A COMPARISON OF CORONARY ANGIO GRAPHY RE SULTS IN PATIENTS WI TH STABLE AND UNSTABLE ANGIN A PECTORIS

To study the newly mentioned significance of the obstructive lesion morphology in coronary artery disease (CAD), a study has been designed to compare this feature between patients having stable angina (SA) or unstable angina (UA) who underwent coronary angiography in Tehran Heart Institute. Study objectives were detection of the angina producing artery (AP A) and its morphologic lesion type, detection of the number of diseased vessels, determining the left ventricular ejection fraction (L VEF) and end-diastolic pressure (L VEDP), and comparing these findings between the two patient groups. The study population consisted of 205 patients, 141 with SA and 64 with U A, who underwent standard coronary angiography. Lesion types were divided to type I, concentric lesions type IIA, eccentric broad neck lesions type IIB, eccentric narrow base lesions and type Ill, multiple lesions. There was no difference in L VEF or L VEDP in the two angina group patients. In the SA group the APA lesion was type I in 25%, type IIA in 39%, type lIB in 9%, and type III in 27% of patients, while these figures were 9.3%, 5.6%, 31.5% and 53.7% respectively in the VA group. The APA in the SA group was the left main stem in 5.7%, the left anterior descending in 41.8% the left circumflex in 14.2%, the right coronary artery in 14.2%, and neither of these vessels in 29.1 %. For the VA group, these figures wereO.54%, 21.9%.14.1 %, and 9.9%, respectively. Review of these results reveals that although there was no quantitative difference between the two groups, the qualitative lesion type differences were significant, a finding in accordance with some theories that focus on atherosclerotic plaque rupture as the etiology of VA.