Sudden coronary death caused by pathologic intimal thickening without atheromatous plaque formation

Cardiovascular Pathology : the Official Journal of the Society for Cardiovascular Pathology
Fabio TavoraAllen Burke

Abstract

Atherosclerotic plaques progress from early lesions with little free cholesterol and lipid to late fibroatheromas with necrotic cores that may rupture. The frequency of severe coronary atherosclerosis without core formation in any artery in sudden coronary death is not known. We studied 314 hearts from 253 men and 61 women who died suddenly from severe coronary stenosis (≥ 1 epicardial artery with ≥ 75% luminal area narrowing) and with no other cause of death. If no section demonstrated any necrotic core, the designation was nonatheromatous atherosclerosis; if there was ≥ 1 necrotic core, the designation was atheromatous atherosclerosis. Plaques were scored for the presence of calcification, intimal inflammation, and neovasculature on a 5-point scale. Plaque burden was estimated semiquantitatively. In 22 men (9%) and 14 women (23%), there were no necrotic cores in any plaque (nonatheromatous atherosclerosis). Fourteen of these 36 nonatheromatous atherosclerosis cases had focal acute thrombus due to erosion (39%). Of the remaining 278 cases (atheromatous atherosclerosis), acute erosions were present in 25 (9%; P<.0001). Sudden death due to nonatheromatous atherosclerosis occurred more frequently in women (P<.001), in Blacks (20%...Continue Reading

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Citations

Jun 15, 2011·Circulation Journal : Official Journal of the Japanese Circulation Society·Yasumi UchidaNobuyuki Hiruta
Feb 18, 2016·Current Cardiology Reports·Jonathan A BattyVijay Kunadian
Jan 23, 2016·Thrombosis and Haemostasis·Stephen J WhiteThomas W Johnson
Aug 25, 2011·Cardiovascular Pathology : the Official Journal of the Society for Cardiovascular Pathology·Giulia Ottaviani
Apr 2, 2014·Cardiovascular Pathology : the Official Journal of the Society for Cardiovascular Pathology·Marja-Leena Kortelainen, Katja Porvari
Sep 13, 2016·Cardiovascular Pathology : the Official Journal of the Society for Cardiovascular Pathology·Giulia Ottaviani, L Maximilian Buja
Feb 14, 2018·Journal of the American Heart Association·Isabella AlbaneseAdel Schwertani
Jan 16, 2018·Circulation Journal : Official Journal of the Japanese Circulation Society·Haibo JiaBo Yu
Apr 2, 2021·Scientific Reports·Michael McElroyStephen J White
May 20, 2018·International Journal of Cardiology·Stefania RizzoMarie-Luce Bochaton-Piallat

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