Copyright © 1989 by the European Society of Cardiology.
© 1989 The European Society of Cardiology
Factors influencing the presence or absence of acute coronary artery thrombi in sudden ischaemic death
*British Heart Foundation Unit of Cardiovascular Pathology Cranmer Terrace London U.K
**Clinical Epidemiology and Social Medicine, St. George's Hospital Medical School Cranmer Terrace London U.K
Institute of Pathological Anatomy, University of Padua Via Gabelli 61, 35121 Padova Italy
Institute of Medical and Veterinary Sciences Frome Road Adelaide, South Australia
Received 27 June 1988; revised 23 August 1988; .
Address for reprints. M. J. Davies, St. George's Hospital Medical School, Departments of Histopathology, Cranmer Terrace London, SW17 0RE, U.K.
Abstract
Sudden ischaemic death results either from an episode of acute myocardial ischaemia consequent upon coronary thrombosis or from an arrhythmia arising within a scarred left ventricle. Very different proportions of these two groups have been reported in both clinical studies in resuscitated subjects with out-of-hospital ventricular fibrillation, and in necropsy series. In 168 cases of sudden death due to ischaemic heart disease coming to necropsy 73(43.5%) had mural intraluminal coronary thrombi, 50(29.8%) had occlusive intra-luminal thrombi, and 45(26.7%) had no intraluminal thrombi, giving a ratio of 2.7:1 for those with and without coronary thrombosis. Single vessel disease, the presence of acute infarction at autopsy and prodromal symptoms were positively associated with the presence of coronary thrombosis. Conversely, the presence of old myocardial infarction at necropsy, a known clinical history of ischaemic heart disease and triple vessel disease were associated with the absence of acute thrombosis. The reported variation in the incidence of coronary thrombi in sudden ischaemic death can be largely explained by selection of subjects with those clinical characteristics which are positively or negatively associated with coronary thrombosis.
Key Words: Coronary thrombosis • sudden death • ischaemic heart disease
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P. Smith, H. Arnesen, and M. Abdelnoor Effects of Long-term Anticoagulant Therapy in Subgroups After Acute Myocardial Infarction Arch Intern Med, May 1, 1992; 152(5): 993 - 997. [Abstract] [PDF]
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