1. Nat. Rev. Cardiol. doi:10.1038/nrcardio.2016.19
Figure 1 Histomorphological characteristics of plaque erosion, plaque rupture, and a stable plaque
Figure 1 | Histomorphological characteristics of plaque erosion, plaque rupture, and a stable plaque. Low magnification photo micrographs of a | plaque erosion, b | plaque rupture, and c | stable plaque from patients dying from sudden cardiac death are displayed in the top panel. The boxed areas are magnified in the bottom panels for better histological characterization. a | An eroded plaque with subcritical stenosis, an unremarkable necrotic core (NC), and an overlying thrombus on an intact fibrous cap. The cap is rich in smooth muscle cells and proteoglycans, and there is minimal inflammation at the base of the thrombus. The plaque does not show any positive remodelling. b | A positively remodelled, critically occlusive atherosclerotic plaque with a cholesterol crystal-rich large NC covered by a very thin and inflamed fibrous cap, which is disrupted (area between the arrowheads). Smooth muscle cells are visible in the medial layer and thin fibrous cap and minimally present at the base of the neointima. A large thrombogenic NC is in communication with the vessel lumen with an occlusive thrombus. c | A stable plaque shows smooth muscle and collagen-rich histology. The haemorrhagic NC in the middle that separates the collagen of two separate ages represents a healed rupture site. The lesion is critically narrowed, but does not show any positive remodelling or overlying thrombus. Reprinted from Prati, F. et al. OCT-based diagnosis and management of STEMI associated with intact fibrous cap. JACC Cardiovasc. Imaging 6, 283–287 © (2013), with permission from Elsevier.
Reprinted from Prati, F. et al. OCT-based diagnosis and management of STEMI associated with intact fibrous cap. JACC Cardiovasc. Imaging 6, 283–287 © (2013), with permission from Elsevier
Akasaka, T. & Narula, J. et al. (2016) Acute coronary syndromes without coronary plaque rupture
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