International Journal of Current Research and Review
ISSN: 2231-2196 (Print)ISSN: 0975-5241 (Online)
Bootstrap Slider

Indexed and Abstracted in: SCOPUS, Crossref, CAS Abstracts, Publons, CiteFactor, Open J-Gate, ROAD, Indian Citation Index (ICI), Indian Journals Index (IJINDEX), Internet Archive, IP Indexing, Google Scholar, Scientific Indexing Services, Index Copernicus, Science Central, Revistas Medicas Portuguesas, EBSCO, BOAI, SOROS, NEWJOUR, ResearchGATE, Ulrich's Periodicals Directory, DocStoc, PdfCast, getCITED, SkyDrive, Citebase, e-Print, WorldCat (World's largest network of library content and services), Electronic Journals Library by University Library of Regensburg, SciPeople.

Search Articles

Track manuscript

Readers around the world

Full Html

IJCRR - Vol 10 Issue 06, March, 2018

Pages: 10-13

Date of Publication: 28-Mar-2018


Print Article   Download XML  Download PDF

Coronary Artery Status in Young Age Group in Autopsy Study

Author: Nidhi Dhingani, Bhavika Vaghela, Hansa Goswami

Category: Healthcare

Abstract:Introduction: The coronary atherosclerosis is one of the common diseases in elders. Now it is growing fast among young age group in developing countries. The purpose of this study is to analyze the changing epidemiological trends and prognosis of CAD in young population.
Material and Method: This study was conducted from January 2016 to June 2017 at Department of Pathology, B.J. Medical College, Ahmedabad, Gujarat. This is a retrospective study. Data taken from autopsy section, B.J. Medical college, Ahmedabad.
Result: A total of 708 autopsy cases were studied. In the study 536 (75.7%) were males and 172 (24.3%) were females. Among them 260(48.5%) males and 128(74.5%) females below 40 years of age had coronary artery lesions. Most commonly involved coronary artery was Left coronary artery.
Conclusion: The study showed alarmingly high prevalence of Atherosclerosis in young age. So screening for the same should begin at an early age. The incidence of atherosclerosis is more common in males compared to females; though coronary atherosclerosis is an important risk factor for IHDs in both sex.

Keywords: Atherosclerosis, Younger age, Coronary vessels, Autopsy

DOI: 10.7324/IJCRR.2018.1063

Full Text:

Text:                                                              

Introduction:

Coronary artery disease occurring below the age of 45 years is termed as young coronary artery disease (CAD)[1]. Atherosclerosis is a chronic degenerative condition of arteries responsible for significant cardiovascular morbidity and mortality worldwide. In the Indian subcontinent‚ it is reported to be responsible for more than 25% of deaths [2‚3]. The prevalence of coronary artery disease (CAD) among Asian Indians is higher than among Europeans, Americans and other Asians [4‚5]. Many studies showed that the case load of CAD in India is alarming. According to the World Health Report 2002‚ 45 million people in India are suffering from CAD and it is contributing to one fifth of the deaths in India and also‚ by the year 2020, CAD will account for one third of all deaths. The same report estimated that heart disease in Indian population occurs 10 to 15 years earlier than in the western population [6]. Atherosclerotic lesions start developing at an earlier age and are found to be in more advanced stage in Indian population as compared to the population in western countries. Atherosclerosis can lead to various complications like myocardial infarction (MI)‚ stroke‚ embolization‚ ulceration‚ thrombosis,aneurysm which cause considerable morbidity and mortality‚ thus affecting the life span and the quality of life of a large segment of population.

Material and method:

This study was conducted from January 2016 to June 2017 at Department of Pathology‚ B.J. Medical College‚ Ahmedabad‚  Gujarat. The deceased patients who underwent autopsy at the hospital and their past medical history were recorded and their hearts were sent to our department for histopathological  analysis. The Hearts were grouped according to age and sex. The specimen  were fixed in 10% formalin solution for 2-5 days. The coronary arteries dissected and examined grossly for other anomalies. Identified segments of coronary arteries viz. left and right coronary artery were sectioned at 3 mm interval and histopathological slides were made. All the histological sections were examined microscopically for the presence of atheroma and MI. Grading of atherosclerotic plaque according to American Heart Association was done below.

