Non-ST elevation myocardial infarction: A new pathophysiological concept could solve the contradiction between accepted cause and clinical observations

Acta Physiologica Hungarica

Volumn 98, Issue 3, 2011, Pages 252-261

  Medvegy, Mihály ^a   Simonyi, G ^a   Medvegy, N ^b   Pecsvarady Zs ^a  

^a Pest Megyei Flor Ferenc Korhaz   (Hungary)

^b KRKA Hungary Ltd   (Hungary)

Author keywords

acute coronary syndrome; microcirculation; myocardial infarction

Indexed keywords

AUTOPSY; CLINICAL EVALUATION; CORONARY ARTERY DISEASE; DISEASE COURSE; ELECTROCARDIOGRAM; FALSE POSITIVE RESULT; HEART MUSCLE BLOOD FLOW; HEART MUSCLE CONDUCTION DISTURBANCE; HEART MUSCLE REVASCULARIZATION; HEART REPOLARIZATION; HEMODYNAMIC PARAMETERS; ISCHEMIC HEART DISEASE; MICROCIRCULATION; NON ST SEGMENT ELEVATION MYOCARDIAL INFARCTION; REVIEW; ST SEGMENT ELEVATION MYOCARDIAL INFARCTION; SUPRAVENTRICULAR TACHYCARDIA; SYSTEMATIC REVIEW (TOPIC); TREATMENT CONTRAINDICATION; TREATMENT PLANNING; VASCULAR RESISTANCE;

ANIMALS; CORONARY ARTERY DISEASE; CORONARY CIRCULATION; EVIDENCE-BASED MEDICINE; HUMANS; MICROCIRCULATION; MYOCARDIAL INFARCTION; PROGNOSIS; RISK ASSESSMENT; RISK FACTORS; SEVERITY OF ILLNESS INDEX; VASCULAR RESISTANCE;

EID: 80052553720     PISSN: 0231424X     EISSN: 15882683     Source Type: Journal    
DOI: 10.1556/APhysiol.98.2011.3.2     Document Type: Review

References (48)

1. Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE, Chavey WE, Fesmire FM, Hochman JS, Levin TN, Lincoff AM, Peterson ED, Theroux P, Wenger NK, Wright RS: ACC/AHA 2007 Guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction. J. Am. Coll. Cardiol. 50, 1-157 (2007)
2. Antaloczy Z, Barcsák J, Magyar E: Correlation of electrocardiologic and pathologic findings in 100 cases of Q wave and non-Q wave myocardial infarction. J. Electrocardiol. 21, 331-335 (1988) (Pubitemid 19010388)
3. Athyros VG, Papageorgiou AA, Mercouris BR, Athyrou VV, Symeonidis AN, Basayannis EO, Demitriadis DS, Kontopoulos AG: Treatment with atorvastatin to the National Cholesterol Educational Program goal versus 'usual' care in secondary coronary heart disease prevention. The GREek Atorvastatin and Coronary-heartdisease Evaluation (GREACE) study. Curr. Med. Res. Opin. 18, 220-228 (2002)
4. Authors/Task Force Members, Bassand JP, Hamm CW, Ardissino D, Boersma E, Budaj A, Fernandez-Aviles F, Fox KAA, Hasdai D, Ohman EM, Wallentin L, Wijns W: Guidelines for the diagnosis and treatment of non-STsegment elevation acute coronary syndromes. Eur. Heart. J. 28, 1598-1660 (2007)
5. Banyai S, Banyai M, Falger J, Jansen M, Alt E, Derfler K, Koppensteiner R: Atorvastatin improves blood rheology in patients with familial hypercholesterolemia (FH) on long-term LDL apheresis treatment. Atherosclerosis 159, 513-519 (2001) (Pubitemid 33127266)
6. Braunwald E, Antman EM, Beasley JW, Califf RM, Cheitlin MD, Hochman JS, Jones RH, Kereiakes D, Kupersmith J, Levin TN, Pepine CJ, Schaeffer JW, Smith EE 3rd, Steward DE, Theroux P, Gibbons RJ, Alpert JS, Faxon DP, Fuster V, Gregoratos G, Hiratzka LF, Jacobs AK, Smith SC Jr: ACC/AHA 2002 guideline updatefor the management of patients with unstable angina and non-ST-segment elevation myocardial infarction. J. Am. Coll. Cardiol. 40, 1366-1374 (2002)
7. Brush JE Jr, Cannon RO 3rd, Schenke Wh, Bonow RO, Leon MB, Maron BJ, Epstein SE: Angina due to microvascular disease in hypertensive patients without left ventricular hypertrophy. N. Eng. J. Med. 319, 1302-1307 (1988) (Pubitemid 19003391)
8. Budaj A, Yusuf S, Mehta S, Fox K, Tognoni G, Zhao F, Chrolavicius S, Hunt D, Keltai M, Franzosi: For the Clopidogrel in Unstable angina to prevent Recurrent Events (CURE) Trial Investigators. Benefit of clopidogrel in patients with acute coronary syndromes without ST-segment elevation in various risk groups. Circulation 10, 1622-1626 (2002)
9. Camici PG, Crea F: Medical progress: Coronary microvascular dysfunction. N. Eng. J. Med. 356, 830-840 (2007)
10. Cannon RO, Epstein SE: "Microvascular angina" as a cause of chest pain with angiographically normal coronary arteries. Am. J. Cardiol. 61, 1338-1343 (1988)
11. Crea F, Lanza GA: Angina pectoris and normal coronary arteries: Cardiac syndrome X. Heart 90, 457-463 (2004) (Pubitemid 38406928)
12. de Lemos JA, Blazing MA, Wiviott SD, Lewis EF, Fox KA, White HD, Rouleau JL, Pedersen TR, Gardner LH, Mukherjee R, Ramsey KE, Palmisano J, Bilheimer DW, Pfeffer MA, Califf RM, Braunwald E: A to Z Investigators. Early intensive vs a delayed conservative simvastatin strategy in patients with acute coronary syndromes: Phase Z of the A to Z trial. JAMA 292, 1307-1316 (2004) (Pubitemid 39223221)
13. Deanfield JE, Detry JM, Sellier P, Lichtlen PR, Thaulow E, Bultas J, Brennan C, Young ST, Beckerman B: CAPE II Trial Investigators. Medical treatment of myocardial ischemia in coronary artery disease: Effect of drug regime and irregular dosing in the CAPE II trial. J. Am. Coll. Cardiol. 40, 917-925 (2002) (Pubitemid 34994985)
14. Di Stefano R, Di Bello V, Barsotti MC, Grigoratos C, Armani C, Dell'Omodarme M, Carpi A, Balbarini A.: Inflammatory markers and cardiac function in acute coronary syndrome: Difference in ST-segment elevation myocardial infarction (STEMI) and in non-STEMI models. Biomed. Pharmacother. 63(10), 773-780 (2009)
15. Dujovne CA, Harris WS, Altman R, Overhiser RW, Black DM: Effect of atorvastatin on hemorheologichemostatic parameters and serum fibrinogen levels in hyperlipidemic patients. Am. J. Cardiol. 85, 350-353 (2000) (Pubitemid 30052909)
16. Ernst E, Hammerschmidt DE, Bagge U, Matrai A, Dormandy JA: Leukocytes and the risk of ischemic heart diseases. JAMA, 257, 2318-2324 (1987) (Pubitemid 17059605)
