Elderly Patients With Minimal Common Carotid Atherosclerosis Not Infrequently Have Severe Coronary Atherosclerosis and Myocardial Infarction

Abstract

Background The presence of discordances between common carotid and coronary atherosclerosis in the same individual has not been previously reported. Methods and ResultsThe subjects of the present study were 1,518 consecutive autopsy cases at a general geriatric hospital. All were aged 60 years or older (821 men, 697 women) with an average age of 80 years. The atherosclerotic index of the common carotid artery (CC-AI) and coronary stenotic index (CSI) were semi-quantitatively evaluated. The simple correlation coefficient between the CC-AI and CSI was 0.456 (p<0.0001). Among 689 cases with minimal common carotid atherosclerosis (CC-AI ≤2), 74 (11%) had severe coronary atherosclerosis (CSI ≥12), 68 (10%) had coronary heart disease, and 80 (12%) had pathologically-verified myocardial infarction (MI). Among those with minimal common carotid atherosclerosis, the serum total cholesterol level, diabetes mellitus, and history of smoking were significantly higher or more frequent in cases with a CSI ≥12 than in the patients with a CSI <12. Conclusions A considerable proportion of cases with minimal common carotid atherosclerosis had severe coronary atherosclerosis and MI. This discordance can potentially lead to an underestimation of coronary risks if normal common carotid morphology is obtained by ultrasound. (Circ J 2008; 72: 1946 -1952

Caveolin-1 deletion exacerbates cardiac interstitial fibrosis by promoting M2 macrophage activation in mice after myocardial infarction

“…Myocardial infarction (MI) occurs as a result of ischemic damage to the left ventricle (LV) [1,2]. Within hours following ischemia, an acute inflammatory response is initiated, with neutrophils infiltrating the necrotic area first, followed by infiltration of macrophages days later [3,4].…”

ORIGINAL ARTICLE: Morphometric evaluation for relationship of atherosclerosis developed in coronary and peripheral muscular arteries: An autopsy study

“…As in previous researches, [13][14][15] this autopsy study also confirmed the correlation between the IMT of the carotid artery and atherosclerosis in the left anterior descending branch of the coronary artery and in the right coronary artery. These findings suggest 20 in which atherosclerosis in the coronary arteries significantly advances although atherosclerosis in the carotid artery was not severe. In their study, such cases accounted for 11% of the total number of cases.…”

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High lipoprotein(a) level promotes both coronary atherosclerosis and myocardial infarction: a path analysis using a large number of autopsy cases

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