Patients with late-stage thrombi due to eroded plaques may benefit from different treatment
THURSDAY, Oct. 8 (HealthDay News) -- Thrombus healing in sudden cardiac death victims may depend on the presence of plaque ruptures or erosions, and, in some patients, call for different treatment approaches, according to research published online Oct. 7 in the Journal of the American College of Cardiology.
Miranda C.A. Kramer, M.D., of the University of Amsterdam in the Netherlands, and colleagues analyzed data from 115 coronary lesions with thrombi from 111 sudden death victims. Researchers classified thrombus healing as early (less than one day) or late stage (one to more than seven days).
The researchers note that late-stage thrombi were found in 69 percent of plaques, with woman presenting with more erosions of late-stage thrombi than plaque ruptures. In terms of plaque ruptures, half of thrombi showed various stages of healing, whereas more than 85 percent of thrombi due to erosions showed late stages of healing. The internal elastic area and percent stenosis were larger in ruptures as compared to erosions, and no relationship was found between thrombus organization, thrombus length, or presence of occlusion and macrophage infiltration.
"Considering that STEMI patients with healing thrombi of less than one day have poorer prognosis, the present findings that erosions are the main cause of healing thrombi -- which occur predominantly in women and younger men -- together with the increased risk for distal intramyocardial embolization would further indicate that women and younger men might require different strategies of treatment," the authors conclude.
A co-author reported financial relationships with various pharmaceutical and medical companies.