Plaque erosion is a major substrate for coronary thrombosis in acute myocardial infarction

被引:334
作者
Arbustini, E
Dal Bello, B
Morbini, P
Burke, AP
Bocciarelli, M
Specchia, G
Virmani, R
机构
[1] IRCCS, Policlin San Matteo, Dept Pathol, I-27100 Pavia, Italy
[2] IRCCS, Policlin San Matteo, Dept Cardiol, I-27100 Pavia, Italy
[3] Armed Forces Inst Pathol, Dept Cardiovasc Pathol, Washington, DC 20306 USA
关键词
plaque erosion; rupture; acute myocardial infarction;
D O I
10.1136/hrt.82.3.269
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective-To evaluate the prevalence of plaque erosion as a substrate for coronary thrombosis. Design-Pathological study in patients with acute myocardial infarction not treated with thrombolysis or coronary interventional procedures. Patients-298 consecutive patients (189 men, mean (SD) age 66 (11) years; 109 women, 74 (8) years) dying in hospital between 1984 and 1996 from acute myocardial infarction, diagnosed by ECG changes and rise in cardiac enzymes. Main outcome measures-Histopathological determination of plaque erosion as substrate for acute thrombosis; location and histological type of coronary thrombosis; acute and healed myocardial infarcts; ventricular rupture. Results-Acute coronary thrombi were found in 291 hearts (98%); in 74 cases (25%; 40/107 women (37.4%) and 34/184 men (18.5%); p = 0.0004), the plaque substrate for thrombosis was erosion. Healed infarcts were found in 37.5% of men v 22% of women (p = 0.01). Heart rupture was more common in women than in men (22% v 10.5%, p = 0.01). The distribution of infarcts, thrombus location, heart rupture, and healed infarcts was similar in cases of plaque rupture and plaque erosion. Conclusions-Plaque erosion is an important substrate for coronary thrombosis in patients dying of acute myocardial infarction. Its prevalence is significantly higher in women than in men.
引用
收藏
页码:269 / 272
页数:4
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