Frequência de rupturas agudas de placas e fibroateromas de capa fina em locais de estenose máxima

background: there have been few autopsy studies relating sites of thin cap atheroma (tcfa) to sites of acute plaque rupture in culprit arteries, and sites of maximal narrowing in non-culprit arteries. objective: we aimed to quantify and locate the frequency of tcfa related to the sites of maximal stenosis in atherosclerotic plaques. methods: we studied 88 hearts in victims of sudden death dying with coronary thrombus overlying acute plaque rupture. thin cap atheromas were defined as fibrous cap < 65 microns overlying a necrotic core. percent luminal narrowing was determined at the sites of plaque rupture and thin cap atheromas. results: there were 81 men and 7 women, mean age 50 years ± 9 sd. the plaque rupture was the site of maximal luminal narrowing in 47% of culprit arteries. tcfas were present in 67 hearts (83%). of these, 49 (73%) demonstrated tcfas in the culprit artery; 17 (25%) in the culprit artery only, 32 (48%) in the culprit artery and in a non-culprit artery, and 18 (27%) only in a non-culprit artery. in non-culprit arteries, tcfas represented the maximal site of stenosis in 44% of arteries. the acute rupture site is the site of maximal luminal narrowing in the involved vessel in 47% of hearts from patients dying with acute plaque rupture. conclusion: these data may suggest that luminal narrowing is not a reliable marker for tcfa.