Characteristics of the Pathological Images of Coronary Artery Thrombi According to the Infarct-Related Coronary Artery in Acute Myocardial Infarction
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概要
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Background Unstable plaque and coronary arterial thrombi sometimes induce a no-reflow phenomenon after intervention whereby there is sufficient reperfusion. The greater susceptibility of the right coronary artery to development of large thrombi makes successful reperfusion more difficult, therefore the characteristics of the pathological images of coronary arterial thrombi according to the infarct-related coronary artery were investigated. Methods and Results Coronary arterial thrombi were extracted from 77 patients with acute myocardial infarction (AMI) using a thrombectomy catheter. The 36 patients had a thrombus containing atherosclerotic cells. Platelets, fibrin, and neutrophils were seen in all cases. The mean ratios of structural components of thrombi were 51.0±29.5% (mean±SD) of the platelet component, 19.9±25.7% of the erythrocyte component and 11.9±22.5% of atherosclerosis component. Erythrocyte-rich thrombi and mixed thrombi mainly composed of erythrocytes were seen in 14 of the 30 cases involving the right coronary artery, 6 of the 35 cases in the left anterior descending artery, 2 of the 11 cases of the left circumflex artery, and in the 1 case of saphenous vein bypass graft. There was significantly more erythrocyte component in the thrombi from the right coronary artery (28.7±30.1%) than in those from the left coronary artery (12.1±18.4%). Conclusion Coronary artery thrombi in AMI are composed principally of platelets. Atherosclerotic cells were identified within thrombi from some patients. In the right coronary artery there were many more thrombi that were rich in erythrocytes than in thrombi from the left coronary artery.
- 社団法人日本循環器学会の論文
- 2004-03-20
著者
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Nagata Yoshiki
Department of Internal Medicine, Toyama Prefectural Central Hospital
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Usuda Kazuo
Department of Internal Medicine, Toyama Prefectural Central Hospital
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Uchiyama Akio
Department of Pathology, Toyama Prefectural Central Hospital
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Miwa Atsuo
Department of Pathology, Toyama Prefectural Central Hospital
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Ishikawa Tadao
Department of Internal Medicine, Toyama Prefectural Central Hospital
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Uchiyama Akio
Department Of Pathology Toyama Prefectural Central Hospital
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Miwa Atsuo
Department Of Pathology Toyama Prefectural Central Hospital
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Usuda Kazuo
Department Of Internal Medicine Toyama Prefectural Central Hospital
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Usuda Kazuo
Department Of Cardiology Toyama Prefectural Central Hospital
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Nagata Yoshiki
Department Of Internal Medicine Toyama Prefectural Central Hospital
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Nagata Yoshiki
Department Of Cancer Gene Regulation Gastroenterology And Nephrology Graduate School Of Medical Scie
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Ishikawa Tadao
Department Of Internal Medicine Toyama Prefectural Central Hospital
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KATO Hiroaki
Department of Urology
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Uchikoshi Manabu
Department of Cardiology, Kouseiren Takaoka Hospital
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Sekiguchi Yoshiteru
Departments of Internal Medicine, Toyama Prefectural Central Hospital
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Ishikawa Tadao
Department Of Cardiology Toyama Prefectural Central Hospital
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Sekiguchi Yoshiteru
Department Of Cardiology Kanazawa National Hospital
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Sekiguchi Yoshiteru
Departments Of Internal Medicine Toyama Prefectural Central Hospital
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Kato Hiroaki
Departments Of Internal Medicine Toyama Prefectural Central Hospital
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Uchiyama Akio
Department Of Clinical Pathology Toyama Prefectural Central Hospital
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Miwa Atsuo
Department Of Gastroenterology Aichi Cancer Center Hospital
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Uchikoshi Manabu
Departments Of Internal Medicine Toyama Prefectural Central Hospital
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Uchikoshi Manabu
Department Of Cardiology Kouseiren Takaoka Hospital
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Kato Hiroaki
Department Of Agricultural Chemistry Yamagata University
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Miwa Atsuo
Department of Clinical Pathology, Toyama Prefectural Central Hospital
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