Department of Pathology, Government TD Medical College, Alappuzha, Kerala, India.
Department of Forensic Medicine, Government TD Medical College, Alappuzha, Kerala, India.
Indian J Med Res. 2019 Dec;150(6):592-597. doi: 10.4103/ijmr.IJMR_811_17.
BACKGROUND & OBJECTIVES: The burden of cardiovascular diseases is high in Kerala, India, and a considerable proportion of these occur in young people. The objective of this study was to estimate the severity of atherosclerosis in autopsies done for accidental and suicidal deaths in victims below 40 yr of age.
Coronary arteries from 77 autopsies done for unnatural deaths in a population below 40 yr were graded, and the degree of stenosis, intimal thickness index (ITI) and the intima-media ratio (IMR) were measured.
There were 65 males and 12 females in the sample. The American Heart Association (AHA) type 3-6 (pathological intimal thickening) was seen in 55.4 per cent [95% confidence interval (CI): 42.5-67.7%] of males and 25 per cent (95% CI: 5.5-57.2%) of females and advanced lesions (type 4-6) in 44.6 per cent (95% CI: 32.3-57.5%) of males and 8.3 per cent (95% CI: 0.2-38.5%) of females. Types 5 or 6 lesions were seen in 32.2 per cent (95% CI: 21.2-45.1%) of males. The mean stenosis was 57.3 per cent in males and 40.6 per cent in females. More than 40 per cent stenosis was seen in 76.6 per cent cases, more than 50 per cent in 54.5 per cent cases and more than 75 per cent stenosis in 14.3 per of the sample. The mean ITI (MIT) was 1.85 and the mean IMR was 4.11. The degree of stenosis, MIT and IMR were significantly associated with male sex, overweight and smoking.
INTERPRETATION & CONCLUSIONS: Morphometric data showed that the degree of atherosclerotic narrowing of coronary arteries in young non-diseased population was high. It portends a danger to the community unless preventive measures are taken up.
在印度喀拉拉邦，心血管疾病负担沉重，其中相当一部分发生在年轻人中。本研究旨在评估 40 岁以下非自然死亡尸检中发生的动脉粥样硬化的严重程度。
对 77 例非自然死亡尸检的冠状动脉进行分级，并测量狭窄程度、内膜厚度指数（ITI）和内膜-中膜比（IMR）。
样本中包括 65 名男性和 12 名女性。55.4%（95%置信区间：42.5-67.7%）的男性和 25%（95%置信区间：5.5-57.2%）的女性存在 AHA 3-6 型（病理性内膜增厚）病变，44.6%（95%置信区间：32.3-57.5%）的男性和 8.3%（95%置信区间：0.2-38.5%）的女性存在进展性病变（4-6 型）。32.2%（95%置信区间：21.2-45.1%）的男性存在 5 或 6 型病变。男性平均狭窄程度为 57.3%，女性为 40.6%。76.6%的病例存在超过 40%的狭窄，54.5%的病例存在超过 50%的狭窄，14.3%的病例存在超过 75%的狭窄。平均 ITI（MIT）为 1.85，平均 IMR 为 4.11。狭窄程度、MIT 和 IMR 与男性、超重和吸烟显著相关。
形态计量学数据显示，年轻非患病人群的冠状动脉粥样硬化狭窄程度较高。除非采取预防措施，否则这将对社区构成威胁。
