THROMBOSIS AND ACUTE CORONARY-ARTERY LESIONS IN SUDDEN CARDIAC ISCHEMIC DEATH
THROMBOSIS AND ACUTE CORONARY-ARTERY LESIONS IN SUDDEN CARDIAC ISCHEMIC DEATH
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DOI：
10.1056/nejm198405033101801
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发表时间：
1984-01-01
影响因子：
158.5
通讯作者：
THOMAS, A
中科院分区：
文献类型：
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作者：
DAVIES, MJ;THOMAS, A
心脏缺血性猝死的病理损害的性质存在争议。在100名死于缺血性心脏病的受试者中，74人发现了冠状动脉血栓。在< 15分钟内死亡的患者之间的发病率没有差异，15-60 min死亡组和1 h后死亡组。在26例无腔内血栓的病例中，21例发现斑块破裂，因此，仅5例未显示急性动脉病变。在年龄匹配的对照组中没有发现腔内血栓。在74例血栓中，48例位于先前存在的高度狭窄部位; 14例位于先前狭窄<管腔直径50%的部位。血栓中47%位于右冠状动脉。左前降支病变仅占30%。缺血性猝死的病理过程涉及快速发展的冠状动脉病变，其中存在斑块破裂和血栓形成。这些发现对于通过抗血栓治疗预防心脏性猝死具有重要意义。
The nature of the pathologic lesion in sudden cardiac ischemic death is in dispute. Among 100 [human] subjects who died of ischemic heart disease in < 6 h, coronary thrombi were found in 74. There was no difference in incidence between those who died in < 15 min., those who died in 15-60 min, and those who died after 1 h. Among 26 cases without an intraluminal thrombus, plaque fissuring was found in 21; thus, in only 5 cases was no acute arterial lesion demonstrated. No intraluminal thrombi were found in age-matched controls. Of the 74 thrombi, 48 were found at sites of preexisting high-grade stenosis; 14 were found at points of previous stenosis of < 50% of the diameter of the lumen. Of the thrombi, 47% were found in the right coronary artery. Only 30% were found in the left anterior descending coronary artery. The pathologic process in sudden ischemic death involves a rapidly evolving coronary-artery lesion in which plaque fissuring and resultant thrombus formation are present. These findings have implications for the prevention of sudden cardiac death by antithrombotic therapy.