title: Morphologic features of culprit lesions in sudden coronary death with family history of premature coronary artery disease.
abstract: The morphologic features of familial coronary artery disease (CAD) resulting in sudden coronary death (SCD) are poorly studied. The presence and type of culprit lesions may have important implications in the genetic basis for familial heart disease. Autopsies of SCD victims over a 5-year period from a statewide medical examiner's office were studied. Premature familial disease was defined as sudden death at ≤50 years in women and ≤45 years in men, with premature SCD or acute coronary syndrome in a first-degree relative. Culprit lesion was defined as acute plaque rupture, plaque erosion, and severe narrowing without thrombus (stable plaque). There were 174 acute plaque ruptures (age 49±10 years, 9% women), 49 plaque erosions (age 45±8 years, 37% women), and 213 stable plaques (age 53±11 years, 22% women). There were 8 plaque rupture with family history. There were 9 plaque erosions with family history. There were 7 stable plaques with family history. The rate of familial history in premature coronary disease was 18.4% in erosions, 4.6% in ruptures (p=.02 vs. erosion), and 3.3% in stable plaque (p=.002 vs. erosion). We concluded that the frequency of family history of premature sudden death due to CAD may be higher in plaque erosion as compared to patients dying with acute plaque rupture or stable plaque.
authors.affiliation: Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China.
authors.forename: Ming Chang
authors.initials: MC
authors.lastname: Zhang
authors.affiliation: Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China.
authors.forename: Yiwen
authors.initials: Y
authors.lastname: Shen
authors.affiliation: Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China.
authors.forename: Aimin
authors.initials: A
authors.lastname: Xue
authors.affiliation: Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China.
authors.forename: Meng
authors.initials: M
authors.lastname: He
authors.affiliation: Department of Pathology, Georgetown University Hospital, Washington, DC 20007, USA.
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Cresswell
authors.affiliation: Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China; University of Maryland Medical System, Baltimore, MD 20201, USA.
authors.forename: Ling
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China.
authors.forename: Ziqin
authors.initials: Z
authors.lastname: Zhao
authors.affiliation: Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China. Electronic address: jiangyan@fudan.edu.cn.
authors.forename: Yan
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: Department of Forensic Medicine, School of Basic Medical Sciences, Fudan University, Shanghai 200032, China; University of Maryland Medical System, Baltimore, MD 20201, USA. Electronic address: aburke@umm.edu.
authors.forename: Allen
authors.initials: A
authors.lastname: Burke
mesh_terms: D000328:Adult; D001344:Autopsy; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000473:pathology*; D003331:Coronary Vessels / Q000473:pathology; D016757:Death, Sudden, Cardiac / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D012422:Rupture, Spontaneous
keywords: Coronary artery disease; Forensic pathology; Plaque erosion; Plaque rupture; Stable plaque; Sudden coronary death