Circulation, Vol 71, 699-708, Copyright © 1985 by American Heart Association
E Falk
Extensive microscopic examination of epicardial arteries and myocardium was
performed in 25 cases of sudden death due to acute coronary thrombosis.
Eighty-one percent of the thrombi had a layered structure with thrombus
material of differing age, indicating that they were formed successively by
repeated mural deposits that caused progressive luminal narrowing over an
extended period of time. This episodic growth of the thrombus was
accompanied by intermittent fragmentation of thrombus in 73% of the cases,
with peripheral embolization causing microembolic occlusion of small
intramyocardial arteries associated with microinfarcts. The period of
unstable angina before the final heart attack was, in all but one of 15
patients, characterized by such an ongoing thrombotic process in a major
coronary artery where recurrent mural thrombus formation seemed to have
alternated with intermittent thrombus fragmentation. The culmination of
this "dynamic" thrombotic process in total vascular occlusion caused the
final infarction and/or sudden death.
ARTICLES
Unstable angina with fatal outcome: dynamic coronary thrombosis leading to infarction and/or sudden death. Autopsy evidence of recurrent mural thrombosis with peripheral embolization culminating in total vascular occlusion
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R. Erbel and G. Heusch Coronary microembolization J. Am. Coll. Cardiol., July 1, 2000; 36(1): 22 - 24. [Full Text] [PDF]
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K. P. Rentrop Thrombi in Acute Coronary Syndromes : Revisited and Revised Circulation, April 4, 2000; 101(13): 1619 - 1626. [Full Text] [PDF]
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J. Ravkilde Risk Stratification in Acute Coronary Syndrome Using Cardiac Troponin I Clin. Chem., April 1, 2000; 46(4): 443 - 444. [Full Text] [PDF]
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M. J Davies CORONARY DISEASE: The pathophysiology of acute coronary syndromes Heart, March 1, 2000; 83(3): 361 - 366. [Full Text]
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J. A. Ambrose and G. Dangas Unstable Angina: Current Concepts of Pathogenesis and Treatment Arch Intern Med, January 10, 2000; 160(1): 25 - 37. [Abstract] [Full Text] [PDF]
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C.W. Hamm Unstable angina: the breakthrough Eur. Heart J., November 1, 1999; 20(21): 1517 - 1519. [PDF]
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X.-Q. Zhao, P. Theroux, S. M. Snapinn, and F. L. Sax Intracoronary Thrombus and Platelet Glycoprotein IIb/IIIa Receptor Blockade With Tirofiban in Unstable Angina or Non-Q-Wave Myocardial Infarction : Angiographic Results From the PRISM-PLUS Trial (Platelet Receptor Inhibition for Ischemic Syndrome Management in Patients Limited by Unstable Signs and Symptoms) Circulation, October 12, 1999; 100(15): 1609 - 1615. [Abstract] [Full Text] [PDF]
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F. Grund, H. T. Sommerschild, T. Lyberg, K. A. Kirkeboen, and A. Ilebekk Microembolization in pigs: effects on coronary blood flow and myocardial ischemic tolerance Am J Physiol Heart Circ Physiol, August 1, 1999; 277(2): H533 - H542. [Abstract] [Full Text] [PDF]
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M Gyongyosi, P Yang, A Hassan, F Weidinger, H Domanovits, A Laggner, and D Glogar Arterial remodelling of native human coronary arteries in patients with unstable angina pectoris: a prospective intravascular ultrasound study Heart, July 1, 1999; 82(1): 68 - 74. [Abstract] [Full Text] [PDF]
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A. D. Tselepis, J. A. Goudevenos, A. P. Tambaki, L. Michalis, C. S. Stroumbis, D. C. Tsoukatos, M. Elisaf, and D. A. Sideris Platelet aggregatory response to platelet activating factor (PAF), ex vivo, and PAF-acetylhydrolase activity in patients with unstable angina: effect of c7E3 Fab (abciximab) therapy Cardiovasc Res, July 1, 1999; 43(1): 183 - 191. [Abstract] [Full Text] [PDF]
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J. E. Freedman, R. Sauter, E. M. Battinelli, K. Ault, C. Knowles, P. L. Huang, and J. Loscalzo Deficient Platelet-Derived Nitric Oxide and Enhanced Hemostasis in Mice Lacking the NOSIII Gene Circ. Res., June 25, 1999; 84(12): 1416 - 1421. [Abstract] [Full Text] [PDF]
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G. Maresca, A. Di Blasio, R. Marchioli, and G. Di Minno Measuring Plasma Fibrinogen to Predict Stroke and Myocardial Infarction : An Update Arterioscler Thromb Vasc Biol, June 1, 1999; 19(6): 1368 - 1377. [Abstract] [Full Text] [PDF]
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S. Kiechl and J. Willeit The Natural Course of Atherosclerosis : Part I: Incidence and Progression Arterioscler Thromb Vasc Biol, June 1, 1999; 19(6): 1484 - 1490. [Abstract] [Full Text] [PDF]
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J Ge, F Chirillo, J Schwedtmann, G Görge, M Haude, D Baumgart, V Shah, C von Birgelen, S Sack, H Boudoulas, et al. Screening of ruptured plaques in patients with coronary artery disease by intravascular ultrasound Heart, June 1, 1999; 81(6): 621 - 627. [Abstract] [Full Text]
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C. W. Hamm, C. Heeschen, B. Goldmann, A. Vahanian, J. Adgey, C. M. Miguel, W. Rutsch, J. Berger, J. Kootstra, M. L. Simoons, et al. Benefit of Abciximab in Patients with Refractory Unstable Angina in Relation to Serum Troponin T Levels N. Engl. J. Med., May 27, 1999; 340(21): 1623 - 1629. [Abstract] [Full Text] [PDF]
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B. E. Sobel Increased Plasminogen Activator Inhibitor-1 and Vasculopathy : A Reconcilable Paradox Circulation, May 18, 1999; 99(19): 2496 - 2498. [Full Text] [PDF]
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Y.-H. Li, J.-K. Teng, W.-C. Tsai, L.-M. Tsai, L.-J. Lin, H.-R. Guo, and J.-H. Chen Prognostic significance of elevated hemostatic markers in patients with acute myocardial infarction J. Am. Coll. Cardiol., May 1, 1999; 33(6): 1543 - 1548. [Abstract] [Full Text] [PDF]
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J. J. Badimon, M. Lettino, V. Toschi, V. Fuster, M. Berrozpe, J. H. Chesebro, and L. Badimon Local Inhibition of Tissue Factor Reduces the Thrombogenicity of Disrupted Human Atherosclerotic Plaques : Effects of Tissue Factor Pathway Inhibitor on Plaque Thrombogenicity Under Flow Conditions Circulation, April 13, 1999; 99(14): 1780 - 1787. [Abstract] [Full Text] [PDF]
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