Histological Analysis of Coronary Atherosclerosis at Division: A Cadaveric Study

Background: Coronary artery disease is the leading cause of mortality in India and it is predominately due to atherosclerosis. The present study was conducted to determine the prevalence of atherosclerosis in coronary arteries without a history of cardiac disease and to determine plaque location in the coronary arterial system. Methodology: This study was conducted in the departments of anatomy and forensic medicine on 50 adult human hearts which had no history of cardiac disease. The coronary arteries were dissected, and 300 sections were taken from the origin, division, and from the distal end of right and left coronary arteries. These tissues underwent (histological) evaluation to note atherosclerosis. Results: In the present study, out of 50 cases, 40 (80%) had atherosclerosis. The majority of atherosclerosis was present at the division of coronary arteries (18.6%). Seventy-two percentage of atherosclerosis is present at left coronary artery (LCA) division (bifurcation) and 40% at right coronary artery (RCA) division (bifurcation). Grade I atherosclerosis was observed in 18.3% of hearts, grade II in 7%, and grade III in 2% of specimens, respectively. Both RCA and LCA had a higher proportion and grade of atherosclerosis at bifurcation points than proximal and distal segments. Conclusion: The proportion and grade of atherosclerosis are significantly higher at the division of coronary arteries without a history of cardiac disease. The identification of high-risk areas for atherosclerosis will lead to future advances in locally oriented preventive strategies.