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Histologic characteristics of tissue excised during directional coronary atherectomy in stable and unstable angina pectoris

https://doi.org/10.1016/0002-9149(93)90609-GGet rights and content

Abstract

Unstable angina is an acute coronary syndrome associated with substantial short- and medium-term morbidity and mortality.1 The understanding of the pathogenesis of this syndrome has been based largely on postmortem studies of coronary arteries2 and supported by indirect evidence of coronary thrombosis in relation to the syndrome.3–5 Because directional coronary atherectomy is unique in extracting intact atheromatous tissue during coronary recanalization, it may facilitate the study of the processes taking place in the vessel in different coronary syndromes. In the present study the histopathologic characteristics of atherectomy samples retrieved in 93 patients with stable or unstable angina pectoris were compared and related to different clinical variables.

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    Citation Excerpt :

    Previous IVUS and pathologic studies have shown that positive vessel remodeling is observed frequently in culprit lesions with unstable clinical presentation and plaque rupture.5,6,18 Observational studies by pathologists who used necropsy and atherectomy material showed that plaques that cause thrombosis are rich in lipid.19,20 The link between positive vessel remodeling and lipid-rich plaque may be macrophage-derived foam cell expression of the metalloproteinases,21 a group of proteins involved in cell matrix breakdown.

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1

Dr. Escaned is supported by the FPU programme of the Spanish Ministry of Science and Education.

2

Dr. MacLeod is a recipient of the British Heart Foundation International Research Fellowship.

3

Mr. de Jong is a grant recipient from the Dutch Heart Foundation.

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