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Morphometric and histological study of coronary plaques in stable angina and acute myocardial infarctions

H Shi1, L Wei, T Yang

  • 1Department of Pathology, Chinese PLA General Hospital, 28 Fu-Xing Road, Beijing 100853, China.

Chinese Medical Journal
|November 28, 2001
PubMed

Insights

Acute myocardial infarction (AMI) cases show significantly larger lipid cores in coronary plaques compared to stable angina (SA). Plaque rupture with thrombus formation is a primary cause of AMI, with atheroemboli also playing a key role.

Area of Science:

  • Cardiovascular Pathology
  • Histopathology
  • Coronary Artery Disease

Background:

  • Coronary plaque morphology differs between acute myocardial infarction (AMI) and stable angina (SA).
  • Understanding these differences is crucial for elucidating the mechanisms behind these distinct cardiovascular events.

Purpose of the Study:

  • To compare the morphological characteristics of coronary plaques in patients with AMI versus SA.
  • To identify key pathological differences that explain the occurrence of AMI and SA.

Main Methods:

  • Postmortem histological examination of coronary arteries from 68 AMI and 34 SA cases.
  • Quantitative analysis of plaque area and lipid core size using a computer-aided planimeter.
  • Histological assessment for plaque rupture, thrombus formation, and atheroemboli.

Main Results:

  • A significantly higher proportion of coronary blocks in AMI cases (51.0%) exhibited lipid cores exceeding 40% of the plaque area compared to SA cases (10.3%).
  • Thrombi were present in 89.7% of AMI cases, predominantly associated with ruptured plaques (56 cases), while no thrombi were observed in SA cases.
  • Atheroemboli were frequently found in thrombus-negative AMI cases (6/7) but were absent in SA cases.

Conclusions:

  • Distinct morphological bases exist for coronary plaques in AMI and SA.
  • AMI is characterized by plaques with larger lipid cores, and its occurrence is primarily driven by plaque rupture and subsequent thrombus formation.
  • Atheroemboli represent another significant contributing factor to acute myocardial infarction.
Abstract

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