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Published on: June 12, 2019
GRADING ATHEROSCLEROSIS IN AORTA AND CORONARY ARTERIES OBTAINED AT AUTOPSY: APPLICATION OF A TESTED METHOD
Insights
This study validated a method for assessing atherosclerosis, demonstrating its ability to differentiate lesion quantities across nearly 3000 individuals. The atherosclerosis assessment method proved effective in comparing groups and identifying statistically significant differences in lesion severity.
Area of Science:
- Cardiovascular Pathology
- Epidemiology
- Biostatistics
Background:
- A previous study established a method for assessing atherosclerosis capable of discriminating between groups based on lesion quantity.
- The method quantifies relative differences in atherosclerosis rather than absolute amounts, indicating statistical significance.
Purpose of the Study:
- To apply and evaluate the discriminatory power of an established atherosclerosis assessment method in a multi-country study.
- To assess the method's reliability through intra-observer and inter-observer calibration and inter-sessional tests.
- To determine the method's effectiveness in discriminating lesion types and severity across various arteries.
Main Methods:
- Application of a defined atherosclerosis assessment protocol to arterial specimens from six communities in three countries.
- Routine intra-observer and inter-observer calibration tests conducted over four grading sessions.
- Calculation of discriminatory power for "total amount of atherosclerosis", "fatty streak", "fibrous plaque", "complicated lesion", "calcification", and "coronary stenosis".
Main Results:
- The atherosclerosis assessment method demonstrated significant discriminatory power when comparing groups from nearly 3000 subjects.
- Effectiveness was shown across different arteries including thoracic aorta, descending aorta, and coronary arteries (right, left anterior descending, left circumflex).
- The method proved valuable for assessing "coronary stenosis", exceeding prior expectations.
Conclusions:
- The validated atherosclerosis assessment method is reliable and effective for epidemiological studies comparing lesion burden.
- The method provides statistically significant discrimination of atherosclerosis and coronary stenosis across diverse populations and arterial segments.
- This approach offers practical value for quantitative assessment of atherosclerosis in large-scale research.
Abstract:
A method of assessing "atherosclerosis", if used according to certain rules, was shown in an earlier study to be capable of discriminating between groups of aortas or coronary arteries according to the quantity of certain defined lesions. It would not measure absolute amounts, but would show whether one group of specimens had more or less of the factor assessed than another and would indicate the statistical significance of this finding according to the number of specimens in each group.The method has now been applied to a study of material from six communities in three countries.This paper outlines how the rules of procedure were applied. Intra-observer and inter-observer calibration tests carried out in a routine manner during four "grading sessions" and inter-sessional tests are described.The discriminatory power in comparing groups of specimens from nearly 3000 subjects is calculated and shown according to artery (thoracic aorta, descending aorta, right coronary, left anterior descending coronary, left circumflex coronary) and type of lesion ("total amount of atherosclerosis", "fatty streak", "fibrous plaque", "complicated lesion" and "calcification"). Observations on "coronary stenosis" were also made. The discriminatory power of the method was calculated for this factor and, contrary to many expectations, was found to be of practical value.Definitions and general procedure are described in annexes.
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