17. Fox K, Ford I, Steg PG, Tendera M, Ferrari: On behalf of the BEAUTIFUL. Ivabradine for patients with stable coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): A randomized, double-blind, placebo-controlled trial. Lancet DOI:10.1016/S0140-6736(08)61170-8 (2008)
18. Fox KM: EURopean trial on reduction of cardiac events with Perindopril in stable coronary Artery disease Investigators. Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease: Randomised, double-blind, placebo-controlled, multicentre trial (the EUROPA study). Lancet 362, 782-788 (2003) (Pubitemid 37093919)
19. Jorgensen B, Simonsen S, Endresen K, Forfang K, Vatne K, Hansen J, Webb J, Buller C, Goulet G, Erikssen J, Thaulow E: Restenosis and clinical outcome in patients treated with amlodipine after angioplasty: Results from the Coronary AngioPlasty Amlodipine REStenosis Study (CAPARES). J. Am. Coll. Cardiol. 35, 592-599 (2000) (Pubitemid 30170253)
20. Kobaladze SG, Tschikvadze IV: The use of pentoxiphyllin in the treatment of ischemic heart disease. Current Medical Research and Opinion 6(s4), 12-14 (1979) (Pubitemid 10194318)
21. LaRosa JC, Grundy SM, Waters DD, Shear C, Barter P, Fruchart JC, Gotto AM, Greten H, Kastelein JJ, Shepherd J, Wenger NK: Treating to New Targets (TNT) Investigators. Intensive lipid lowering with atorvastatin in patients with stable coronary disease. N. Engl. J. Med. 352, 1425-1435 (2005) (Pubitemid 40471450)
22. Lauer MA, Houghtaling PI, Peterson JG, Granger CB, Bhatt DL, SappSK, Simoons ML, Harrington RA, Topol EJ, Lincoft A: And Platelet IIb/IIIa in Unstable Angina Receptor Suppression Using Integrilin Therapy (PURSUIT) trial investigators. Attenuation of rebound ischemia after discontinuation of heparin therapy by glycoprotein IIb/IIIa inhibition with eptifibatide in patients with acute coronary syndromes: Observations from the Platelet IIb/IIIa in Unstable angina: Receptor Suppression Using Integrilin Therapy (PURSUIT) trial. Circulation 104, 2772-2777 (2001) (Pubitemid 33126649)
23. Lerman A, Holmes DR, Herrmann J, Gersch BJ: Microcirculatory dysfunction in ST-elevation myocardial infarction: Cause, consequence, or both? Eur. Heart. J. Advance doi:10.1093/eurheartj/ehl501 Access published online on March 8, (2007) (Pubitemid 47343589)
24. Lowe G, Rumley A, Norrie J, Ford I, Shepherd J, Cobbe S, Macfarlane P, Packard C: Blood rheology, cardiovascular risk factors, and cardiovascular disease: The West of Scotland Coronary Prevention Study. Thromb. Haemost. 84, 533-538 (2000)
25. Marcus ML, Chilian WM, Kanatsuka H, Dellsperger KC, Eastham CL, Lamping KG: Understanding the coronary circulation through studies at microvascular level. Circulation 82, 1-7 (1990) (Pubitemid 20216309)
26. Marzilli M, Focardi M, Sambuceti G (2006): Microvascular function before and after coronary recanalization. In: The paradox of angina persisting after coronary revascularization. Ed.: Marzilli M, Paris, France: Elsevier, pp. 41-51
27. Marzilli M, Sambuceti G, Fedele S, L'Abbate A: Coronary microcirculatory vasoconstriction during ischemia in patients with unstable angina. J. Am. Coll. Cardiol. 35, 327-334 (2000) (Pubitemid 30125521)
28. Medvegy M, Savard P, Pintér A, Tremblay G, Nasmith JB, Palisaitis D., Duray G, Préda I, Nadeau RA: Simple, quantitative body surface potential map parameters in the diagnosis of remote Q-wave and non-Q-wave myocardial infarction. Can. J. Cardiol 20, 1109-1115 (2004) (Pubitemid 39302737)
29. Medvegy M, Nadeau RA, Szucs E, Szakolczai K, Simonyi G, Bauernfeind T, Szedlák M, Savard P, Palisaitis D, Préda I: Diagnosis and discrimination of remote antero- and inferoseptal non-Q wave myocardial infarctions with body surface potential mapping. Can. J. Cardiol 24, 53-55 (2008) (Pubitemid 351385404)
30. Medvegy M, Préda I, Savard P, Pintér A, Tremblay G, Nasmith J, Palisaitis D, Nadeau RA: A new body surface isopotential map evaluation method to detect minor potential losses in non-Q wave myocardial infarction. Circulation 101, 1115-1121 (2000) (Pubitemid 30146612)
31. Montalescot G, Dallongeville J, Van Belle E, Rouanet S, Baulac C, Degrandsart A, Vicaut E: STEMI and NSTEMI: Are they so different? 1-year outcomes in acute myocardial infarction as defined by the ESC/ACC definition (the Opera registry). Eur. Heart J. 28, 1409-1417 (2007) (Pubitemid 47343817)
