Plaque erosion is a major substrate for coronary thrombosis in acute myocardial infarction

E. Arbustini, B. Dal Bello, P. Morbini, A. P. Burke, M. Bocciarelli, G. Specchia, R. Virmani

Research output: Contribution to journalArticlepeer-review


Objective - To evaluate the prevalence of plaque erosion as a substrate for coronary thrombosis. Design - Pathological study in patients with acute myocardial infarction not treated with thrombolysis or coronary interventional procedures. Patients - 298 consecutive patients (189 men, mean (SD) age 66 (11) years; 109 women, 74 (8) years) dying in hospital between 1984 and 1996 from acute myocardial infarction, diagnosed by ECG changes and rise in cardiac enzymes. Main outcome measures - Histopathological determination of plaque erosion as substrate for acute thrombosis; location and histological type of coronary thrombosis; acute and healed myocardial infarcts; ventricular rupture. Results - Acute coronary thrombi were found in 291 hearts (98%); in 74 cases (25%; 40/107 women (37.4%) and 34/184 men (18.5%); p = 0.0004), the plaque substrate for thrombosis was erosion. Healed infarcts were found in 37.5% of men υ 22% of women (p = 0.01). Heart rupture was more common in women than in men 22% υ 10.5%, p = 0.01). The distribution of infarcts, thrombus location, heart rupture, and healed infarcts was similar in cases of plaque rupture and plaque erosion. Conclusions - Plaque erosion is an important substrate for coronary thrombosis in patients dying of acute myocardial infarction. Its prevalence is significantly higher in women than in men.

Original languageEnglish
Pages (from-to)269-272
Number of pages4
Issue number3
Publication statusPublished - 1999


  • Acute myocardial infarction
  • Plaque erosion
  • Rupture

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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