Reperti istopatologici in campioni di aterectomia ottenuti da pazienti con angina instabile, con angina stabile e con ristenosi

Translated title of the contribution: Istopathological features in atherectomy samples from patients with unstable angina, stable angina and restenosis

Eloisa Arbustini, Patrizia Morbini, Stefano De Servi, Emanuele Porcu, Mauro Boscarini, Andrea Pilotto, Ezio Bramucci, Barbara Dal Bello, Luigi Angoli, Sergio Repetto, Luigi Niccoli, Gianbattista Danzi, Anna Maria Costante, Giuseppe Colombo, Luigi Campolo, Giuseppe Specchia

Research output: Contribution to journalArticle

Abstract

BACKGROUND. The present study was aimed at investigating the pathologic features of directional coronary atherectomy (DCA) samples obtained from 194 patients (14 females) with stable (n = 68) and unstable (n = 95) angina, and with restenosis (n = 27). METHODS. DCA samples were obtained from culprit lesions, using the Simpson technique. Unstable angina was classified according to E. Braunwald criteria. Stable angina was grouped according to the presence or absence of a prior myocardial infarction (MI). DCA samples were fixed, processed, serially cut and stained with hematoxilin-eosin and with Movat pentachrome stain. RESULTS. The major pathologic findings were thrombosis, inflammation of the superficial plaque layers, and neointimal hyperplasia which often coexisted within a same sample. Their frequencies, in that order, were distributed in the differing groups of patients as follows: - 21% (n = 9), 29.2% (n = 12) and 51% (n = 21) of the 41 cases with stable angina without prior MI. - 40.7% (n = 11), 40.7% (n = 11), and 51.8% (n = 14) of the 27 cases with stable angina with prior MI. - 25% (n = 4), 56.2% (n = 9) and 68.7% (n = 11), of the 16 cases with BI unstable angina. - 35.3% (n = 14), 55.8% (n = 19) and 44% (n = 15), of the 34 cases with BII unstable angina. - 44.4% (n = 4), 33.3% (n = 3) and 33.3% (n = 3), of the 9 cases with BIII unstable angina. - 48.2% (n = 14), 48.2% (n = 14) and 51.8% (n = 15), of the 29 cases with CII unstable angina at 35.8 days after MI. - 60% (n = 3), 60% (n = 3) and 40% (n = 2), of the 5 cases with CIII unstable angina at 8.3 days after MI. - 26% (n = 7), 48% (n = 13) and 85.1% (n = 23), of the 27 cases with restenosis. According to above observation, the frequency of coronary thrombosis increases with the increase of the severity of myocardial ischemia. However, thrombosis is not found in most unstable angina without prior Ml (63% of BI-II-III unstable angina cases do not have thrombus). In addition, thrombus is not a specific finding of unstable angina, given its occurrence, although in a much lower percentage of cases, in stable angina and in restenosis. CONCLUSIONS. Present data show that different ischemic syndromes show similar pathologic substrates which therefore do not fully clarify the relationship between ischemia and plaque lesions. This observation questions on the pathogenetic role of thrombus in unstable angina and calls for further investigations on inflammation and neointimal hyperplasia, as well as on the reciprocal relation between these findings which are often combined within a same lesion.

Translated title of the contributionIstopathological features in atherectomy samples from patients with unstable angina, stable angina and restenosis
Original languageItalian
Pages (from-to)623-633
Number of pages11
JournalGiornale Italiano di Cardiologia
Volume26
Issue number7
Publication statusPublished - 1996

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Arbustini, E., Morbini, P., De Servi, S., Porcu, E., Boscarini, M., Pilotto, A., Bramucci, E., Dal Bello, B., Angoli, L., Repetto, S., Niccoli, L., Danzi, G., Costante, A. M., Colombo, G., Campolo, L., & Specchia, G. (1996). Reperti istopatologici in campioni di aterectomia ottenuti da pazienti con angina instabile, con angina stabile e con ristenosi. Giornale Italiano di Cardiologia, 26(7), 623-633.