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Study of coronary atherosclerosis by modified american heart association classification of atherosclerosis-an autopsy
Viral M Bhanvadia1, Nandini J Desai2, Neeru M Agarwal3
1Assistant Professor, Department of Pathology, MP. Shah Medical College, Jamnagar, Gujarat, India.
Insights
Atherosclerosis affects both urban and rural populations in Jamnagar, India, with early lesions observed in younger individuals. This highlights the need for early lifestyle interventions to prevent coronary artery disease.
Area of Science:
- Cardiovascular Pathology
- Public Health Research
- Epidemiology
Background:
- Assesses atherosclerotic lesions in coronary arteries using autopsy data.
- Applies Modified American Heart Association (AHA) classification for grading lesions.
- Evaluates atheromatous and vulnerable plaques to determine age and sex-related prevalence of atherosclerosis in Jamnagar, Western India.
Purpose of the Study:
- To grade atherosclerotic lesions in coronary arteries.
- To evaluate atheromatous and vulnerable plaques.
- To determine age and sex-related prevalence of atherosclerosis in Jamnagar's semi-urban and urban population.
Main Methods:
- Conducted autopsies on 264 cases aged 8-79 years.
- Dissected hearts following the direction of blood flow.
- Performed microscopic assessment of the three main coronary arteries.
Main Results:
- Maximum cases of atherosclerosis were observed in the 40-49 years age group.
- Intimal xanthoma was the most common lesion across all three coronary arteries.
- Intermediate lesions were common in young individuals (10-39 years); 59% of males and 52% of females were affected.
Conclusions:
- Atherosclerotic lesions significantly impact the Jamnagar population.
- Increased intermediate lesions in the young suggest a need for early preventive measures.
- Dietary and lifestyle modifications in young individuals are crucial to prevent coronary artery disease and reduce economic burden.
Background:
The study was designed to assess the atherosclerotic lesions in coronary arteries in cases subjected to autopsy to grade by applying Modified American Heart Association (AHA) classification, evaluate the atheromatous & vulnerable plaques to find out the to age and sex related prevalence of atherosclerosis in the semi-urban & urban population of Jamnagar, a district in Western India.
Material & Methods:
Autopsy was conducted on 264 cases whose age ranged from 8-79 years, by the conventional technique; heart was removed & dissected along the direction of blood flow. Microscopic assessment of the three main coronary arteries was done.
Result:
According to Modified AHA classification of atherosclerosis, maximum number of cases were in the 40-49 years age group. Intimal xanthoma was the most common type in all three coronary arteries. The number of males was 168(64%) and females was 96(36%). 59% males & 52% female were affected from atherosclerosis. An intermediate lesion was noted commonly in young individuals (10-39 years) and older individuals (40-79 years) were 46% & 41% respectively. Pathological Intimal thickening was more common in left anterior descending coronary artery compared to others. Thin fibrous cap atheroma was more common in Left circumflex artery than compared to Left anterior descending artery & Right coronary artery.
Conclusion:
The study highlights the impact of atherosclerotic lesions in the population of Jamnagar, a district in Gujarat state of Western India. The increased amount of intermediate atherosclerotic lesions found in the young population gives an indication that anti-atherogenic preventive measures and drastic dietary & life style modification need to be implemented in young individuals, this will help to prevent coronary artery disease from causing premature death that lead to huge financial burden on the economy and health sector of India.
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