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Query: UMLS:C0004153 (atherosclerosis)
 77,401 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Careful histologic studies were performed on the coronary arteries, myocardium and conduction system of the hearts of six men aged 32 to 44 years who died suddenly with no history of heart disease. All six hearts demonstrated coronary atherosclerosis without evidence of complete obstruction or myocardial infarction. A nonobstructing mural coronary thrombus was found in all six hearts; in four, the thrombus was located in the left anterior descending coronary artery. Distal microthrombi were found in four hearts. In these six men, the terminal event, often a ventricular arrhythmia, may have been related to the mural coronary thrombus. Small fragments originating from such lesions can obstruct the microcirculation producing sudden lethal arrhythmias. Nonobstructing mural coronary thrombosis may be more prevalent and more significant than previously suspected and should be considered in cases of sudden cardiac death.
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PMID:Nonobstructive coronary thrombosis in sudden cardiac death. 67 36

Lymphocyte transformation and serum levels of immunoglobulins and complement were measured in groups of patients with old myocardial infarction, with peripheral vascular disease and in age- and sex-matched controls. There were no significant differences between the groups in phytohaemagglutinin (PHA) induced lymphocyte transformation, in IgA or in serum complement levels. The levels of IgG and IgM were significantly raised in patients with old proven infarcts while the level of IgM was raised in patients with peripheral vascular disease.
Atherosclerosis 1978 Nov
PMID:Immune mechanisms in patients with proven vascular disease. 71 41

Risk factors were compared in 300 patients with brain stroke and 120 patients with neurosis or sciatic pains. It was found that arterial hypertension (p = 0.001) and diabetes (p = 0.01) were significantly more frequent in cases of brain stroke. Disturbances of lipid metabolism, tobacco smoking and obesity showed no significant difference. Extracerebral atherosclerosis (p = 0.001) increased the risk of stroke. Coronary arterial disease was most frequent (48.8%), myocardial infarction (8.3%) and calcifications in the aorta (32%) were second and third in frequency. Presence of at least two risk factors may be an indication to prophylactic treatment.
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PMID:[Risk factors in stroke]. 72 25

We studied the prevalence and the risk factor among the patients of gout in Mexico. Research was conducted in the National Institute of Cardiology and in our private practice. Prevalence of hiperuricemia and gout in the Institute of Cardiology was of 1% (970 out of nearly 100,000 patients). We divided those cases of two subgroups: Reumatology patients (333) and Cardiovascular patients (529). In the first group primary gout was (96.3), and (50.32% in the second. Risk factor was quite different too: nephropathy 9.9%, lithiasis 9.3%, pyelonephritis 2.7%, cardioangiosclerosis 12.9%, aortosclerosis 6.6%, coronary insufficiency 6.3%, myocardial infarction 0.9%, arterial hypertension 24.6% obesity 56.1% and diabetes 9.9% in the Reumatology group; in the Cardiovascular one, nephropathy 14.3%, lithiasis 12.2%, pyelonephritis 7.1%, cardioangiosclerosis 62.7%, aortosclerosis 31.7%, coronary insufficiency 24.9%, myocardial infarction 29%, arterial hypertension 51%, obesity 54.8% and diabetes 20.4%. Among the private practice patients prevalence was of 10.1% (961). In an early age (39 years) in men and a later one for women (53 years). Other characteristics of epidemiology and risk factor are: primary gout 89%, atherosclerosis 5%, coronary disease 4.6%, lithiasis 4.7%, nephropathy 2%, pyelonephritis 1%, obesity 43%, and diabetes 4.6%. In an small group of patients of our private practice we made an exhaustive study of risk factor and the metabolic disorder of lipids. We found the following frequency: 9.3 of nephropathy, 31.2% of lithiasis, 18.7% of pyelonephritis, 68.9% of cardioangiosclerosis, 46.8% de coronary insufficiency, 9.3% of myocardial infarction, 68.7% of arterial hypertension, 68.7% of obesity and 18.7% of diabetes. In the lipid profile we found an increase in triglicerids and prebeta lipoprotein. We have amply discussed the relation between hiperuricemia and pathology considered as a risk factor from the genetic point of view as well as the metabolic and circumstancial aspect. From all that we concluded that risk is multifactorial.
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PMID:[Various epidemiological aspects of hyperuricemia and gout in Mexico: incidence and the cardiovascular risk factor]. 72 44

Clinical, angiological, and biochemical examinations were performed in 981 men and 30 women with organic afflictions of peripheral arteries, and in 411 men and 50 women without any signs of peripheral arterial lesions. Their family histories were thoroughly recorded with particular reference to the occurrence of myocardial infarction, cerebral accidents before and after the age of 60 years, and death of these causes; further, of hypertension, diabetes mellitus, obliterations and gangraenes, in each patient's siblings, parents, and all four grandparents. Furthermore, the significance of positive family history in combination with other risk factors was investigated. Family history can be considered positive with respect to obliterative atherosclerosis when in anyone of the patient's grandparents, parents, or siblings an obliteration of peripheral arteries is present or when anyone of them died of myocardial infarction or apoplexy, especially when aged under 60 years. Presence of several factors in the specified next of kin accelerates the obliterative process in the patient. A positive family history, however, plays no decisive role either alone or in combination with any other single risk factor, but only in combination with two or more other factors, one of which is always tobacco smoking; it is not significant in any combination with obesity.
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PMID:Positive family history as a risk factor of obliterative atherosclerosis. 72 85

