ArticleInternational journal of legal medicine2021
Postmortem coronary artery calcium score in cases of myocardial infarction.
Article in International journal of legal medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 10 papers.
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10 citing papers in PubMed, 23 citations in OpenAlex.
- Multiphase post-mortem CT angiography (MPMCTA) in sudden natural death: diagnostic contribution and workflow impact in a forensic autopsy series.Forensic science, medicine, and pathology · 2026Article
- Blood omega-3 fatty acids and coronary artery stenosis: a postmortem study.Lipids in health and disease · 2025Article
- Cardiac-specific troponin-I (cTnI) in a post-mortem setting.International journal of legal medicine · 2025Article
- The current state of forensic imaging - post mortem imaging.International journal of legal medicine · 2025Review
- High-risk coronary plaque of sudden cardiac death victims: postmortem CT angiographic features and histopathologic findings.International journal of legal medicine · 2024Article
- Is there an association between coronary artery inflammation and coronary atherosclerotic burden?Quantitative imaging in medicine and surgery · 2023Article
- Characterization of global research trends and prospects on sudden coronary death: A literature visualization analysis.Heliyon · 2023Article
- Article
- Application of postmortem imaging modalities in cases of sudden death due to cardiovascular diseases-current achievements and limitations from a pathology perspective : Endorsed by the Association for European Cardiovascular Pathology and by the International Society of Forensic Radiology and Imaging.Virchows Archiv : an international journal of pathology · 2023Article
- Risk of sudden coronary death based on genetic background in Chinese Han population.Experimental and therapeutic medicine · 2021Article
Corrections and comments
- Erratum issued
Authors and funding
7 authors at 4 institutions in 2 countries.
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No grant is acknowledged in the PubMed record.
Abstract
Sudden cardiac death (SCD) related to atherosclerotic coronary artery disease (ACAD) resulting in myocardial infarction is the most prevalent cause of death in western countries. In clinical practice, coronary artery calcium score (CACS) is considered an independent predictor of coronary events, closely related to atherosclerotic burden and is quantified radiologically by the Agatston score being calculated through computed tomography. Postmortem computed tomography (PMCT) allows the visualization and quantification of coronary calcifications before the autopsy. However, it was reported that some patients who died from severe ACAD had a zero CACS in PMCT. In this study, a retrospective evaluation of CACS in adult's myocardial infarction cases related to ACAD, with available CACS and histological slides of coronary arteries, was performed in order to gain a deeper understanding of coronary calcifications and their role in myocardial infarction cases. The CACS was calculated by using the software Smartscore 4.0 after the radiological examination on a 64-row CT unit using a specific cardiac protocol. Thirty-six cases were identified out of 582 autopsies, recorded during a 2-year study period (29 men, 7 women; age 56.3 ± 11.7). CACS was 0-10 in 5 cases (5 men, 44.8 ± 13.7), 11-100 in 8 cases (6 men, 2 women, 53.1 ± 7.7), 101-400 in 13 cases (11 men, 2 women, 57.4 ± 9.6), and > 400 in 10 cases (9 men, 1 woman, 63.1 ± 11.9). Coronary thrombosis was found in 28 cases, histologically identified as plaque erosions in 6 cases and as plaque ruptures in 22 cases. Statistical analyses showed that CACS increases significantly with age (p-value < 0.05) and does not show significant correlation with gender, body weight, body mass index, and heart weight. CACS was significantly higher in plaque ruptures than in plaque erosions (p-value < 0.01). Zero or low CACS on unenhanced PMCT cannot exclude the presence of myocardial infarction related to ACAD. This paradoxical discrepancy between imaging and autopsy findings can be explained considering the histological aspect of fatal coronary plaques.
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