ĐẶC ĐIỂM MÔ BỆNH HỌC XƠ VỮA ĐỘNG MẠCH VÀNH THEO PHÂN LOẠI AHA TRÊN CÁC TRƯỜNG HỢP ĐỘT TỬ TỰ NHIÊN QUA GIÁM ĐỊNH PHÁP Y

Abstract

Background: Coronary artery disease is increasing in both Vietnam and worldwide. Grading of coronary atherosclerotic lesions is important because it correlates with significant cardiac pathologies such as myocardial infarction, myocardial fibrosis, and left ventricular hypertrophy. Comprehensive histopathological evaluation of coronary atherosclerosis in living individuals remains limited; therefore, we conducted an autopsy study of natural sudden death cases to describe the characteristics of coronary atherosclerosis and provide a more comprehensive understanding of this disease. Objectives: To describe the histopathological characteristics of coronary atherosclerosis according to the American Heart Association (AHA) classification in cases of natural sudden death. Methods: A retrospective cross-sectional study was conducted at the Ho Chi Minh City Forensic Medicine Center on 152 natural sudden death cases during the first six months of 2020. Heart specimens were examined both grossly and microscopically, and lesions were classified according to the AHA 2000 system. Results: Intermediate lesions (type III) were frequently observed in individuals aged 21–40 years and represented the most common lesion type (40.9%). Advanced lesions (types IV–VIII) accounted for 55.6% of cases, with type IV being the most prevalent advanced stage (23.4%). The left anterior descending artery was the most commonly affected vessel (56.2%). Most cases involved a single vessel (88.2%). Severe cardiac lesions were commonly associated with advanced atherosclerotic plaques (type ≥VI). Eccentric plaques predominated (87.1%), compared with concentric plaques (12.9%). Conclusions: Coronary atherosclerosis is highly prevalent in natural sudden deaths and appears to begin at a relatively young age. The AHA classification is valuable for assessing lesion progression and its association with myocardial infarction.