Arbustini E, Dal Bello B, Morbini P, Burke A P, Bocciarelli M, Specchia G, Virmani R
Department of Pathology, IRCCS-Policlinico San Matteo, Via Forlanini 16, 27100 Pavia, Italy.
Heart. 1999 Sep;82(3):269-72. doi: 10.1136/hrt.82.3.269.
To evaluate the prevalence of plaque erosion as a substrate for coronary thrombosis.
Pathological study in patients with acute myocardial infarction not treated with thrombolysis or coronary interventional procedures.
298 consecutive patients (189 men, mean (SD) age 66 (11) years; 109 women, 74 (8) years) dying in hospital between 1984 and 1996 from acute myocardial infarction, diagnosed by ECG changes and rise in cardiac enzymes.
Histopathological determination of plaque erosion as substrate for acute thrombosis; location and histological type of coronary thrombosis; acute and healed myocardial infarcts; ventricular rupture.
Acute coronary thrombi were found in 291 hearts (98%); in 74 cases (25%; 40/107 women (37.4%) and 34/184 men (18.5%); p = 0.0004), the plaque substrate for thrombosis was erosion. Healed infarcts were found in 37.5% of men v 22% of women (p = 0.01). Heart rupture was more common in women than in men (22% v 10.5%, p = 0.01). The distribution of infarcts, thrombus location, heart rupture, and healed infarcts was similar in cases of plaque rupture and plaque erosion.
Plaque erosion is an important substrate for coronary thrombosis in patients dying of acute myocardial infarction. Its prevalence is significantly higher in women than in men.
评估斑块侵蚀作为冠状动脉血栓形成基质的发生率。
对未接受溶栓或冠状动脉介入治疗的急性心肌梗死患者进行病理研究。
1984年至1996年间，298例连续住院死亡的急性心肌梗死患者（189例男性，平均（标准差）年龄66（11）岁；109例女性，74（8）岁），通过心电图改变和心肌酶升高诊断。
组织病理学确定斑块侵蚀作为急性血栓形成的基质；冠状动脉血栓形成的部位和组织学类型；急性和愈合的心肌梗死；心室破裂。
291例心脏（98%）发现急性冠状动脉血栓；74例（25%；107例女性中有40例（37.4%），184例男性中有34例（18.5%）；p = 0.0004），血栓形成的斑块基质为侵蚀。愈合梗死在男性中占37.5%，女性中占22%（p = 0.01）。心脏破裂在女性中比男性更常见（22%对10.5%，p = 0.01）。斑块破裂和斑块侵蚀病例中的梗死分布、血栓部位、心脏破裂和愈合梗死情况相似。
斑块侵蚀是死于急性心肌梗死患者冠状动脉血栓形成的重要基质。其发生率在女性中显著高于男性。
