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Pathology Research International
Volume 2010 (2010), Article ID 628247, 7 pages
http://dx.doi.org/10.4061/2010/628247
Research Article

Morphologic Characteristic of Coronary Artery Disease, with Emphasis on Thromboses, in Patients Younger Than 40 Years of Age

1Deparment of Cardiovascular Pathology, Armed Forces Institute of Pathology, 6825 16th Street NW, Building 54, Washington, DC 20306, USA
2Department of Pathology, University of Maryland, Room NBW46, 22 S Greene Street, Baltimore, MD 21201, USA

Received 22 May 2009; Accepted 18 August 2009

Academic Editor: Hans-Anton Lehr

Copyright © 2010 Fabio Tavora et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

There are few pathologic descriptions of fatal coronary artery disease in the young. The morphologic characteristics of sudden coronary deaths in 47 hearts from patients younger than 40 years were studied. Numbers of plaques with necrotic cores were quantitated in each heart. Compared to 194 sudden coronary deaths >40 years, heart weight was lower, acute plaque erosions more frequent, and extent of disease less in the 40 years group. Plaque burden was less in hearts with erosions, and healed infarcts more common in hearts with stable plaque. The numbers of fibroatheromas increased with age until the 6th decade ( 𝑃 < . 0 0 0 1 ) as well as the proportion of total plaques that were atheromatous. Plaques in younger patients have fewer lipid-rich cores. Most thrombi show areas of organization, with layering frequent in erosions, suggesting a possible method of plaque enlargement in the absence of necrotic core formation.