Grade 0

Sections showing  normal histology or adaptive thickening without macrophages or foam cells.

Grade 1                     

Presence of   isolated  macrophages and foam cells.

Grade 2

Mainly  intracellular  lipid accumulation.

Grade 3

Grade 2 lesions along with small extracellular lipid pools.

Grade 4

Grade 2 changes along with a core of extracellular lipid.

Grade 5

Lipid core and fibrotic layer or multiple lipid cores and fibrotic lipid layers; mainly calcific or fibrotic.

Grade 6

Surface defect‚ hematoma‚ hemorrhages  or  thrombus formation.

The degree of atherosclerosis was classified as :

unremarkable (Grade 0)‚

mild (Grade 1-2)‚

moderate  (Grade 3-4)‚

severe  (Grade 5-6).

Result:

Discussion:

Morbidity and mortality due to coronary atherosclerosis in India has reached alarming proportions and these numbers are expected to maintain the upward trend in the next decade. Atherosclerosis is a commonly observed pathological finding in almost all ethnicities and societies worldwide‚ but with variable prevalence in different races. The onset of atherosclerosis starts early in life from childhood and gradually progresses through young adulthood to form the lesion that causes coronary heart disease. In the present study, the overall incidence of atherosclerosis was found to be 82.34%‚ which is higher than what has been founded in earlier studies by Dhruva et al.‚ (23.3%) [7]; Golshahi et al.‚(28.9%)[8]; Garg et al., (46.4%)[9] and Yazdi et al.,(40%)[10]. Ischemic heart disease (IHD) due to coronary vascular lesion is mainly caused by atherosclerosis. The Indian population is vulnerable to coronary vascular disease and the disease also has an earlier onset in our population. In our study we found that there is a progressive steady increase in atherosclerosis in coronary vessels in early age group.  So screening for cardiovascular Risk factor should be start from younger age group.

Lack of exercise and poor dietary habits like intake of junk food and increased use of refined and processed food items in place of whole grains and fresh fruits and vegetables can be important risk factors for earlier initiation of development and progressive increase in atherosclerotic lesions in this young Indian population. Males have a relative preponderance for coronary heart disease as is evident from multitude of national and international studies conducted in the past.

In the study conducted by Garg et al.,[9]; they found coronary atherosclerotic lesions in 80.9%(93)males as compared to 19.1%(22) females. Bhargava and Bhargava[11] reported coronary atherosclerotic lesions were more prevalent in 74.8% males in comparison to 24.2% females in their study. Murthy et al.‚[12]‚ studied 150 cases of coronary atherosclerotic lesions, out of which 123(80%) were males and 27(18%) were females. Singh et al., [14]  also reported coronary atherosclerotic lesions in 200 cases and found that these lesions were more frequently found in males(85%) as compared to females(15%). Padmavati and Sandhu [15%]found that 66.5% males and 33.5% females were affected by coronary atherosclerotic lesions. In the present study too, we found a male (75.7%) preponderance for coronary atherosclerosis as compared to females(24.3%). The findings of our study corroborates well with the findings of previous studies. There may be a protective role of female hormones like estrogen against atherosclerosis. Moreover, there is greater indulgence of males in smoking and alcoholism as compared to females, which may possibly explain the male preponderance towards development of more severe and progressive atherosclerosis.

Incidence of Left coronary artery involvement was 85%, Right coronary artery involvement was 63%. This was in concordance with Data given by sudha et al., [15] and Yazdi et al.,[10], left coronary artery is more commonly involved than right coronary artery.

In left coronary artery, left anterior descending artery is the commonest artery to be involved.

