Quantitative Coronary Artery Motion Analysis Predicts the Location of Future ST Segment Elevation Myocardial Infarctions

Background: Coronary artery motion may contribute to the development of plaques that rupture and cause acute myocardial infarctions. This study evaluates whether a quantitative measure of the compression type of coronary artery motion obtained from analysis of coronary angiograms can predict the location of culprit lesions in patients who have subsequent myocardial infarction. Method: 28 patients were identified with coronary angiography performed on at least two occasions: related to primary or rescue percutaneous coronary intervention for a STEMI and coronary angiography before this that was available for review. These angiograms were used to determine a quantitative index of coronary artery motion (QCAM) (the ratio of the section lengths i.e. systolic length/diastolic length). The culprit section was subsequently identified and QCAM of this section was compared to non-culprit sections. Results: The two sample t-test comparing QCAM for the non-culprit and culprit sections was highly statistically significant with a p-value of 0.0004. The generalized linear mixed model with culprit section as the dependent variable and QCAM as the independent variable also showed a statistically significant result with a p-value of 0.026. Conclusion: QCAM is a predictor of the location of culprit lesions causing future ST segment elevation myocardial infarctions. Predicting the location of future culprit lesions using coronary angiography may allow targeted therapy to prevent myocardial infarctions.