Atherosclerotic coronary artery disease in a tertiary health care facility: an autopsy study

Abstract

Background: Atherosclerotic coronary artery disease (ACAD), which manifests as ischaemic heart disease (IHD), is the single largest killer worldwide with yearly global mortality of about seven million.

Objective: onsidering the rising trends of ACAD worldwide and the report that by year 2020, IHD would be the most common cause of death globally; the need for this study has become imperative.

Methods: This was a prospective study carried out on 135 autopsied bodies in a tertiary hospital in South Western, Nigeria. The heart was routinely removed using the standard dissecting method. The three arteries RCA), LAD, LCx were identified. The wall and the luminal patency of these arteries were then examined, anatomically graded by visual means using a 4-point grading system. Microscopic examination was used to support the visual grading. Data was analysed using the SPSS version 18.

Results: The study revealed 84 males (62.2%) and 51 females (37.8%) representing M:F of 1.6. The ages ranged from 20-83 years. The prevalence of atherosclerosis was 26.7%. Atherosclerosis was most common in the 60-69 years group (40.9%), while it is least common in the 20-29 years (6.7%). Single- and triple-vessel involvement accounted for 17.0% each while double-vessel involvement was seen in 14.1% of the subjects. Evidence of old myocardial infarction was seen in 3 male subjects (2.2%).

Conclusion: Coronary atherosclerosis usually reported rare in the past is now an emerging disease even among the young. This is evidenced by the prevalence in this study. The need has therefore arisen to increase public awareness of this health issue.

Keywords: Coronary artery, Atherosclerosis, Ischaemic heart disease