Acute MI was seen in 13% cases compared to observations of 9.72, 6.5 and 3% acute MI cases observed by Dhruva et al.,[7] Maru [16], garg et al.,[9] respectively. The percentage of MI is slightly higher than previous study. Incidence of MI attack  alarmingly increasing in younger age group.

Conclusion:

The study showed unexpectedly  high prevalence of coronary artery lesion  ahmedabad in India. Though the incidence of atherosclerosis is more in males as compare to females, but there is a  progressive  increase in the proportion of females who present with coronary atherosclerosis. This study highlights the importance of cardiovascular risk factors screening for early ages. The study of human atherosclerotic lesion is an extremely difficult task in a living subjects and autopsy study is the best possible way to work on it. Though our study involved only small numbers of cases, it highlights the early onset and increasing prevalence and severity of atherosclerotic lesions in Indian populations.

 

References:

1. Egred M, Viswanathan G, Davis GK. Myocardial infarction in young adults. Postgrad Med J 2005; 81: 741-745 [PMID: 16344295 DOI: 10.1136/pgmj.2004.027532]

2.Indrayam A. Forecasting vascular disease  and associated mortality in india. NCMH  Background papers: Burden of disease in India. National Commission on macroeconomics and Health , Government of india 2005:197-215

3.Gupta R, Joshi P, Mohan V, Reddy KS, Yusuf  S. Epidemiology and Causation of coronary heart disease and stroke in India. Heart 2008:16-26 (pubmed)

4. Reddy KS. India wakes upto the threat of cardiovascular disease. [1] J Am Coll Cardiol. 2007;50:1370-72.

5.Gupta R. Recent trends in Coronary heart disease epidemiology in India. Indian Heart J. 2008;60(2suppl-B):B4-18.

6. Alarming Statistics from India. [Internet] 2015 [Cited 2015 FEB 19]. Available from http://neocardiabcare.com/alarming-statistics-india.htm.

7.Dhruva GA, Agravat AH, Sanghvi HK. Atherosclerosis of coronary arteries as predisposing factor in myocardial infarction: An autopsy study.(Last assessed on 2013 Dec 13);Online J Health Allied Sac.2012 11:1.Available From: http://www.ojhas.org/issue43/2012-3-1.htm

8.Golshahi J, Rojabi P, Golshahi F. Frequency of atherosclerotic lesions in coronary arteries of autopsy specimens in Isfahan forensic medicine centre. J Res Med.2005;1:16-9.

9.Garg M, Agraval AD, Kataria SP. Coronary atherosclerosis and myocardial infarction: An autopsy study. J Indian Acad Forensic Med.2011 33:39-42. Available from:http://medind.nic.in/jal/t11/il/jalt11ilp39.pdf.

10.Yazdi SA, Razaei A Azari JB, Hezari A, Shakeri MT, Shahri MK. Prevalence of atherosclerotic plaques in autopsy cases with noncardiac death. Iran J pathol. 2009;4:101-4

11.Bhargava MK, Bhargava SK. Coronary atherosclerosis in North Karnataka. Indian J. pathol Microbiol.1975;18:65-79.(pubMed)

12.Murthy MS, Dutta BN, Ramalingaswami V. Coronary atherosclerosis in North india(Delhi india)J pat hol Bacteriol.1963;85:93-101 (pubMed)

13.Padmavati S, Sandhu I. Incidence of coronary artery disease in Delhi from medico-legal autopsies. Indian J Med Res.1969;57:465-76  (pubMed)

14.Singh H, Oberoi SS, Gorea RK, Bal MS. Atherosclerosis in coronaries in malwa region of Punjab. J Indian Acad Forensic Med.2005;27:32-5s

15.Sudha ML. Sundaram S, Purushotaman KR,K Kumar PS, Prathiba  D. Coronary atherosclerosis in sudden cardiac death :An autopsy study. Indian J Pathol Microbiol.2009:52:486-9. (pubMed)

