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Titolo:
Histological analysis of coronary artery lesions in fatal postoperative myocardial infarction
Autore:
Cohen, MC; Aretz, TH;
Indirizzi:
HarvardMAniv, Sch Med, Beth Israel Deaconess Med Ctr, Dept Pathol, Boston,Harvard Univ Boston MA USA srael Deaconess Med Ctr, Dept Pathol, Boston, Harvardv,niv, Sch Med, Beth Israel Deaconess Med Ctr, Dept Med,Cariovasc Di Harvard Univ Boston MA USA rael Deaconess Med Ctr, Dept Med,Cariovasc Di
Titolo Testata:
CARDIOVASCULAR PATHOLOGY
fascicolo: 3, volume: 8, anno: 1999,
pagine: 133 - 139
SICI:
1054-8807(199905/06)8:3<133:HAOCAL>2.0.ZU;2-I
Fonte:
ISI
Lingua:
ENG
Soggetto:
PERIPHERAL VASCULAR-SURGERY; DEEP-VEIN THROMBOSIS; NONCARDIAC SURGERY; CARDIAC MORBIDITY; FIBRINOLYTIC SYSTEM; PLAQUE RUPTURE; BYPASS-SURGERY; BETA-BLOCKADE; ISCHEMIA; ANESTHESIA;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
50
Recensione:
Indirizzi per estratti:
Indirizzo: Cohen, MC Maine Cardiol Associates, 66 Bramhall St, Portland, ME 04102 USAMaine Cardiol Associates 66 Bramhall St Portland ME USA 04102 SA
Citazione:
M.C. Cohen e T.H. Aretz, "Histological analysis of coronary artery lesions in fatal postoperative myocardial infarction", CARDIO PATH, 8(3), 1999, pp. 133-139

Abstract

We sought to evaluate the underlying coronary pathology of fatal postoperative myocardial infarction (MI). It has been hypothesized that most MIs following noncardiac surgery occur in the setting of increased oxygen demand that exceeds coronary blood supply. However, most Mis not associated with surgery are caused by plaque rupture and intracoronary thrombosis. In a retrospective cohort study, we reviewed 1841 consecutive autopsy records from 1981 to 1995 at two institutions and identified 26 cases of postoperative MI with coronary arteries available. Plaque rupture was present in 12 cases (46%, 95% confidence interval [CI] 27%-67%). Of the 9 (35%) patients with intracoronary thrombus, 5 (56%; 19% of entire group) had total occlusion. Thrombus occurred on a >50% stenosis (by cross-sectional area) in a total of 33% (95% CI 16%-55%) of patients. The only statistically significant difference in clinical variables between patients with and without plaque rupture was longer interval from surgery to death in patients with plaque rupture (7.8 +/- 4.4 days versus 4.4 +/- 4.8 days; p = 0.047). In this autopsy series, coronary plaque rupture was associated with almost half of fatal postoperative MI cases. Strategies aimed at reducing triggers of plaque rupture with coronary occlusion might reduce postoperative MI fatality. Cardiovasc Pathol 1999;8:133-139 (C) 1999 by Elsevier Science Inc.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/11/20 alle ore 09:58:33