Plaque histology and myocardial disease in sudden coronary death: the Fingesture study
Abstract Aims At least 50% of deaths due to coronary artery disease (CAD) are sudden cardiac deaths (SCDs), but the role of acute plaque complications on the incidence of sudden death in CAD is somewhat unclear. The present study aimed to investigate plaque histology and concomitant myocardial disea...
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2022
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Online Access: | http://dx.doi.org/10.1093/eurheartj/ehac533 https://academic.oup.com/eurheartj/article-pdf/43/47/4923/47847636/ehac533.pdf |
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croxfordunivpr:10.1093/eurheartj/ehac533 2024-06-23T07:55:31+00:00 Plaque histology and myocardial disease in sudden coronary death: the Fingesture study Holmström, Lauri Juntunen, Samuli Vähätalo, Juha Pakanen, Lasse Kaikkonen, Kari Haukilahti, Anette Kenttä, Tuomas Tikkanen, Jani Viitasalo, Ville Perkiömäki, Juha Huikuri, Heikki Myerburg, Robert J Junttila, Juhani Sigrid Juselius Foundation Academy of Finland Finnish Foundation for Cardiovascular Research Finnish Cultural Foundation Paavo Nurmi Foundation Orion Research Foundation Uolevi Mäki Foundation Instrumentarium Science Foundation 2022 http://dx.doi.org/10.1093/eurheartj/ehac533 https://academic.oup.com/eurheartj/article-pdf/43/47/4923/47847636/ehac533.pdf en eng Oxford University Press (OUP) https://creativecommons.org/licenses/by/4.0/ European Heart Journal volume 43, issue 47, page 4923-4930 ISSN 0195-668X 1522-9645 journal-article 2022 croxfordunivpr https://doi.org/10.1093/eurheartj/ehac533 2024-06-11T04:16:00Z Abstract Aims At least 50% of deaths due to coronary artery disease (CAD) are sudden cardiac deaths (SCDs), but the role of acute plaque complications on the incidence of sudden death in CAD is somewhat unclear. The present study aimed to investigate plaque histology and concomitant myocardial disease in sudden coronary death. Methods and results The study population is derived from the Fingesture study, which has collected data from 5869 consecutive autopsy-verified SCD victims in Northern Finland (population ≈600 000) between 1998 and 2017. In this substudy, histological examination of culprit lesions was performed in 600 SCD victims whose death was due to CAD. Determination of the cause of death was based on the combination of medical records, police reports, and autopsy data. Plaque histology was classified as either (i) plaque rupture or erosion, (ii) intraplaque haemorrhage, or (iii) stable plaque. The mean age of the study subjects was 64.9 ± 11.2 years, and 82% were male. Twenty-four per cent had plaque rupture or plaque erosion, 24% had an intraplaque haemorrhage, and 52% had a stable plaque. Myocardial hypertrophy was present in 78% and myocardial fibrosis in 93% of victims. The presence of myocardial hypertrophy or fibrosis was not associated with specific plaque histology. Conclusion Less than half of sudden deaths due to CAD had evidence of acute plaque complication, an observation which is contrary to historical perceptions. The prevalence of concomitant myocardial disease was high and independent of associated plaque morphology. Article in Journal/Newspaper Northern Finland Oxford University Press European Heart Journal |
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Oxford University Press |
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croxfordunivpr |
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English |
description |
Abstract Aims At least 50% of deaths due to coronary artery disease (CAD) are sudden cardiac deaths (SCDs), but the role of acute plaque complications on the incidence of sudden death in CAD is somewhat unclear. The present study aimed to investigate plaque histology and concomitant myocardial disease in sudden coronary death. Methods and results The study population is derived from the Fingesture study, which has collected data from 5869 consecutive autopsy-verified SCD victims in Northern Finland (population ≈600 000) between 1998 and 2017. In this substudy, histological examination of culprit lesions was performed in 600 SCD victims whose death was due to CAD. Determination of the cause of death was based on the combination of medical records, police reports, and autopsy data. Plaque histology was classified as either (i) plaque rupture or erosion, (ii) intraplaque haemorrhage, or (iii) stable plaque. The mean age of the study subjects was 64.9 ± 11.2 years, and 82% were male. Twenty-four per cent had plaque rupture or plaque erosion, 24% had an intraplaque haemorrhage, and 52% had a stable plaque. Myocardial hypertrophy was present in 78% and myocardial fibrosis in 93% of victims. The presence of myocardial hypertrophy or fibrosis was not associated with specific plaque histology. Conclusion Less than half of sudden deaths due to CAD had evidence of acute plaque complication, an observation which is contrary to historical perceptions. The prevalence of concomitant myocardial disease was high and independent of associated plaque morphology. |
author2 |
Sigrid Juselius Foundation Academy of Finland Finnish Foundation for Cardiovascular Research Finnish Cultural Foundation Paavo Nurmi Foundation Orion Research Foundation Uolevi Mäki Foundation Instrumentarium Science Foundation |
format |
Article in Journal/Newspaper |
author |
Holmström, Lauri Juntunen, Samuli Vähätalo, Juha Pakanen, Lasse Kaikkonen, Kari Haukilahti, Anette Kenttä, Tuomas Tikkanen, Jani Viitasalo, Ville Perkiömäki, Juha Huikuri, Heikki Myerburg, Robert J Junttila, Juhani |
spellingShingle |
Holmström, Lauri Juntunen, Samuli Vähätalo, Juha Pakanen, Lasse Kaikkonen, Kari Haukilahti, Anette Kenttä, Tuomas Tikkanen, Jani Viitasalo, Ville Perkiömäki, Juha Huikuri, Heikki Myerburg, Robert J Junttila, Juhani Plaque histology and myocardial disease in sudden coronary death: the Fingesture study |
author_facet |
Holmström, Lauri Juntunen, Samuli Vähätalo, Juha Pakanen, Lasse Kaikkonen, Kari Haukilahti, Anette Kenttä, Tuomas Tikkanen, Jani Viitasalo, Ville Perkiömäki, Juha Huikuri, Heikki Myerburg, Robert J Junttila, Juhani |
author_sort |
Holmström, Lauri |
title |
Plaque histology and myocardial disease in sudden coronary death: the Fingesture study |
title_short |
Plaque histology and myocardial disease in sudden coronary death: the Fingesture study |
title_full |
Plaque histology and myocardial disease in sudden coronary death: the Fingesture study |
title_fullStr |
Plaque histology and myocardial disease in sudden coronary death: the Fingesture study |
title_full_unstemmed |
Plaque histology and myocardial disease in sudden coronary death: the Fingesture study |
title_sort |
plaque histology and myocardial disease in sudden coronary death: the fingesture study |
publisher |
Oxford University Press (OUP) |
publishDate |
2022 |
url |
http://dx.doi.org/10.1093/eurheartj/ehac533 https://academic.oup.com/eurheartj/article-pdf/43/47/4923/47847636/ehac533.pdf |
genre |
Northern Finland |
genre_facet |
Northern Finland |
op_source |
European Heart Journal volume 43, issue 47, page 4923-4930 ISSN 0195-668X 1522-9645 |
op_rights |
https://creativecommons.org/licenses/by/4.0/ |
op_doi |
https://doi.org/10.1093/eurheartj/ehac533 |
container_title |
European Heart Journal |
_version_ |
1802648151846289408 |