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Coronary artery atherosclerosis observed in men over 14 consecutive years

M L Murphy, N de Soyza, J E Doherty

    Clinical Cardiology
    |February 1, 1985
    PubMed

    Insights

    Cardiovascular death and myocardial infarction rates have decreased. This study found no reduction in coronary atherosclerosis severity, suggesting improved disease mechanisms, not less plaque, explain these positive trends in ischemic heart disease.

    Area of Science:

    • Cardiovascular Medicine
    • Pathology

    Background:

    • Cardiovascular death and myocardial infarction incidence have declined over 15 years.
    • The association between this decline and coronary atherosclerosis severity remains unclear.

    Purpose of the Study:

    • To investigate changes in the extent of coronary atherosclerosis in men over a 14-year period.
    • To determine if observed declines in ischemic heart disease events correlate with reduced atherosclerosis severity.

    Main Methods:

    • Postmortem coronary angiography was performed on 505 male patients.
    • Patients were categorized into groups with (42%) and without (58%) ischemic heart disease.
    • Coronary atherosclerosis extent was quantified using coronary scores over 14 years.

    Main Results:

    • No significant trend in mean coronary scores was observed over the 14-year period for patients without ischemic heart disease.
    • Similarly, no significant trend was found in the last 10 years for patients with ischemic heart disease.
    • Patients with ischemic heart disease early in the study exhibited significantly lower coronary scores compared to later cohorts.

    Conclusions:

    • The decline in cardiovascular death and myocardial infarction may be attributed to favorable changes in disease pathogenesis.
    • These findings suggest that reduced atherosclerosis extent is unlikely to be the primary driver of improved ischemic heart disease outcomes.

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