Factors influencing the presence or absence of acute coronary artery thrombi in sudden ischaemic death

Sudden ischaemic death results either from an episode of acute myocardial ischaemia consequent upon coronary thrombosis or from an arrhythmia arising within a scarred left ventricle. Very different proportions of these two groups have been reported in both clinical studies in resuscitated subjects w...

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Bibliographic Details
Published in:European heart journal 1989-03, Vol.10 (3), p.203-208
Main Authors: DAVIES, M. J., BLAND, J. M., HANGARTNER, J. R. W., ANGELINA, A., THOMAS, A. C.
Format: Article
Language:English
Subjects:
Acute Disease
Adult
Aged
Chest Pain - etiology
Coronary Disease - mortality
Coronary Disease - pathology
Coronary thrombosis
Coronary Thrombosis - mortality
Coronary Thrombosis - pathology
Death, Sudden
Female
Heart Diseases - mortality
Heart Diseases - pathology
Humans
ischaemic heart disease
Male
Middle Aged
Myocardial Infarction - mortality
Myocardial Infarction - pathology
Risk Factors
sudden death
Thrombosis - mortality
Thrombosis - pathology
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Summary:Sudden ischaemic death results either from an episode of acute myocardial ischaemia consequent upon coronary thrombosis or from an arrhythmia arising within a scarred left ventricle. Very different proportions of these two groups have been reported in both clinical studies in resuscitated subjects with out-of-hospital ventricular fibrillation, and in necropsy series. In 168 cases of sudden death due to ischaemic heart disease coming to necropsy 73(43.5%) had mural intraluminal coronary thrombi, 50(29.8%) had occlusive intra-luminal thrombi, and 45(26.7%) had no intraluminal thrombi, giving a ratio of 2.7:1 for those with and without coronary thrombosis. Single vessel disease, the presence of acute infarction at autopsy and prodromal symptoms were positively associated with the presence of coronary thrombosis. Conversely, the presence of old myocardial infarction at necropsy, a known clinical history of ischaemic heart disease and triple vessel disease were associated with the absence of acute thrombosis. The reported variation in the incidence of coronary thrombi in sudden ischaemic death can be largely explained by selection of subjects with those clinical characteristics which are positively or negatively associated with coronary thrombosis.
ISSN:0195-668X
1522-9645
DOI:10.1093/oxfordjournals.eurheartj.a059467