COMPOSITION OF ATHEROSCLEROTIC PLAQUES IN CORONARY-ARTERIES IN WOMEN LESS-THAN-40 YEARS OF AGE WITH FATAL CORONARY-ARTERY DISEASE AND IMPLICATIONS FOR PLAQUE REVERSIBILITY

This study analyzes the composition of atherosclerotic plaques in the 4 major epicardial coronary arteries in 8 women < 40 years of age (mean 34) with fatal coronary artery disease (CAD) and compares these data to previous studies of 37 adults > 45 years of age (mean 59) with fatal CAD. Histologic sections were taken at 5-mm intervals from the entire lengths of the right, left main, left anterior descending and left circumflex coronary arteries. With the use of a computerized morphometry system, analysis of the 4 major epicardial coronary arteries showed the major component of plaque to be a combination of cellular (mean percent total plaque area = 65%, standard error = 6%) and dense (19%, standard error = 6%) fibrous tissue. Arterial segments narrowed > 75% in cross-sectional area from these young women were compared with similarly narrowed arteries from 37 older patients (32 men [86%]) with fatal CAD previously reported by this laboratory, and showed significantly more cellular fibrous tissue and lipid-rich foam cells, and lesser amounts of dense fibrous and heavily calcified tissue. The large amount of lipid-containing foam cells and relative lack of acellular scar tissue in coronary plaques in these young women suggests a greater potential for reversibility of these plaques in this subset of patients with CAD.