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Improved coronary artery flow after coronary angioplasty in patients with unstable angina.

BACKGROUND
Coronary artery flow is impaired after myocardial infarction but there is limited information regarding coronary flow in unstable angina.


AIM
To assess baseline coronary artery flow and the effects of coronary angioplasty on coronary flow in patients with unstable angina.


METHODS
Twenty-one patients with unstable angina with a culprit lesion suitable for coronary angioplasty were enrolled in the study. Coronary flow was assessed with the Thrombolysis In Myocardial Infarction (TIMI) grade and the Corrected TIMI Frame Count (CTFC) pre and post angioplasty.


RESULTS
Baseline flow was impaired in the culprit artery compared to the non culprit artery (42.0+/-28.1 vs 25.3+/-7.0 frames, p<0.02). Pre angioplasty coronary flow was TIMI grade 2 in 52% and TIMI grade 3 in 48% of patients. Post angioplasty flow improved with TIMI grade 2 flow in 5% and TIMI grade 3 in 95%. After angioplasty coronary flow improved from 42.0+/-28.1 frames to 21.6+/-16.3 (p=0.0001). The culprit coronary stenosis decreased from 74+/-9% pre angioplasty to 28+/-12% after intervention (p=0.0001).


CONCLUSIONS
Angioplasty and stenting of the culprit vessel restores normal coronary flow in most patients with unstable angina. This suggests that impaired flow in unstable angina is predominantly related to the culprit lesion residual stenosis.