Angioscopic Evaluation of Coronary-Artery Thrombi in Acute Coronary Syndromes

To the Editor: Mizuno et al. (Jan. 30 issue)¹ provide important information about the morphology of coronary-artery thrombi in unstable angina and acute myocardial infarction using angioscopy. In this study, all the patients with acute infarction had red (fibrin-rich) thrombi, whereas the majority of patients with unstable angina had grayish-white (platelet-rich) clots. The authors postulated that these differences in color might be due to differences in the composition or age of the thrombi. Several decades ago Friedman and Van der Bovenkamp² reported that the composition of a thrombus associated with a ruptured plaque depends on whether the contents of the…