 50 g into the right coronary artery. A coronary arteriogram was obtained when ST segment changes and/or chest pain appeared or 1 min after each injection. When spasm was documented, 0.1 mg nitroglycerin (NTG) was injected into the coronary artery if the attack did not disappear within 2 min. A venous blood sample was obtained from the 165 patients. Blood samples were also obtained from 400 healthy subjects at the time of the health examination at Mitsui Memorial Hospital to determine the population incidence of polymorphisms of the ecNOS gene among Background Coronary artery spasm plays an important role in the pathogenesis of vasospastic angina, and contributes to the devel...

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“…Para explicar o infarto agudo do miocárdio (IAM) com artérias normais, inúmeros modelos fisiopatológicos [1][2][3][4][5] foram propostos, porém o enigma não foi totalmente desvendado, ficando o espasmo arterial e a agregação plaquetária com conseqüente trombose coronária, seguida de lise e reperfusão, as causas mais prováveis. A trombose coronária em artérias angiográficas normais [6][7][8] , embora não rara, quando presente em múltiplos vasos é incomum 9 , o que torna único o caso relatado.…”

Section: Discussionunclassified

“…A prevalência de IAM em indivíduos com artérias angiograficamente normais ou praticamente normais varia entre 1 a 12% 6,7,10,11 com incidência três vezes maior em homens 2 e, freqüentemente, envolve indivíduos jovens 2,6,7,12 com baixa incidência de fatores de risco para doença arterial coronária (DAC). A relação entre consumo de álcool etílico e eventos coronários é, em parte, conhecida.…”

Section: Discussionunclassified

Trombose em artérias coronárias normais causando infarto agudo do miocárdio em paciente alcoólatra

Pamplona¹,

Barduco²,

Vieira³

et al. 1997

Arq. Bras. Cardiol.

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Myocardial infarction with normal coronary arteries: A prospective clinical-angiographic study

Cited by 113 publications

References 38 publications

Síndromes coronarianas agudas na ausência de doença arterial coronariana significativa

Síndromes coronarianas agudas na ausência de doença arterial coronariana significativa

Coronary Artery Spasm and the Polymorphisms of the Endothelial Nitric Oxide Synthase Gene

Trombose em artérias coronárias normais causando infarto agudo do miocárdio em paciente alcoólatra

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