[Myocardial infarction: comparison of anatomo-pathological findings from hearts with and without severe coronary atherosclerosis in 194 necropsy cases].
OBJECTIVE
To compare morphological features of myocardial infarction (MI) from patients with any epicardial coronary artery narrowed at some point more than 70% (severe coronary atherosclerosis--SCA) with those from patients with either no coronary atherosclerosis or only mild (less than 70%) atherosclerosis.


METHODS
Necropsy findings from 194 patients who died due to MI, 174 patients with and 20 without SCA. Ages ranged from 21 to 82 (mean 60) years.


RESULTS
Mean age was 60 years in the cases with SCA and 56 in the case without it; nevertheless, age distribution was different (p = 0.023), due to the existence of more patients under age 40 in the group without SCA. There was no significant difference concerning sex (31.0% of female patients in the group with SCA and 35.0% in the other group, p = 0.718), mean heart weight (500 g and 506 g), distribution of cases according to time of evolution of MI in recent only, old only or both (cases with SCA--36.2%, 28.2% and 35.6%; cases without SCA--45.0% and 20%; p = 0.666), left ventricular wall committed by the MI (p = 0.715), incidence of hemorrhagic infarction (with SCA--8.6%; without SCA--15.0%; p = 0.406), left ventricular rupture (with SCa--5.17%, without SCA--10.0%; p = 0.719) and left ventricular aneurysms (with SCA--12.1%, without SCA--15.0%; p = 0.316). An association was found between coronary atherosclerosis and recent (p = 0.046) and recanalized (p less than 0.001) thrombosis, but absent when only recent thrombosis and non-operated cases with recent MI were considered (p = 0.091).


CONCLUSIONS
Necropsy of fatal cases of MI were not significantly different in the presence or absence of severe atherosclerotic narrowing (greater than 70%) of epicardial coronary arteries, suggesting that this factor does not modify the natural history of MI.
Guitierrez
P S
PS
Instituto do Coração, Hospital das Clínicas, São Paulo, SP.
Higuchi
M de L
Mde L
de Moraes
C F
CF
Cardoso
R H
RH
da Silva
M J
MJ
Ramires
J A
JA
Bellotti
G
G
Lopes
E A
EA
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000150:complications / Q000473:pathology* / Q000601:surgery; D003328:Coronary Thrombosis / Q000150:complications / Q000473:pathology*; D005260:Female; D006341:Heart Rupture / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality / Q000473:pathology*; D013997:Time Factors
Infarto do miocárdio: comparação dos achados anátomo-patológicos em corações com e sem aterosclerose coronária grave em 194 casos de necrópsia.