Coronary arteriographic findings in acute transmural myocardial infarction.
Level 4 - case-series / case-control
Observational case series with angiographic and surgical confirmation
What was done
Coronary arteriography and left ventriculography were performed within 24 hours of symptom onset in 517 patients with acute transmural myocardial infarction. Patients were evaluated across three time intervals: within 6 hours (n = 368), 6 to 12 hours (n = 85), and 12 to 24 hours (n = 64). Arteriographic findings of total occlusion and intraluminal thrombosis were assessed and correlated with surgical exploration findings.
What was found
Total coronary occlusion and coronary thrombosis were most prevalent in the group evaluated within 6 hours from symptom onset, declining significantly in the 6–12 and 12–24 hour groups. Within the first 6 hours, coronary thrombus was identified arteriographically and confirmed surgically in approximately 80% of patients. Specific numerical counts and percentages for the 6–12 hour and 12–24 hour cohorts were not reported in the abstract.
Why it matters
This landmark study provided direct in vivo angiographic and surgical evidence that acute intraluminal coronary thrombosis is the primary mechanism causing transmural myocardial infarction, establishing the rationale for early emergency reperfusion therapies.
Limits
The study is an uncontrolled observational case series limited to patients selected for early catheterization and surgery. Exact event rates, statistical values, and subgroup figures beyond the 6-hour window are omitted from the abstract.
Cited by
- supports Approximately 80 percent of heart attacks are caused by a blood clot rather than plaquing alone.