PDF(Pubmed)
Abstract：
UNASSIGNED: Spontaneous coronary artery dissection (SCAD) is an important cause of acute coronary syndrome in young women. There is no consensus on optimal treatment, though a conservative approach including antiplatelet agents is commonly used. We hypothesized that most cases of SCAD would not demonstrate true lumen thrombus in the dissected artery, suggesting that anti-platelet agents might not have a role in the treatment of SCAD.
UNASSIGNED: We conducted a systematic review of the published literature through March 2022 to identify pathology images from individuals who died of SCAD. The images were independently reviewed by a pathologist to assess for the presence of thrombus and inflammatory cells.
UNASSIGNED: We identified 40 cases from 34 publications with available pathology images and found only one case of true lumen thrombus. Additionally, we found that 53% of cases involved eosinophilic inflammation.
UNASSIGNED: The role of antiplatelet agents in the treatment of SCAD should be re-evaluated. Further studies are needed to better understand the significance and treatment implications of eosinophilic inflammation.
UNASSIGNED: We conducted a systematic review of the published literature through March 2022 to identify pathology images from individuals who died of SCAD. The images were independently reviewed by a pathologist to assess for the presence of thrombus and inflammatory cells.
UNASSIGNED: We identified 40 cases from 34 publications with available pathology images and found only one case of true lumen thrombus. Additionally, we found that 53% of cases involved eosinophilic inflammation.
UNASSIGNED: The role of antiplatelet agents in the treatment of SCAD should be re-evaluated. Further studies are needed to better understand the significance and treatment implications of eosinophilic inflammation.
摘要：
■自发性冠状动脉夹层（SCAD）是年轻女性急性冠状动脉综合征的重要原因。关于最佳治疗没有共识，尽管通常使用包括抗血小板药物在内的保守方法。我们假设大多数SCAD病例不会在解剖的动脉中表现出真正的管腔血栓，提示抗血小板药物可能在SCAD的治疗中没有作用.
■我们对截至2022年3月的已发表文献进行了系统回顾，以识别死于SCAD的个体的病理图像。病理学家独立检查图像以评估血栓和炎症细胞的存在。
■我们从34篇文献中确定了40例具有可用病理图像的病例，仅发现一例真腔血栓。此外,我们发现53%的病例涉及嗜酸性粒细胞性炎症.
■应重新评估抗血小板药物在SCAD治疗中的作用。需要进一步的研究来更好地了解嗜酸性粒细胞性炎症的意义和治疗意义。
■我们对截至2022年3月的已发表文献进行了系统回顾，以识别死于SCAD的个体的病理图像。病理学家独立检查图像以评估血栓和炎症细胞的存在。
■我们从34篇文献中确定了40例具有可用病理图像的病例，仅发现一例真腔血栓。此外,我们发现53%的病例涉及嗜酸性粒细胞性炎症.
■应重新评估抗血小板药物在SCAD治疗中的作用。需要进一步的研究来更好地了解嗜酸性粒细胞性炎症的意义和治疗意义。
