SUDDEN CORONARY DEATH - FREQUENCY OF ACTIVE CORONARY LESIONS, INACTIVE CORONARY LESIONS, AND MYOCARDIAL-INFARCTION
SUDDEN CORONARY DEATH - FREQUENCY OF ACTIVE CORONARY LESIONS, INACTIVE CORONARY LESIONS, AND MYOCARDIAL-INFARCTION
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DOI：
10.1161/01.cir.92.7.1701
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发表时间：
1995-10-01
期刊：
影响因子：
37.8
通讯作者：
VIRMANI, R
中科院分区：
文献类型：
--
作者：
FARB, A;TANG, AL;VIRMANI, R
研究背景在以往的研究中，冠状动脉粥样硬化性猝死（冠心病猝死）中活动性冠状动脉病变（斑块破裂和冠状动脉血栓形成）的发生率为80%。在没有活动性冠状动脉病变的心脏中，猝死通常归因于心肌梗死愈合。本研究的目的是确定的频率，积极和不积极的冠状动脉病变和心肌梗死的个人与冠心病猝死。方法和结果的心脏的人谁死于冠心病猝死的结果进行灌注固定和死后血管造影。活动性冠状动脉病变定义为斑块破裂、管腔纤维蛋白/血小板血栓或两者兼而有之。我们将非活动性病变定义为横截面管腔狭窄大于或等于75%，无斑块破裂或管腔血栓。检查了90个心脏（来自72名男性和18名女性;死亡时的平均年龄为51 ± 10岁）。19例患者出现急性心肌梗死（21% [仅9例急性心肌梗死，10例急性心肌梗死和已愈合心肌梗死]），37例患者仅出现已愈合心肌梗死（41%），34例患者无心肌梗死（38%）。在51例（57%）中发现了活动性冠状动脉病变：27例急性血栓加破裂斑块，21例仅急性血栓，3例仅破裂斑块。在急性心肌梗死的心脏中，活动性冠状动脉病变的发生率明显高于仅治愈心肌梗死的心脏或缺乏急性或治愈心肌梗死的心脏（分别为89%、46%和50%; P
Background The reported frequency of active coronary lesions (plaque rupture and coronary thrombosis) in sudden death due to coronary artery atherosclerosis (sudden coronary death) has varied from 80% of cases in previous series. In hearts lacking an active coronary lesion, sudden death has usually been attributed to a healed myocardial infarction. The purpose of the present study was to determine the frequency of active and inactive coronary lesions and myocardial infarction in individuals with sudden coronary death.Methods and Results The hearts of persons who died as a result of sudden coronary death underwent perfusion-fixation and postmortem angiography. An active coronary lesion was defined as a disrupted plaque, luminal fibrin/platelet thrombus, or both. We defined an inactive lesion as having a cross-sectional luminal stenosis of greater than or equal to 75% with neither plaque disruption nor luminal thrombus. Ninety hearts were examined (from 72 men and 18 women; mean age at the time of death, 51+/-10 years). Acute myocardial infarction was present in 19 (21% [acute myocardial infarction only in 9, both acute and healed myocardial infarction in 10]), healed myocardial infarction only in 37 (41%), and no myocardial infarction in 34 (38%). Active coronary lesions were identified in 51 (57%): acute thrombi plus disrupted plaques in 27, acute thrombi only in 21, and disrupted plaques only in 3. In hearts with acute myocardial infarction, active coronary lesions were significantly more prevalent than in hearts with only healed myocardial infarction or hearts lacking an acute or a healed myocardial infarction (89%, 46%, and 50%, respectively; P