Coronary artery disease in major and minor epicardial vessels in fatal ischaemic cardiopathy. A pathoanatomic study.

Prevalence, degree and location of significant coronary artery disease (CAD), defined as at least 75% stenosis of arterial lumen, were investigated in major and in minor epicardial coronary arteries in a consecutive series of 48 autopsies on patients with acute left ventricular infarction (LV-AMI). Epicardial coronary arteries were cross-sectioned throughout their length and extensive microscopy of all segments was performed. CAD of at least one major artery was found in 92% of the series, and CAD of at least two major arteries was significantly more common in subendocardial than in transmural LV-AMI. CAD was found to be widespread, involving both proximal and distal parts of major arteries. CAD was found in 13 to 52% of the minor arteries. Ramus diagonalis from the left anterior descendent artery differed from the other minor arteries in that prevalence, degree and multiplicity of CAD in that vessel were similar to the pattern in the three major arteries.