Coronary atherosclerosis in Aligarh district, Uttar Pradesh. A morphological study

The present communication deals with the observations of the type and extent of atherosclerotic lesions in coronary arteries obtained from 108 heart specimens. In 81.4% cases the lesions were present. The earliest lesion of fatty streak was noticed in 2nd decade whereas all the cases above 4th decade had atherosclerotic lesion. Fatty streaks involved 4.5% of the intimal surface in 2nd decade, reaching a maximum to 26% in 6th decade and later on receding to 12% in 7th decade. Fibrous plaques were seen in later period of 2nd decade involving 2% of the surface area. There was a slow and tardy progression of the lesion with the maximum involvement of 32% in 7th decade. Complicated lesions were seen in 3rd decade but involved only 7% of the surface in 7th decade. Left coronary artery was involved in 79.62% cases and the right in 78 (72.22%). Salient histomorphological changes as well as degenerative changes occurring in the development of the disease process have been discussed. Main differences in the natural history of the disease in Indians were the slow progression of fibrous plaque and a very low incidence of grade IV lesions (complicated lesions). Marked disparity between the lesions observed in coronary arteries and root of aorta was noticed.