CVPath Institute Inc., Gaithersburg, MD, United States of America.
CVPath Institute Inc., Gaithersburg, MD, United States of America.
Vascul Pharmacol. 2023 Dec;153:107240. doi: 10.1016/j.vph.2023.107240. Epub 2023 Oct 28.
Coronary artery disease (CAD) remains the leading cause of death in the Western world in individuals >20 years of age. CAD is the most common substrate underlying sudden cardiac death (SCD) in the Western world, being responsible for 50-75% of SCDs. In individuals dying suddenly with coronary thrombosis, plaque rupture occurs in 65%, plaque erosion in 30% and calcified nodule in 5%. We evaluated the extent of calcification in radiographs of hearts from patients dying of SCD and showed that calcification is absent in nearly 50% of erosion cases whereas only 10% of plaque rupture show no calcification. Conversely, stable plaques with >75% cross-sectional area luminal narrowing show the severest calcification (moderate to severe) in nearly 50% of cases. Identifying individuals who are susceptible to atherosclerosis may help reduce the incidence of SCD. The identification of coronary calcifications by noninvasive tools, however, only captures a fraction of complicating coronary lesions.
冠状动脉疾病（CAD）仍然是 20 岁以上人群中西方世界的主要死亡原因。CAD 是西方世界心源性猝死（SCD）的最常见基础病变，占 SCD 的 50-75%。在因冠状动脉血栓形成而突然死亡的个体中，斑块破裂占 65%，斑块侵蚀占 30%，钙化结节占 5%。我们评估了死于 SCD 的患者心脏 X 光片的钙化程度，结果表明，近 50%的侵蚀病例中没有钙化，而只有 10%的斑块破裂没有钙化。相反，横截面积管腔狭窄 >75%的稳定斑块中，近 50%的病例有严重钙化（中度至重度）。识别易患动脉粥样硬化的个体可能有助于降低 SCD 的发生率。然而，非侵入性工具识别冠状动脉钙化仅能捕捉到复杂冠状动脉病变的一部分。
