Abstract 20002: Prevalence of Coronary Atherosclerosis in an Unselected Autopsy population in a Tertiary Care Centre in South India
Background: Autopsy studies may be an effective method of identifying population trends in coronary atherosclerosis, which is the leading cause of morbidity and mortality in the industrial world. We aimed to study the prevalence of coronary atherosclerosis in an unselected group of medico-legal autopsies.
Methods: Cross sectional study conducted on 300 consecutive autopsies from February to April 2013. The heart specimens were weighed and gross morphology studied. Serial sections (3mm apart) of coronary arteries were examined for gross atherosclerosis. In the first 100 specimens, macroscopic atherosclerotic lesions were biopsied and graded by histopathology and in their absence, sections from each of the coronary artery segments were examined.
Results: The mean age group was 46.28 ±18 yrs and females accounted for 22.6% of the population studied. Cardiac event as a cause of death was identified in 6.3% of the study population. By visual assessment, significant atherosclerotic luminal stenosis (defined as ≥50% area stenosis in Left Main Coronary Artery (LMCA) & ≥75% area stenosis in other vessels) was identified in 68 (22.6%) of cases. Out of these, isolated significant LMCA disease was found in 7 (2.3%) of cases, LMCA + Single Vessel Disease (SVD) was found in 5 (1.7%) cases, LMCA+ two vessel disease (2VD) was found in 4 (1.3%) of the cases and LMCA+ three vessel disease (3VD) was found in 1(0.3%) case, SVD in 37 (12.3%) cases and 2VD in 14 (4.7%) cases. Histopathology revealed significant atheroma (≥ Grade 4 by American Heart Association grading) in 61% of cases, of which, isolated significant LMCA disease was found in 3% and 3VD in 7% of cases. Visual assessment of significant atherosclerosis was 85% sensitive and 91.25% specific compared to histopathology, the gold standard.
Conclusions: Although cardiac cause of death could be identified only in 6.3% of cases, significant coronary atherosclerosis was identified in 22% of gross specimens and 61% of histopathology specimens, highlighting the high prevalence of significant subclinical coronary atherosclerosis in the study population. Visual assessment has good sensitivity and specificity for detection of significant coronary atherosclerosis.
Author Disclosures: S.G. Nair: None. S. Viswanathan: None. P. Rema: None. S. Kumar: None. K. Gopinath: None.
- © 2014 by American Heart Association, Inc.