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Defining High Bleeding Risk in Patients Undergoing Percutaneous Coronary Intervention: A Consensus Document From the Academic Research Consortium for High Bleeding Risk Left Ventricular Assist Devices: Synergistic Model Between Technology and Medicine Impact of Statins on Cardiovascular Outcomes Following Coronary Artery Calcium Scoring Changes in high-sensitivity troponin after drug-coated balloon angioplasty for drug-eluting stent restenosis sST2 Predicts Outcome in Chronic Heart Failure Beyond NT−proBNP and High-Sensitivity Troponin T Comparison of Heart Team vs Interventional Cardiologist Recommendations for the Treatment of Patients With Multivessel Coronary Artery Disease In-Hospital Costs and Costs of Complications of Chronic Total Occlusion Angioplasty Insights From the OPEN-CTO Registry Improving the Design of Future PCI Trials for Stable Coronary Artery Disease: JACC State-of-the-Art Review Level of Scientific Evidence Underlying the Current American College of Cardiology/American Heart Association Clinical Practice Guidelines Association of CYP2C19 Loss-of-Function Alleles with Major Adverse Cardiovascular Events of Clopidogrel in Stable Coronary Artery Disease Patients Undergoing Percutaneous Coronary Intervention: Meta-analysis

Clinical Case Study2019 Jul 13.[Epub ahead of print]

JOURNAL:Eur Heart J Cardiovasc Imaging. Article Link

Healed coronary plaque rupture as a cause of rapid lesion progression: a case demonstrated with in vivo histopathology by directional coronary atherectomy

Tsuchiya H, Nakano A, Nakamura N et al. Keywords: healed coronary plaque rupture; lesion progression; directional coronary atherectomy

ABSTRACT

Coronary plaque rupture is a culprit lesion morphology of thrombotic events leading to acute coronary syndrome (ACS). Meanwhile, coronary plaque rupture often occurs silently and heals spontaneously. This phenomenon is recognized as healed plaque rupture (HPR) in pathological studies. HPR is considered to be a cause of lesion progression, although most reports have been based on ex vivo autopsy specimens, therefore HPR remains underappreciated.


A 75-year-old man with a history of previous percutaneous coronary intervention to the left circumflex artery was admitted with recurrent ACS. Coronary angiography revealed rapid progressive lesion in the right coronary artery, where only mild stenosis existed 4 months prior (Panels A and...