A perspective of coronary disease seen through the arteries of living man.

Although white adults have more extensive aortic surface involvement with fibrous plaques than do blacks, adolescent blacks have more aortic fatty streaks (FS) than do whites of similar ages. Possible determinants of these racial differences in aortic surface involvement with FS were therefore examined in 44 decedents who had previously been examined as part of the Bogalusa Heart Study. Ages at death ranged from 6 to 27 years (mean, 18 years); the median interval between the last risk factor examination and death was 3.5 years. More extensive aortic surface involvement with FS was observed in blacks (n = 11) as compared with whites (n = 33; 37% vs 16%, p = .0003). This racial difference was independent of age at death, and was seen in both male and female subjects. Black-white differences in several of the previously measured risk factors (serum lipids and lipoproteins, blood pressure, and obesity) were also observed, and in both races, aortic FS were related to several of these characteristics. (For example, the correlation between levels of low-density lipoprotein cholesterol and aortic FS was 0.49 in whites and 0.73 in blacks.) However, even after controlling for antemortem levels of risk factors, blacks had an additional 16% surface involvement with aortic FS as compared with whites (p < .001). These findings suggest that the more extensive surface involvement of the aorta with FS in young blacks is not due to differences in clinical risk factors. Because more extensive raised lesions are found in white adults, the transition of FS to advanced atherosclerotic lesions may differ in whites and blacks.Circulation 77, No. 4, 856-864, 1988. ATHEROSCLEROSIS begins early in life. Fatty streaks are found in the aortas of nearly all children by the age of 3 years,1' 2 and appear in the coronary arteries during the second decade of life.3 Fibrous plaques also appear in the aorta and coronary arteries during the second decade.4 5 Antemortem levels of cardiovascular disease risk factors have been related to fibrous plaques (and more advanced lesions) in several autopsy studies of middle-aged men,6 and overwhelming evidence7' 8 implicates these lesions in clinical disease. Although the possible transition of fatty streaks to fibrous plaques remains controversial,9' 10

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“…The (11) 10 (3) 35 (7) 1958-1959 2 11 (8) 19 (13) 11 (7) 29 (7) 1960- 1965 4 7 (5) 19 (18) 5 (3) 13 (10) 1978-1986 Current study…”

Section: Discussionunclassified

Black-white differences in aortic fatty streaks in adolescence and early adulthood: the Bogalusa Heart Study.

et al. 1988

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“…The Cedars-Sinai group in Los Angeles'8 19 AVasoconstrjction (may contribute to coronary occlusion).…”

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confidence: 99%

Insights into the pathogenesis of acute ischemic syndromes.

et al. 1988

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OVER THE LAST few years clinical/pathologic observations and experimental investigation have led us to a better understanding of the pathogenetic factors leading to the acute coronary syndromes: unstable angina, myocardial infarction, and ischemic sudden death. The elegant pathologic studies of Falk' and Davies and Thomas2 have emphasized that thrombus formation secondary to plaque rupture and fissuring in the atherosclerotic coronary artery play a major and frequent role in the acute coronary syndromes. Indeed, their observations and the observations of others have established that this pathologic phenomenon is a common link between the three acute coronary syndromes in man.3 This review focuses on three areas of recent progress: (1) the interaction between platelets, thrombosis, and blood rheology in experimental vessel wall injury, (2) the relevance of these blood vessel interactions to the acute coronary syndromes in man, and briefly (3) the usefulness of antithrombotic therapy in reducing morbidity and mortality due to the acute coronary syndromes.

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“…Baseline clinical characteristics and quantitative angiographic data pre-and post-PTCA Existent differences in pathophysiology of effort angina and angina at rest, as evidenced by recent angioscopic findings that each of these clinical coronary syndromes appears to have its own specific underlying endothelial pathology [20][21], leads to the hypothesis that the early and 'late' vessel wall response to dilatation injury may be dissimilar in mechanism and/or magnitude.…”

Section: Discussionmentioning

confidence: 99%

“…In view of these discrepant results, and given the distinctly different coronary morphology observed by angioscopy in patients with stable exercise-induced angina versus those with unstable rest angina [20,21], elucidation of the question whether the H.E. Luijten, MD, is the recipient of a Research Fellowship from the Dutch Heart Foundation (no.…”

Section: Introductionmentioning

confidence: 99%

Angioplasty for stable versus unstable angina pectoris: Are unstable patients more likely to get restenosis?

Luijten¹,

Beatt²,

Feyter³

et al. 1988

Int J Cardiac Imag

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Current evidence with regard to the possible association between clinical expression of coronary disease prior to the time of angioplasty, and the subsequent risk of restenosis following successful dilatation, remains inconclusive. To prospectively compare the incidence of restenosis in stable versus unstable angina pectoris patients, follow-up angiography was performed in 85 percent of patients from a consecutive series with a successful PTCA, irrespective of presence or absence of recurrent ischemic symptoms. Furthermore, changes in lesion severity were assessed quantitatively by an automated edge-detection technique rather than visual analysis. Employing such a study design and follow-up protocol, it was found that the incidence of restenosis in patients with stable coronary artery disease was similar to that of patients with unstable rest angina, irrespective of the type of angiographic definition used.

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A perspective of coronary disease seen through the arteries of living man.

Cited by 192 publications

References 30 publications

Black-white differences in aortic fatty streaks in adolescence and early adulthood: the Bogalusa Heart Study.

Black-white differences in aortic fatty streaks in adolescence and early adulthood: the Bogalusa Heart Study.

Insights into the pathogenesis of acute ischemic syndromes.

Angioplasty for stable versus unstable angina pectoris: Are unstable patients more likely to get restenosis?

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