Coronary disease severity at necropsy.

One of the most objective clinical manifestations of coronary disease is cardiac infarction. Two main pathological processes may be implicated in its pathogenesis: first, the degree of disease in the vessel wall, and secondly, the presence of disease within the arterial lumen in the form ofan occluding thrombus. Because of this potentially dual pathogenesis, there is a distinct possibility that any of the lipid abnormalities associated with the development of cardiac infarction, e.g. a high serum cholesterol level, could be relevant either to the degree of disease in the vessel wall, or alternatively to thrombosis itself, for occluding or near-occluding thrombi are found in over 90 per cent of recent infarcts (Mitchell and Schwartz, 1963). We have, therefore, made an attempt to assess the relationships between the amount of the various macroscopic types of coronary artery disease and age, diastolic blood pressure, heart weight, post-mortem serum cholesterol, and total coronary artery area. These findings are presented and discussed.