32. Nissen SE, Tuzcu EM, Libby P, Thompson PD, Ghali M, Garza D, Berman L, Shi H, Buebendorf E, Topol EJ: CAMELOT Investigators. Effect of antihypertensive agents on cardiovascular events in patients with coronary disease and normal blood pressure: The CAMELOT study: A randomized controlled trial. JAMA 292, 2217-2225 (2004)
33. Pasqui AL, Di Renzo M, Bova G, Bruni F, Puccetti L, Pompella G, Auteri A: T cell activation and enhanced apoptosis in non-ST elevation myocardial infarction. Clinical and Experimental Medicine 3, 37-44 (2003) (Pubitemid 36649012)
34. Poldermans D, Boersma E, Bax JJ, Thomson IR, van de Ven LL, Blankensteijn JD, Baars HF, Yo TI, Trocino G, Vigna C, Roelandt JR, van Urk H: The effect of bisoprolol on perioperative mortality and myocardial infarction in high-risk patients undergoing vascular surgery. Dutch Echocardiographic Cardiac Risk Evaluation Applying Stress Echocardiography Study Group. New Engl. J. Med. 341, 1789-1794 (1999)
35. Rosenson RS: Statin therapy: New therapy for cardiac microvascular dysfunction. Eur. Heart J. 24, 1993-1994 (2003) (Pubitemid 37420443)
36. Rott D, Leibowitz D: STEMI and NSTEMI are two distinct pathophysiological entities. Eur. Heart J. 28, 2685 (2007) (Pubitemid 350071513)
37. Rubio R, Berne RM: Regulation of coronary blood flow. Prog. Cardiovasc. Dis. 18, 105-136 (1975)
38. Sambuceti G, Marzilli M, Fedele S, Marini C, L'Abbate A: Paradoxical increase in microvascular resistance during tachycardia downstream from a severe stenosis in patients with coronary artery disease: Reversal by angioplasty. Circulation 103, 2352-2360 (2001) (Pubitemid 32448799)
39. Sambuceti G, Marzilli M, Mari A, Marini C, Schluter M, Testa R, Papini M, Marraccini P, Ciriello G, Marzullo P, L'Abbate A: Coronary microcirculatory vasoconstriction is heterogeneously distributed in acutely ischemic myocardium. Am. J. Physiol. Heart Circ. Physiol. 288, H2298-H2305 (2005) (Pubitemid 40604118)
40. Sato H, Iida H, Tanaka A, Tanaka H, Shimodouzono S, Uchida E, Kawarabayashi T, Yoshikawa J: The decrease of plaque volume during percutaneous coronary intervention has a negative impact coronary flow in acute myocardial infarction: A major role of percutaneous coronary intervention-induced embolization. J. Am. Coll. Cardiol. 44, 300-304 (2004) (Pubitemid 38950586)
41. Schwartz GG, Olsson AG, Ezekowitz MD, Ganz P, Oliver MF, Waters D, Zeiher A, Chaitman BR, Leslie S, Stern T: Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) Study Investigators. Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes: The MIRACL study: A randomized controlled trial. JAMA 285, 1711-1718 (2001) (Pubitemid 32259905)
42. Shepherd J, Blauw GJ, Murphy MB, Bollen EL, Buckley BM, Cobbe SM, Ford I, Gaw A, Hyland M, Jukema JW, Kamper AM, Macfarlane PW, Meinders AE, Norrie J, Packard CJ, Perry IJ, Stott DJ, Sweeney BJ, Twomey C, Westendorp RG: PROSPER study group. PROspective Study of Pravastatin in the Elderly at Risk. Pravastatin in elderly individuals at risk of vascular disease (PROSPER): A randomised controlled trial. Lancet 360, 1623-1630 (2002) (Pubitemid 35379733)
43. Steen H, Giannitsis E, Futterer S, Merten C, Juenger C, Katus HA: Cardiac troponin T at 96 hours after acute myocardial infarction correlates with infarct size and cardiac function. J. Am. Coll. Cardiol. doi:10.1016/j. jacc.2006.06.002 published online Nov 8 (2006)
44. Stenestrand U, Wallentin L: For the Swedish Register of Cardiac Intensive Care (RIKS-HIA). Register of Information and Knowledge About Swedish Heart Intensive Care Admissions. JAMA 285, 430-436 (2001)
45. Sweetnam PM, Thomas HF, Yarnell JWG, Beswick AD, Baker IA, Elwood PC: Fibrinogen, viscosity and the 10-year incidence of ischemic heart disease. Eur. Heart J. 17, 1814-1820 (1996)
46. Szucs E, Szakolczai K, Simonyi G, Bauernfeind T, Pintér A, Préda I, Medvegy M: Diagnostic value of body surface potential mapping in assessment of the coronary artery lesion after angina pectoris and without repolarization changes on the ECG. J. Electrocardiol. 49(4), 326-335 (2010)
47. TIMI III-B Investigators: Effects of tissue plasminogen activator and a comparison of early invasive and conservative strategies in unstable angina and non-Q wave myocardial infarction: Results of the TIMI IIIB trial. Thrombolysis In Myocardial Ischaemia. Circulation 89, 1545-1556 (1994)
48. Yusuf S, Sleight P, Pogue J, Bosch J, Davies R, Dagenais G: Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators. New Eng. J. Med. 342, 145-153 (2000) (Pubitemid 30051645)