Joly P, Geslin P, Raynaud P, Slama M
Clinique Résidence du Parc, Marseille.
Arch Mal Coeur Vaiss. 1993 Dec;86(12):1675-81.
Non-Q wave myocardial infarction is associated with a high recurrence rate of ischaemic events (angina and infarction). The artery responsible for the infarction is usually patent but stenosed and seems to be the cause of these complications. This prospective multicenter series of 66 patients treated by Heparin, Aspirin, Diltiazem and undergoing coronary angiography during the hospital period studied the artery responsible for the infarction and the value of coronary angiography in this setting. Several conclusions were drawn from the results: the precise diagnosis of the artery responsible for the infarct may be difficult (14%); the left circumflex artery or one of its branches is often implicated (47%); non-Q wave infarction is a various and heterogeneous group, including: infarctions located on small branch arteries, "warning" ischaemic episodes in the left anterior descending artery territory. definitive infarction of the left circumflex artery territory; nevertheless, this group is an intermediate state between Q wave infarction and unstable angina (low occlusion rate 26% and angiographic lesional appearances similar to those of unstable angina); early coronary angiography (48-72 h) seems to be useful to improve prevention of ischaemic recurrences by adequate revascularisation.
非Q波心肌梗死与缺血性事件（心绞痛和梗死）的高复发率相关。导致梗死的动脉通常是通畅的，但有狭窄，似乎是这些并发症的原因。本前瞻性多中心研究纳入了66例在住院期间接受肝素、阿司匹林、地尔硫䓬治疗并接受冠状动脉造影的患者，研究了导致梗死的动脉以及冠状动脉造影在此情况下的价值。从结果中得出了几个结论：确定导致梗死的动脉可能困难（14%）；左旋支动脉或其分支之一常受累（47%）；非Q波梗死是一个多样且异质性的组，包括：位于小分支动脉的梗死、左前降支动脉区域的“预警”缺血发作、左旋支动脉区域的明确梗死；然而，该组是Q波梗死和不稳定型心绞痛之间的中间状态（低闭塞率26%，血管造影病变表现与不稳定型心绞痛相似）；早期冠状动脉造影（48 - 72小时）似乎有助于通过适当的血运重建改善缺血复发的预防。