16.Maru M. Coronay atheraosclerosis and myocardial infarction in autopsied patients in Gondar. Ethiopia. JR soc Med.1989;82:399-401.(PMC free article)(PubMed)

Research Incentive Schemes

Awards, Research and Publication incentive Schemes by IJCRR

Best Article Award: 

One article from every issue is selected for the ‘Best Article Award’. Authors of selected ‘Best Article’ are rewarded with a certificate. IJCRR Editorial Board members select one ‘Best Article’ from the published issue based on originality, novelty, social usefulness of the work. The corresponding author of selected ‘Best Article Award’ is communicated and information of award is displayed on IJCRR’s website. Drop a mail to editor@ijcrr.com for more details.

Women Researcher Award:

This award is instituted to encourage women researchers to publish her work in IJCRR. Women researcher, who intends to publish her research work in IJCRR as the first author is eligible to apply for this award. Editorial Board members decide on the selection of women researchers based on the originality, novelty, and social contribution of the research work. The corresponding author of the selected manuscript is communicated and information is displayed on IJCRR’s website. Under this award selected women, the author is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.

Emerging Researcher Award:

‘Emerging Researcher Award’ is instituted to encourage student researchers to publish their work in IJCRR. Student researchers, who intend to publish their research or review work in IJCRR as the first author are eligible to apply for this award. Editorial Board members decide on the selection of student researchers for the said award based on originality, novelty, and social applicability of the research work. Under this award selected student researcher is eligible for publication incentives. Drop a mail to editor@ijcrr.com for more details.


Best Article Award

A Study by Juna Byun et al. entitled "Study on Difference in Coronavirus-19 Related Anxiety between Face-to-face and Non-face-to-face Classes among University Students in South Korea" is awarded Best Article for Vol 12 issue 16
A Study by Sudha Ramachandra & Vinay Chavan entitled "Enhanced-Hybrid-Age Layered Population Structure (E-Hybrid-ALPS): A Genetic Algorithm with Adaptive Crossover for Molecular Docking Studies of Drug Discovery Process" is awarded Best article for Vol 12 issue 15
A Study by Varsha M. Shindhe et al. entitled "A Study on Effect of Smokeless Tobacco on Pulmonary Function Tests in Class IV Workers of USM-KLE (Universiti Sains Malaysia-Karnataka Lingayat Education Society) International Medical Programme, Belagavi" is awarded Best article of Vol 12 issue 14, July 2020
A study by Amruta Choudhary et al. entitled "Family Planning Knowledge, Attitude and Practice Among Women of Reproductive Age from Rural Area of Central India" is awarded Best Article for special issue "Modern Therapeutics Applications"
A study by Raunak Das entitled "Study of Cardiovascular Dysfunctions in Interstitial Lung Diseas epatients by Correlating the Levels of Serum NT PRO BNP and Microalbuminuria (Biomarkers of Cardiovascular Dysfunction) with Echocardiographic, Bronchoscopic and HighResolution Computed Tomography Findings of These ILD Patients" is awarded Best Article of Vol 12 issue 13 
A Study by Kannamani Ramasamy et al. entitled "COVID-19 Situation at Chennai City – Forecasting for the Better Pandemic Management" is awarded best article for  Vol 12 issue 12
A Study by Muhammet Lutfi SELCUK and Fatma COLAKOGLU entitled "Distinction of Gray and White Matter for Some Histological Staining Methods in New Zealand Rabbit's Brain" is awarded best article for  Vol 12 issue 11
A Study by Anamul Haq et al. entitled "Etiology of Abnormal Uterine Bleeding in Adolescents – Emphasis Upon Polycystic Ovarian Syndrome" is awarded best article for  Vol 12 issue 10
A Study by Arpita M. et al entitled "Estimation of Reference Interval of Serum Progesterone During Three Trimesters of Normal Pregnancy in a Tertiary Care Hospital of Kolkata" is awarded best article for  Vol 12 issue 09
A Study by Ilona Gracie De Souza & Pavan Kumar G. entitled "Effect of Releasing Myofascial Chain in Patients with Patellofemoral Pain Syndrome - A Randomized Clinical Trial" is awarded best article for  Vol 12 issue 08
A Study by Virendra Atam et. al. entitled "Clinical Profile and Short - Term Mortality Predictors in Acute Stroke with Emphasis on Stress Hyperglycemia and THRIVE Score : An Observational Study" is awarded best article for  Vol 12 issue 07
A Study by K. Krupashree et. al. entitled "Protective Effects of Picrorhizakurroa Against Fumonisin B1 Induced Hepatotoxicity in Mice" is awarded best article for issue Vol 10 issue 20
A study by Mithun K.P. et al "Larvicidal Activity of Crude Solanum Nigrum Leaf and Berries Extract Against Dengue Vector-Aedesaegypti" is awarded Best Article for Vol 10 issue 14 of IJCRR
A study by Asha Menon "Women in Child Care and Early Education: Truly Nontraditional Work" is awarded Best Article for Vol 10 issue 13
A study by Deep J. M. "Prevalence of Molar-Incisor Hypomineralization in 7-13 Years Old Children of Biratnagar, Nepal: A Cross Sectional Study" is awarded Best Article for Vol 10 issue 11 of IJCRR
A review by Chitra et al to analyse relation between Obesity and Type 2 diabetes is awarded 'Best Article' for Vol 10 issue 10 by IJCRR. 
A study by Karanpreet et al "Pregnancy Induced Hypertension: A Study on Its Multisystem Involvement" is given Best Paper Award for Vol 10 issue 09
Late to bed everyday? You may die early, get depression
Egg a day tied to lower risk of heart disease
88 Percent Of Delhi Population Has Vitamin D Deficiency: ASSOCHAM Report

