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급성심근경색증 환자의 관상동맥 및 좌심실 조영 소견

Other Titles
 Coronary and Left Ventricular Angiographic Findings of Patients with Acute Myocardial Infarction 
Authors
 홍명기  ;  조승연  ;  홍범기  ;  이문형  ;  김한수  ;  권혁문  ;  장양수  ;  정남식  ;  심원흠 
Citation
 Korean Circulation Journal (순환기), Vol.24(5) : 601-611, 1994-10 
Journal Title
KOREAN CIRCULATION JOURNAL(순환기)
ISSN
 1738-5520 
Issue Date
1994-10
Keywords
Acute myocardial infarction ; Coronary angiography
Abstract
Background
Results of recent studies have suggested that the extent and severity of coronary artery disease and the degree of left ventricular dysfunction are two major factors influencing survival in patients with acute myocardial infarction. Although non-invasive modalities including exercise stress electrocardiography, echocardiography and nuclear cardiologic techniques can predict the prognosis of patients with acute myocardial infarction to an extent, coronary angiography is still the best modality for exact evaluation of the severity and the extent of coronary artery disease.

Methods
A review was done from January, 1985, to August, 1993, on 631 patients with acute myocardial infarction who underwent coronary angiography with or without left ventricular angiography within 30 days after onset of acute myocardial infarction at Yonsei University Severance Hospital.

Results
1) The mean age of the 631 patients was 55.2 years(23-82 years). Five hundred thirty three(84.5%) were males and 98(15.5%) were females. The prevalences of coronary artery disease were high in the 5th decade in males and in the 6th decade in females.

2) The major risk factors were cigarette smoking(69.6%), hypertension(34.9%), diabetes mellitus(18.9%), and hypercholesterolemia(12.3%). Cigarette smoking was statistically more frequent in males and hypertension was more frequent in female.

3) Of the 631 patients studied, 570 patients(90.3%) had Q wave myocardial infarction and 61 patients(9.7%) had a non-Q wave myocardial infarction. 33 patients(5.2%) had a history of previous myocardial infarction.

4) The coronary angiogram showed 25 patients(4.0%) had normal coronary anatomy and 29 patients(4.6%) had minimal coronary vessel lesions. Lesions greater than 50% were confined to one major artery in 309 patients(49.0%), whereas two-and three-vessel disease were found in 179(28.3%) and 83(13.1%) patients respectively.

5) The normal or minimal lesion coronary anatomy and one-vessel disease were significantly frequent in patients under 40 years of age. However, multi-vessel disease was significantly more frequent in patients over 40 years of age.

6) The patients who had a history of cigarette smoking often had more normal or minimal lesion coronary anatomy, one vessel disease and less multi-vessel disease, compared with those without a history of cigarette smoking. The patients with hypertension had more multi-vessel disease and less normal or minimal lesion coronary anatomy, one vessel disease. The patients with diabetes mellitus had less one vessel disease and more multi-vessel disease.

7) According to the site of infarction, anterior myocardial infarction was associated with more prevalence in normal or minimal lesion coronary anatomy, one vessel disease, inferior myocardial infarction was associated with more prevalence in multi-vessel disease.

8) The infarct related artery was the left anterior descending artery in 5.3.7%, the right coronary artery in 35.9%, the left circumflex artery in 10.3%. Additionally, there was one case of anterior myocardial infarction associated with the left main coronary artery occlusion.

9) With the passage of time, there was a decrease of total occlusion in all cases whether thrombolytic therapy was administered or not. The patients with thrombolytic therapy had a lower total occlusion rate of infarct related artery compared with those without thrombolytic therapy.

10) The left ventricular ejection fraction was higher in the patients with non-Q wave infarction than in those with Q wave infarction. The left ventricular ejection fraction was higher in the patients with thrombolytic therapy in comparison with those who did not receive thrombolytic therapy.

Conclusion
The coronary angiographic findings of patients with acute myocardial infarction showed higher prevalence of one vessel disease, and more frequent onset of myocardial infarct under 40 years of age with normal or minimal lesion coronary anatomy. Thrombolytic therapy administered to patients with acute myocardial infarction resulted in the beneficial effects of decreased total occlusion rate of the infarct related artery and improved left ventricular function.
DOI
10.4070/kcj.1994.24.5.601
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kwon, Hyuck Moon(권혁문) ORCID logo https://orcid.org/0000-0001-9901-5015
Lee, Moon-Hyoung(이문형) ORCID logo https://orcid.org/0000-0002-7268-0741
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
Hong, Bum Kee(홍범기) ORCID logo https://orcid.org/0000-0002-6456-0184
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/195267
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