Plaque fissure and calcified nodule: histopathological findings.
Level 5 - mechanism / opinion, no new human data
Narrative review of coronary plaque histopathology without systematic review methodology or primary data.
PubMed 40971984 · doi:10.1093/eurheartj/ehaf672
What was done
This narrative review defines and contrasts specific coronary plaque phenotypes: plaque fissure versus plaque rupture, and calcified nodules versus nodular calcification. It also reviews their implications for acute coronary syndrome presentations and detection via advanced intravascular imaging.
What was found
The abstract reports no numerical or quantitative data. It outlines key qualitative histopathological distinctions: - Plaque fissures display a lateral tear traversing a thick fibrous cap into a small necrotic core, generating intraplaque thrombus with absent or minimal luminal thrombus. - Plaque ruptures involve disruption of a thin fibrous cap accompanied by prominent macrophage and T-lymphocyte infiltration. - Calcified nodules consist of dense calcium fragments interspersed with fibrin that protrude into the lumen devoid of fibrous tissue or endothelium, triggering non-occlusive luminal thrombus. - Nodular calcifications have an intact, thick fibrous cap lined by endothelial cells without associated thrombus.
Why it matters
Distinguishing these distinct culprit lesion morphologies clarifies the mechanisms underlying coronary events and informs the interpretation of high-resolution intravascular imaging for lesion-targeted interventions.
Limits
The abstract describes a narrative review with no primary data, sample size, systematic search criteria, or quantitative comparative metrics reported.
Cited by
- contradicts Calcified atherosclerotic plaque does not rupture or cause heart attacks; rather, non-calcified plaque ruptures and occludes the blood vessel.