Quantitative Extent of Atherosclerotic Plaque in the Major Epicardial Coronary Arteries in Patients with Fatal Coronary Heart Disease, in Coronary Endarterectomy Specimens, in Aorta-Coronary Saphenous Venous Conduits, and Means to Prevent the Plaques: A Review after Studying the Coronary Arteries for 50 Years

Am J Cardiol. 2018 Jun 1;121(11):1413-1435. doi: 10.1016/j.amjcard.2018.02.017. Epub 2018 Mar 27.

Abstract

This review tries to answer the following 15 questions: Is atherosclerosis a systemic or a regional disease? Is atherosclerosis in any particular region focal or diffuse? What is the quantity of atherosclerotic plaques in endarterectomy specimens of the right coronary artery in patients undergoing coronary artery bypass grafting (CABG) compared to that in the right coronary artery in patients with fatal coronary artery disease? How do the units used for measuring arterial narrowing by angiography compare to the units used for measuring arterial narrowing at necropsy? What do atherosclerotic plaques consist of in coronary arteries in patients with fatal coronary disease? What is the quantity of atherosclerotic plaque in bypassed -vs- non-bypassed native coronary arteries in patients dying early (<60 days) or late (>60 days) after coronary artery bypass grafting? What is the frequency of acute coronary lesions and multi-luminal channels at necropsy in patients with unstable angina pectoris, sudden coronary death, and acute myocardial infarction? What is the mechanism of luminal widening by angioplasty in the coronary arteries? What observations suggest that atherosclerotic plaques are the result at least in part of organization of thrombi? Is atherosclerosis a multifactoral or a unifactoral disease? What characteristics distinguish carnivores and herbivores? What are reasonable guidelines for whom to treat with lipid-altering agents? What is the rule of 5 and the rule of 7 in statin therapy? What is the effect of lipid lowering drug therapy on coronary luminal narrowing? What are some requisites for a healthy life?

Publication types

  • Review

MeSH terms

  • Angina, Unstable / diagnostic imaging
  • Angina, Unstable / mortality
  • Angina, Unstable / pathology
  • Angina, Unstable / surgery
  • Angioplasty
  • Autopsy
  • Coronary Angiography
  • Coronary Artery Bypass
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / mortality
  • Coronary Artery Disease / pathology*
  • Coronary Artery Disease / surgery
  • Coronary Disease / diagnostic imaging
  • Coronary Disease / mortality
  • Coronary Disease / pathology
  • Coronary Disease / surgery
  • Coronary Thrombosis / diagnostic imaging
  • Coronary Thrombosis / mortality
  • Coronary Thrombosis / pathology
  • Coronary Thrombosis / surgery
  • Death, Sudden, Cardiac / pathology
  • Endarterectomy
  • Humans
  • Myocardial Infarction / diagnostic imaging
  • Myocardial Infarction / mortality
  • Myocardial Infarction / pathology
  • Myocardial Infarction / surgery
  • Plaque, Atherosclerotic / diagnostic imaging
  • Plaque, Atherosclerotic / mortality
  • Plaque, Atherosclerotic / pathology*
  • Plaque, Atherosclerotic / surgery
  • Saphenous Vein / diagnostic imaging
  • Saphenous Vein / pathology
  • Saphenous Vein / transplantation