Abstract
Objectives: Ischemic heart disease resulting from atherosclerosis of coronary arteries is the most common fatal cardiac disease found in autopsies. With increase in incidence of coronary heart diseases it became challenging in India. The study was designed to assess the histomorphological atherosclerotic changes in coronary arteries at autopsy and to find out the age and sex related prevalence of atherosclerosis in population of Patna, Bihar a district in North India. This study will help in collecting baseline information of prevalence of such lesions which will help in framing health care programs to prevent the formation of these lesions.
Methods: In the present study, a total of 125 cases were autopsied to study and grade atherosclerotic lesions in the coronaries. Slides were prepared by sections of these specimens and stained with hematoxylin and eosin for microscopic examination.
Results: Among 125 studied specimens (98 males and 27 females) atherosclerotic lesions was found in 83.20% cases. It was observed in 83.67% of the male and 81.48% of female specimens. Significant atheroma was detected in 49.03% Cases. Commonest type of atherosclerosis seen was grade 3. The most frequently involved branch was left anterior descending artery. Relative frequency of lesions increased with age.
Conclusions: With high prevalence of cardiovascular disease, the study of subclinical atherosclerosis is the need of the day to estimate the disease burden in the hidden portion of iceberg which are symptom free. In this study atherosclerotic lesions was observed in very young population which may be an indication that there is need of implementation of anti atherogenic preventive measures in young individuals. It also highlights the importance of cardiovascular risk factors screening from early ages.
Keywords: Atherosclerosis, Coronary arteries, Autopsy, American Heart Association classification.
References
- Mohan V, Deepa R. Risk factors for coronary artery disease in Indians. J Assoc Physicians India. 2004; 52:95–7. [Pub Med]
- Yazdi SA, Rezaei A, Azari JB, Hejazi A, Shakeri MT, Shahri MK. Prevalence of atherosclerotic plaques in autopsy cases with non cardiac death. Iran J Pathol. 2009; 4:101–4.
- Indrayan A. Forecasting vascular disease cases and associated mortality in India. NCMH Background Papers: Burden of Disease in India. National Commission on Macroeconomics and Health, Government of India. 2005.
- Schoen FJ. Blood vessels. In: Cotran RS, Kumar V, Robbins SL, eds. Pathological basis of disease. Philadelphia: W B Saunders, 1994:473-484.
- Widimsky P, Andel M. Prevalence of coronary atherosclerosis in asymptomatic population. Eur Heart J 2000; 21: 13-14.
- Fausto N. Atherosclerosis in young people: The value of the autopsy for studies of the epidemiology and pathobiology of disease. Am J Pathol. 1998; 153:1021–2. [PMC free article] [Pub Med]
- Bertomeu A, Garcia- Vidal O, Farre X, Galobart A, Vazquez M, Laguna JC, Ros E. Preclinical coronary atherosclerosis in a population with low incidence of myocardial infarction: cross sectional study. BMJ 2003; 327:591-2.
- Reddy SK, Yusuf S. Emerging epidemic of cardiovascular disease in developing countries. Circulation. 1998; 97:596–601. [Pub Med]
- Stary HC. Natural History and Histolo-gical Classification of Atherosclerotic lesions: An Update. Arteriscler Thromb VascBiol 2000; 20:1177-1178.
- Curtiss LK. Reversing Atherosclerosis? N Engl J Med. 2009; 360:1144–6. [Pub Med]
- Naher S, Naushaba H, Muktadir G, Rahman MA, Khatun S, Begum M. Percentage area of intimal surface of the abdominal aorta affected by atherosclerosis: A Postmortem Study. J Med Sci Res. 2007; 9:26–30.
- Bhargava MK, Bhargava SK. Coronary atherosclerosis in North Karnataka. Indian J PatholMicrobiol 1975; 18:65 77.
- Virmani R, Kolodgie FD, Burke AP, Farb A, Schwartz SM. Lessons from sudden coronary death – Virmani R, Kolodgie FD, Burke AP, Farb A, Schwartz SM. Lessons from sudden coronary death – A compreh-ensive morphological classification scheme for atherosclerotic lesions. Arterioscler Thromb Vasc Biol 2000; 20:1262-75
- Monika Garg, Akash Deep Agarwal, Sant Prakash Kataria. Coronary Atherosclerosis and Myocardial Infarction an Autopsy Study. J Indian Acad Forensic Med. Jan-Mar 2011, Vol.33: 1; 39-42.
- Golshahi J, Rojabi P, Golshahi F. Frequency of atherosclerotic lesions in coronary arteries of autopsy specimens in Isfahan forensic medicine center. J Res Med 2005; 1(10):16-9.
- Sudha ML, Sundaram S, Purushothaman KR, Kumar PS, Prathiba D. Coronary atherosclerosis in sudden cardiac death: An autopsy study. Indian J Pathol Microbiol 2009;52(4):486-9
- Noeman A, Ahmad N, Azhar M. Coronary artery disease in young: Faulty life style or heredofamilial or both. Annals. 2007; 13:162–4.
- Singh H, Oberoi SS, Gorea RK, Bal MS. Atherosclerosis in Coronaries in Malwa Region of Punjab. J Indian Acad Forensic Med 2005; 27(4):32-5.
- Murthy MSN, Dutta BN, Ramalingaswami V. Coronary atherosclerosis in North India (Delhi Area). J Pathol Bacteriol 1963; 85:93-101
Corresponding Author
Aman Kumar
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.