Right Coronary Artery In Patient Research Articles

D-61 | Outcomes of Acute ST Elevation Myocardial Infarction of Right Coronary Artery in Patients with Chronic Total Occlusion

D-61 | Outcomes of Acute ST Elevation Myocardial Infarction of Right Coronary Artery in Patients with Chronic Total Occlusion

P1003New onset atrial fibrillation after stenting of the right coronary artery in patients with ischemic disease of the heart

Abstract Background Atrial fibrillation (AF) is a major heart rhythm disorder among population older age. Percutaneous coronary intervention (PCI) with stenting of the right coronary artery may increase the new onset AF. Aim of the study was to estimate the new onset AF after stenting of the right coronary artery (RCA) in patients with stable ischemic disease of the heart and its effect on short-term prognosis. Methods 765 patients in whom performed PCI with stenting of the proximal and medial segment of RCA were enrolled in this study (aged 41-71 years; mean age 55.8 ± 12.0 years; male 51%). Short-term outcomes were analyzed in median 1.1-year follow-up due to the development of new onset AF. Results Among 765 patients, after PCI in RCA developed AF in 58 patients (7.5%) within follow-up. Among them, 40 patients (5.2%) with type 2 diabetes mellitus, 37 patients (4.8%) hypertension, 34 patients (4.4%) older than 60 years old, 30 patients (3.9%) myocardial infarction in history. Restoration of sinus rhythm (cardioversion rate) was in 86%. Majority of the patients in whom sinus rhythm was not recovered were older (11.0%) and diabetic mellitus (8.0%). The propensity-matched model showed that new onset AF was associated with an increased risk of bleeding during the procedure (OR 1.4; 95% confidence interval, 1.27-1.74) and heart failure (OR 1.27; 95% confidential interval, 1.16-1.45). Conclusion: New onset AF is common within short-term period after PCI in proximal and distal segments of the RCA and it was independently associated with post procedural complications and heart failure.

Assessment of right ventricular function using right ventricular outflow tract-systolic excursion in inferior wall myocardial infarction and angiographic correlation to proximal right coronary artery stenosis

Background There are inadequate studies validating the efficacy of several echocardiographic parameters of right ventricular (RV) function in assessing RV infarction and predicting stenosis of proximal right coronary artery (RCA). Most of them evaluated a single parameter and many lacked angiographic correlations.Aim To evaluate RV systolic function using systolic excursion of right ventricular outflow tract (RVOT-SE) by echocardiography with correlation to stenosis of proximal RCA in patients with first incident of acute inferior wall myocardial infarction.Patients and methods Parasternal short-axis view at the level of the aortic valve was obtained using M-mode echocardiography, and RVOT-SE was defined as the RVOT-SE anterior wall. It was measured in 50 patients who underwent CA after acute Inferior ST elevaion myocardial (STEMI).Results Patients with reduced RV function were identified with tricuspid annular plane systolic excursion (TAPSE) below 16 mm. RVOT-SE optimal cutoff values to predict RV systolic dysfunction was SE=5.4 mm with a sensitivity of 91.7% and specificity of 99.97% (area under the curve=0.935, P=0.00). RVOT-SE prediction of proximal RCA stenosis was with a sensitivity of 91.4% and specificity of 90.2%. The study showed significant positive correlations with RV-fractional area change and TAPSE (P=0.00) and significant negative correlations with tissue Doppler myocardial performance index and pulsed wave myocardial performance index (P=0.00).Conclusion RVOT-SE is a naive and precise method for assessing RV systolic function. This study suggested the use of RVOT-SE as a parameter of RV function paired with other indices such as TAPSE.

The results of intramyocardial implantation of autologous bone marrow cells treated with erythropoietin in the surgical treatment of coronary artery disease with severe lesion of vessels

Aim. To assess safety and efficacy of intramyocardial implantation of autologous bone marrow cells treated with erythropoietin in surgery for coronary artery disease (CAD).Materials and methods. Eighty patients with CAD with diffuse and (or) distal lesions of the right coronary artery were randomly assigned to two groups: patients of group 1 (n=40) underwent coronary bypass surgery, implantation of autologous bone marrow cells treated with erythropoietin into the lower wall of the left ventricle, patients of group 2 (control group, n=40) underwent bypass surgery of the left coronary artery. Evaluation of the clinical status, perfusion and contractility of the myocardium was performed initially, 6 and 12 months after surgery.Results. Six months after the operation, we found more pronounced decrease of functional class (FC) of angina and improvement in the 6-min walk distance in the main group compared with the control group.Twelve months after surgery, the severity of angina remained at the same level in both groups. In the control group, 45,2% of patients had FC I, 52,3% of patients did not have angina. In both groups, angina return was detected in 1 patient (FC III). According to the results of two-step myocardial scintigraphy with Technetril (Tc99), 6 months after surgery, a significant improvement in myocardial perfusion was observed. In the control group, after 6 months, no significant dynamics of perfusion of the lower wall of the left ventricle was detected.Twelve months after the surgical treatment of the right coronary artery in patients from the group 1 revealed a decrease in the stress defect and the stable perfusion defect. In patients from the control only a significant stress defect was found to decrease.Conclusion. The study demonstrated decrease of FCs, significant improvement in perfusion, functional state of the myocardium and 6-min walk distance in patients of group 1.

