The Significance Of Multiple Plaque Disruptions In Patients With Acute Coronary Disease | 16534
Journal of Clinical & Experimental Cardiology
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Multiple plaque disruptions (PD?s) are common in patients with acute coronary disease (ACD), but many are
frequently unrecognized at the time of coronary angiography. The natural history of these PD?s has not been determined, but
they are potentially unstable because they are exposed to flowing blood.
Materials and Methods:
The hearts of 83 patients who died of ACD were injected with a colored barium gelatin mass, fixed
in formalin, the coronary arteries dissected from the heart, decalcified, cut at 2-3 mm intervals and all segments mounted for
211 PD?s were identified in these 83 patients with 32 patients (39%), having 3 or more PD?s. Luminal thrombosis was
associated with 102 PD?s (48%), with 97 (95%) located at sites with >70% stenosis. 109 PD?s were not associated with luminal
thrombosis, with 69 (63%) located in segments with <70% stenosis.
Multiple PD?s are common in patients who die of ACD, are often present without luminal thrombosis, and are
frequently present in plaques causing insignificant stenosis. These PD?s are potentially unstable and could be the substrate for
the rapid progression of insignificant lesions.
Richard J. Frink is the Principal Investigator of the Heart Research Foundation of Sacramento. He received his training at the University of Iowa, the Mayo Clinic and
the University of Alabama in Birmingham. He practiced invasive cardiology in Sacramento, California for 35 years and established a laboratory to study the post-
mortem heart. He has published approximately 25 research papers and a book, Inflammatory Atherosclerosis: Characteristics of the Injurious Agent, detailing the
pathologic findings in patients who died of acute coronary disease. The primary focus of his work has been the pathogenesis of atherosclerosis and the mechanism
responsible for sudden cardiac death.
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