The cause-effect relationship between recent coronary artery occlusion and acute myocardial infarction

Chapman, Irving

doi:10.1016/0002-8703(74)90062-3

Cited by 68 publications

(18 citation statements)

References 10 publications

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“…[11][12][13][14][15] Since the 1970s, scientists have been seeking the mechanisms responsible for converting chronic coronary atherosclerosis to acute coronary artery disease. [11][12][13][14][15]17 As insights into this process have evolved, the relevant terminology has been continually updated. In the 1980s, Falk 11 and Davies and Thomas 15 used "plaque disruption" synonymously with "plaque rupture."…”

Section: Underlying Causes Of Sudden Fatal Andmentioning

confidence: 99%

From Vulnerable Plaque to Vulnerable Patient

et al. 2003

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Abstract-Atherosclerotic cardiovascular disease results in Ͼ19 million deaths annually, and coronary heart disease accounts for the majority of this toll. Despite major advances in treatment of coronary heart disease patients, a large number of victims of the disease who are apparently healthy die suddenly without prior symptoms. Available screening and diagnostic methods are insufficient to identify the victims before the event occurs. The recognition of the role of the vulnerable plaque has opened new avenues of

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Section: Underlying Causes Of Sudden Fatal Andmentioning

confidence: 99%

From Vulnerable Plaque to Vulnerable Patient

et al. 2003

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“…19 In 64%-100% of patients with nonoperative MIs, coronary artery plaque fissuring occurs, 20,21 and in 65%-95% there is an acute luminal thrombus. [21][22][23][24][25] The pathophysiology underlying MIs in the operative setting is less clear.…”

Section: Myocardial Infarctionmentioning

confidence: 99%

Perioperative cardiac events in patients undergoing noncardiac surgery: a review of the magnitude of the problem, the pathophysiology of the events and methods to estimate and communicate risk

Devereaux

Goldman

Cook

et al. 2005

CMAJ

571

350

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THIS IS THE FIRST OF 2 ARTICLES EVALUATING cardiac events in patients undergoing noncardiac surgery. In this article, we review the magnitude of the problem, the pathophysiology of these events, approaches to risk assessment and communication of risk. The number of patients undergoing noncardiac surgery worldwide is growing, and annually 500 000 to 900 000 of these patients experience perioperative cardiac death, nonfatal myocardial infarction (MI) or nonfatal cardiac arrest. Although the evidence is limited, a substantial proportion of fatal perioperative MIs may not share the same pathophysiology as nonoperative MIs. A clearer understanding of the pathophysiology is needed to direct future research evaluating prophylactic, acute and long-term interventions. Researchers have developed tools to facilitate the estimation of perioperative cardiac risk. Studies suggest that the Lee index is the most accurate generic perioperative cardiac risk index. The limitations of the studies evaluating the ability of noninvasive cardiac tests to predict perioperative cardiac risk reveals considerable uncertainty as to the role of these popular tests. Similarly, there is uncertainty as to the predictive accuracy of the American College of Cardiology / American Heart Association algorithm for cardiac risk assessment. Patients are likely to benefit from improved estimation and communication of cardiac risk because the majority of noncardiac surgeries are elective and accurate risk estimation is important to allow informed patient and physician decision-making

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“…Consistent with this notion, clinical studies showed that coronary throm- bosis was not detected in patients with subendocardial infarction. 9,10,[17][18][19] The areas of fresh myocardial lesions were small despite showing typical ST elevation in ECG ( Figure II). WHHLMI rabbits, which we could monitor, deceased within 15 minute after a heart attack.…”

Section: Shiomi Et Al Myocardial Infarction Of Whhlmi Rabbitmentioning

confidence: 99%

Development of an Animal Model for Spontaneous Myocardial Infarction (WHHLMI Rabbit)

Shiomi

Ito

Yamada

et al. 2003

ATVB

152

139

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Objective-Coronary heart disease is the most common cause of death in developed countries. However, there are no suitable animal models that mimic spontaneous myocardial infarction in humans. In this study, we attempted to obtain a rabbit strain with spontaneous myocardial infarction by selective breeding of coronary atherosclerosis-prone Watanabe heritable hyperlipidemic (WHHL) rabbits, designated as WHHLMI rabbits. Methods and Results-WHHLMI rabbits were characterized by the high incidence of fatal myocardial infarction at ages 11 to 35 months, being increased from 23% to 97% after the selective breeding. The ECG on WHHLMI rabbits showed a typical feature of myocardial infarction. Histological examination of hearts from suddenly deceased WHHLMI rabbits revealed old myocardial infarction accompanied by fresh myocardial lesions. The culprit coronary arteries exhibited severe atheromatous plaques (Ͼ90% lumen area stenosis), suggesting that coronary atherosclerosis is responsible for myocardial infarction observed in WHHLMI rabbits. In addition, the coronary plaques showed vulnerable features including macrophage-rich thin cap and large necrotic core. Conclusions-To the best of our knowledge, this is the first report of spontaneous myocardial infarction in rabbits, and it is suggested that this WHHLMI rabbit strain will be a useful animal model to study human myocardial infarction. Key Words: coronary atherosclerosis Ⅲ myocardial infarction Ⅲ vulnerable plaque Ⅲ WHHLMI rabbit C oronary heart disease is the major cause of death in developed countries. However, there are no suitable animal models for human myocardial infarction. It is essential to develop animal models for myocardial infarction to reveal its mechanisms and to develop new therapeutic interventions. Although several genetically modified mouse models with hypercholesterolemia and atherosclerosis have been reported, 1-3 coronary atherosclerosis and subsequent myocardial lesions resembling those of humans have not been documented, possibly because of the difference in lipoprotein metabolism between humans and mice. 4,5 In addition, the mouse is small in size, which may hamper its use in many surgical manipulations and therapeutic interventions. Therefore, there is a need to develop a relatively large animal model for the study of myocardial infarction. Until now, such an ideal model (eg, rabbits) with spontaneous myocardial infarction has not been established.In 1980, our institute developed Watanabe heritable hyperlipidemic (WHHL) rabbits as a suitable animal model for human familial hypercholesterolemia and atherosclerosis. 6 Based on this strain, we additionally developed coronary atherosclerosisprone WHHL rabbits, a variant strain, which have higher low-density lipoprotein cholesterol and typical coronary atheromatous plaques similar to those of humans. 7 However, the incidence of spontaneous myocardial infarction in coronary atherosclerosis-prone WHHL rabbits was extremely low, which limits their use in the study of myocardial infarction. Since 1994...

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The cause-effect relationship between recent coronary artery occlusion and acute myocardial infarction

Cited by 68 publications

References 10 publications

From Vulnerable Plaque to Vulnerable Patient

From Vulnerable Plaque to Vulnerable Patient

Perioperative cardiac events in patients undergoing noncardiac surgery: a review of the magnitude of the problem, the pathophysiology of the events and methods to estimate and communicate risk

Development of an Animal Model for Spontaneous Myocardial Infarction (WHHLMI Rabbit)

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