The coronary collateral circulation of 162 patients suffering from atherosclerosis and coronary insufficiency (coronary artery disease) was studied. It was found to be present in 44 patients, or 27.1%; homocoronary in 9%, intercoronary in 90.9%. As other Authors have previously reported, anastomotic circulation is more developed when the coronary occlusion exceeds 75%. Not one of the 44 cases with normal coronary arteries or occlusion inferior to 75% presented collateral circulation. In addition, it was found to be present more frequently in cases with three branch lesions. The time of insurgence of coronary insufficiency seems to condition the development of anastomotic circulation which appears more frequently when the symptoms have been present for more than 5 years (43.9%). Anastomotic circulation is also found more frequently (48.4%) in patients who have suffered myocardial infarction and who have angina. Collateral circulation was not found in any of the 46 patients with unstable isolated angina; this seems to show the importance, in its pathogenesis, of the functional factor (spasm). In conclusion, we may say that anastomotic circulation is more developed: 1) in cases of severe occlusive lesions (in severe coronary occlusive disease/atherosclerosis) (85%);2) in three branch lesions; 3) in cases of long standing symptomatology; 4) in stable angina and in angina t infarction.
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PMID:[Coronary collateral circulation in coronary atherosclerosis (author's transl)]. 73 69

Although hypertension is an acknowledged risk factor in ischaemic heart disease (IHD) the question remains whether antihypertensive therapy is necessarily beneficial. A priori, because coronary atherosclerosis is probably irreversible, the time for effective intervention would seem to be well before the development of clinical manifestations. The Australian National Blood Pressure Study, a long term clinical trial of the treatment of mild hypertension, is in principle better suited than previous trials to answer the question because the trial population selected (4000 subjects aged 30-69) contains substantial proportions of younger age groups (26% below 45) and of females (37%) and none had manifest IHD at entry. Sensitivity to the emergence of IHD in the trial population is increased by including as diagnostic indices angina and ischaemic ECG changes, using suitably objective methods, as well as myocardial infarction and sudden death. Thus morbidity and mortality from IHD which currently accounts for 71% of trial end points (cf 19% for stroke) will effectively determine the outcome of the trial. The occurrence of a substantial proportion of subjects withdrawn from randomised treatment will mean that the question will be answered necessarily in two ways: firstly in respect of those subjects remaining on their assigned treatments and secondly in terms of all subjects initially assigned one treatment or other irrespective of the subsequent need to change treatment on ethical grounds or of the degree of compliance.
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PMID:The Australian National Blood Pressure Study: a test of the effectiveness of antihypertensive therapy on the incidence of ischaemic heart disease. 79 27

By far the most frequent pathologic condition preceding myocardial infarction is coronary atherosclerosis. Because the great majority of patients who are first seen with acute myocardial infarction have atherosclerotic coronary artery disease, there is usually little thought given to other causes, except in children where congenital coronary anomalies are considered. However, there are multiple other conditions, albeit far rarer than atherosclerosis, that can result in clinical acute myocardial infarction, and a classification of these other conditions, an anatomic-pathophysiologic one, was developed from illustrative material from the files of the Armed Forces Institute of Pathology. This classification is an inclusive listing of all conditions, however unusual, that can result in acute myocardial infarction.
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PMID:Myocardial infarction without atherosclerosis. 80 70

Report of an anatomical-clinical study concerning 173 patients with an average follow-up period of 5 and 1/2 years after the onset of myocardial infarction. They were subdivided into four comparable groups differing only in the quality of the long-term antivitamin K treatment which was administered. A survey of the coronary artery and myocardial lesions was performed for every heart. Acute occlusive coronary artery thromboses were four times less frequent in the correctly treated group then in the other three groups (p less than 0.001). There was no significant difference between the insufficiently treated groups and the untreated group. Recurrent myocardial infarctions were accompanied in 90 per cent of cases by acute occlusive coronary artery thromboses and were four times less frequent when treatment was efficient (p less than 0.001). These results confirm the part played by coronary artery thrombosis in the aggravation of coronary atherosclerosis and justify the attempts at long-term prophylaxis. The provide the proof that antivitamin K administration, at efficient dosage, maintained for a long time, has a significant influence on the cause of death in these patients, by decreasing the number of coronary artery thrombosis. Long-term anticoagulant treatment, in spite of its haemorrhagic complications and limits, should not be given up until a new efficient treatment is available.
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PMID:[Coronary thrombosis and long term anticoagulant treatment. Results of 173 autopsies after myocardial infarction]. 80 85

Study of four personal cases and of twelve cases reported in the literature makes it possible to describe the characteristics of coronary embolism in mitral stenosis, a rare complication but indicating the presence of a left intra-atrial thrombosis: -- variable clinical picture, dominated by a syndrome combining simultaneously a picture of myocardial infarction and of peripheral arterial emboli of other localizations; -- diagnosis to be discussed within the framework of coronary syndromes in mitral heart disease: embolism requiring to be distinguished from coronary atherosclerosis combined with mitral stenosis, more rarely a functional coronary insufficiency; -- severe course and prognosis: besides the possibility of rapidly lethal cases, coronary embolism seems liable to result in weakening and diminishing of the adaptation possibilities of the left ventricle, responsible for attacks of heart failure after mitral valvulotomy.
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PMID:[Coronary emboli in mitral stenosis]. 81 66


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