Acute coronary syndromes: The degree and morphology of coronary stenoses

The best method for predicting future acute coronary events in patients with coronary artery disease has been difficult to determine. For instance, is the severity of coronary artery stenosis a good predictor of future acute coronary events? Past research in the late 1980s by Ambrose et al. and Little et al. indicated that it is not. Does the morphology of the coronary lesion help determine the clinical status or risk of subsequent occlusion? The historical article highlighted in this issue of the Journal was published by Ambrose et al. in 1985, and it indicated that morphology does assist the cardiologist in detecting high-risk lesions such as the type II eccentric lesions suggesting plaque disruption and thrombosis. The Ambrose classification of coronary lesions at risk is now used worldwide.