It is now clear that TCFA can not be considered 'vulnerable plaque' as less than 20% lead to ACS (myocardial infarction). ACS we propose is a failure of plaques to heal as it is a plaque rupture. Through both OCT (optical coherence tomography) and histopathology in the axial rather than the cross sectional plane, we propose vulnerability is characterized by two factors. 1. Failure of plaque healing for pathology in the vessels. 2. That long necrotic cores predispose to failed healing. Aspects of this are covered in our 2019 JAMA Cardiology paper.
JAMA Cardiol. 2019;4(4):329-331. doi:10.1001/jamacardio.2019.0312 ([ Ссылка ])
Int J Cardiol. 2014 Dec 20;177(3):738-41. doi: 10.1016/j.ijcard.2014.09.144. Epub 2014 Oct 16.
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Circulation. 1996 Mar 15;93(6):1206-13.
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Earlier Youtube Video:
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Also see:
(Kubo T, Maehara A, Mintz GS, et al. The dynamic nature of coronary artery lesion morphology assessed by serial virtual histology intravascular ultrasound tissue characterization. J Am Coll Cardiol.2010;55(15):1590 1597. doi:10.1016/j.jacc.2009.07.078)
Rittersma SZ, van der Wal AC, Koch KT, et al. Plaque instability frequently occurs days or weeks before occlusive coronary thrombosis: a pathological thrombectomy study in primary percutaneous coronary intervention. Circulation 2005;111:1160 –5.
#ACS,#vulnerable,#plaque,#coronary#PCI,#rupture,#myocardial,#infarction,#MI,#angiogenesis
