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August 2, 2014

Autopsy findings suggest end of decline

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Autopsies of individuals in one county in the United States suggest that the decades-long decline in the rate of coronary artery disease there may have ended and possibly reversed after 2000, according to a new report from American and Canadian researchers.
In the study, doctors from the Mayo Clinic and University of British Columbia used data from death certificates and pathology reports to assess trends in coronary artery disease among Olmsted County residents who died of unnatural causes between 1981 and 2004.


A total of 3,237 Olmsted County residents in this age group died in those years, 515 of unnatural causes.
Among those 515, 96 per cent were autopsied and 82 per cent (425) had grades assigned based on the amount of blockage in several coronary arteries, with grades ranging from zero (no blockage) to five (100 per cent blocked).

“Over the full period, 8.2 per cent of the 425 individuals had high-grade disease, and 83 per cent had evidence of any disease,” the researchers reported.

Analyses adjusted to consider the individuals’ age and sex revealed declines over the entire period for high-grade disease, any disease, and the average grade of disease. However, “declines in the grade of coronary disease ended after 1995 and possibly reversed after 2000.”

“Our finding that temporal declines in the grade of coronary artery disease at autopsy have ended, together with suggestive evidence that declines have recently reversed, provides some of the first data to support increasing concerns that declines in heart disease mortality may not continue,” the study’s authors concluded.