List of Awardees

Awardees of COVID-19 Research

Woman Researcher Award

A Study by Neha Garg et al. entitled "Optimization of the Response to nCOVID-19 Pandemic in Pregnant Women – An Urgent Appeal in Indian Scenario" published in Vol 12 issue 09

A Study by Sana Parveen and Shraddha Jain entitled "Pathophysiologic Enigma of COVID-19 Pandemic with Clinical Correlates" published in Vol 12 issue 13

A Study by Rashmi Jain et al. entitled "Current Consensus Review Article on Drugs and Biologics against nCOVID-19 – A Systematic Review" published in Vol 12 issue 09

Emerging Researcher Award

A Study by Madhan Jeyaraman et al. entitled "Vitamin-D: An Immune Shield Against nCOVID-19" published in Vol 12 issue 09


RSS feed

Indexed and Abstracted in


Antiplagiarism Policy: IJCRR strongly condemn and discourage practice of plagiarism. All received manuscripts have to pass through "Plagiarism Detection Software" test before forwarding for peer review. We consider "Plagiarism is a crime"

IJCRR Code of Conduct: We at IJCRR voluntarily adopt policies on Code of Conduct, and Code of Ethics given by OASPA and COPE. To know about IJCRRs Code of Conduct, Code of Ethics, Artical Retraction policy, Digital Preservation Policy, and Journals Licence policy click here

Disclaimer: International Journal of Current Research and Review (JICRR) provides platform for researchers to publish and discuss their original research and review work. IJCRR can not be held responsible for views, opinions and written statements of researchers published in this journal.



Company name

International Journal of Current Research and Review (JICRR) provides platform for researchers to publish and discuss their original research and review work. IJCRR can not be held responsible for views, opinions and written statements of researchers published in this journal

Contact

148, IMSR Building, Ayurvedic Layout,
        Near NIT Complex, Sakkardara,
        Nagpur-24, Maharashtra State, India

editor@ijcrr.com

editor.ijcrr@gmail.com


Copyright © 2020 IJCRR. Specialized online journals by ubijournal .Website by Ubitech solutions