Survey of Coronary Artery Atherosclerosis among 30-45 and 60-75 Year Old Patients: An Autopsy Based Study
AJ Wilhorn, DV Miller. Mayo Clinic, Rochester, MN
Background: Ischemic heart disease and coronary atherosclerosis remain the leading cause of death in the United States. The literature is replete with studies comparing the severity and distribution of coronary artery stenosis as assessed at autopsy and by other in-vivo methods (angiography, coronary CT, and other imaging modalities). However, the vast majority of autopsy based studies were conducted more than 2 decades ago. Since that time, education and prevention programs have helped increase patient awareness of coronary disease and ostensibly made an impact on the overall coronary disease burden in our population. Given the potential impact of these initiatives over the past 2 decades, it is of interest to assess the severity and distribution of coronary artery disease in a more recent cohort of patients in a large autopsy series.
Design: This study included a retrospective review of autopsy reports to abstract manner and cause of death, degree of coronary atherosclerosis in each coronary vessel, and other significant clinical and pathological parameters. Autopsy reports from 2003-2008 were used for the purpose of this study to identify patients between the ages of 30-45 and 60-75 years of age. Coronary obstructions were graded as 1: <25%, 2: 26-50%, 3: 51-75%, and 4: >75% luminal occlusion.
30-45 yr. Old Patients*p<0.001
|Average LAD Disease Grade:||1.87*|
|Average LCX Disease Grade:||1.51*|
|Average RCA Disease Grade:||1.73*|
|% with Severe 3-vessel Disease:||6%|
|% with at least 1-vessel Severe Disease:||18%|
|Cardiac Related Cause of Death||20%|
60-75 yr. Old Patients*p<0.001
|Average LAD Disease Grade:||3.11*|
|Average LCX Disease Grade:||2.77*|
|Average RCA Disease Grade:||2.94*|
|% with Severe 3-vessel Disease:||29%|
|% with at least 1-vessel Severe Disease:||58%|
|Cardiac Related Cause of Death||30%|
Conclusions: Like the majority of older studies, lesions of the LAD were slightly more common in both groups. The incidence of severe single vessel disease is significant (58%) in the age 60-75 group, even among patients not dying from cardiac disease. A surprisingly high rate of single vessel disease was also seen in the 30-45 year age group as well.
Wednesday, March 11, 2009 1:00 PM
Poster Session VI # 2, Wednesday Afternoon