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Study Assesses Thrombi in Plaque Erosions, Ruptures

Most thrombi in erosions were infiltrating or healing; more women had erosions than ruptures

FRIDAY, Jan. 8 (HealthDay News) -- In victims of sudden coronary death, more thrombi in erosions showed later stages of healing than thrombi in ruptures, according to research published in the Jan. 12 issue of 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 coronary lesions with thrombi from 111 sudden coronary death cases. Of these, 65 were ruptures and 50 were erosions.

The researchers found that most culprit plaques (69 percent) contained late-stage thrombi. Early and lytic thrombi -- classified as less than one day and one to three days, respectively -- were more common in plaque ruptures. Most thrombi in erosions were infiltrating, which was classified as four to seven days, or healing, which was classified as more than seven days. Women more often had erosion, with a higher prevalence of late-stage thrombi than ruptures.

"Considering that ST-segment elevation myocardial infarction patients with healing thrombi of greater 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.

Several co-authors reported financial relationships with a number of pharmaceutical and medical equipment companies.

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