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

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?

Direct Injury to Right Coronary Artery in Patients Undergoing Tricuspid Annuloplasty

Direct injury to the right coronary artery as a result of reparative operation on the tricuspid valve is a rare, probably underdiagnosed, but serious complication, which often involves dramatic clinical consequences. So far, only five cases have been described in the literature. We describe our single-center experience of this complication, and review and analyze relevant clinical and anatomic considerations related to this entity. Cases previously reported in the literature were also reviewed. We describe four cases of direct injury to the right coronary artery in patients undergoing tricuspid annuloplasty (DeVega annuloplasty, 3; ring annuloplasty, 1) in our institution since 2005. All patients had right ventricular dilatation and severely dilated tricuspid annulus. Right coronary artery occlusion always occurred between the right marginal artery and the crux of the heart. Patients presented with hemodynamic or electrical instability. Coronary flow could be restored in 2 patients (percutaneously 1; surgically 1), both of whom finally survived, while it was not technically possible in the other 2 (1 died). Occlusion of the right coronary artery in patients undergoing tricuspid annuloplasty is a rare complication that may occur if great annulus dilatation is present, thus altering both normal annular geometry and the relationship between the right coronary artery and the tricuspid annulus, particularly when DeVega annuloplasty is performed. Such an entity should be considered in the immediate postoperative period in an unstable patient, especially when complementary tests support this diagnosis. Prompt recognition and treatment can positively affect the patient's outcome, most often by means of an emergency revascularization strategy.

Presence of sigma shaped right coronary artery is an indicator of poor prognosis in patients with inferior myocardial infarction treated with primary percutaneous coronary intervention

The effectiveness of primary percutaneous coronary intervention (PCI) in ST segment elevation myocardial infarction (STEMI) is well established. The clinical variables associated with poor prognosis in patients with STEMI have been extensively investigated. Right coronary artery (RCA) has two anatomical variations detected on coronary angiography namely C-shaped and sigma shaped RCA. The clinical importance of the shape of RCA in patients with STEMI has not been investigated before. To investigate the prognostic value of RCA shape in patients with inferior STEMI treated with primary PCI. Angiographic data of patients with inferior STEMI who were treated with primary PCI were retrospectively recruited. The differentiation of sigma and C-shaped RCAs was shown using single-frame angiograms, obtained during end-diastole of cardiac cycle in the left anterior oblique projection at 25° to 35° with no cranio-caudal angulation. Cardiovascular events at 30-days and on follow up were obtained through review of hospital records and telephone contact with the patient or the patient's relatives. Patients with C-shaped RCAs served as the control group. A total number of 824 patients with inferior STEMI who were treated with primary PCI for RCA were included. Sigma shaped RCA was observed in 15.1% of the subjects. In the sigma shaped RCA group, the door-to-balloon times were longer (32.5 ± 5.1 vs. 27.8 ± 4.6 min; P = 0.01) and TIMI 3 flow restoration rates were lower (76.8% vs. 94.1%; p=0.01) compared to the controls. Mean SYNTAX scores were significantly higher in patients with sigma shaped RCA. Four patients (3.2%) in the sigma shaped RCA group and 23 patients (3.3%) in the control group died by day 30. The incidence of stent thrombosis, recurrent MI, and target lesion revascularization, were similar between the groups. During the follow-up (mean 37.6 ± 13.4 months) 15 patients (12.3%) from the sigma shaped RCA group and 28 (4.1%) patients from the control group died (P = 0.01). The incidence of recurrent MI (27.2% vs. 13.7%; P = 0.01) and major adverse cardiovascular events (29.7% vs. 16.3%; P = 0.01) were significantly higher in the sigma shaped RCA group. In multivariate analysis, age, Killip class of >1, the presence of sigma shaped RCA, post PCI TIMI flow <3 and decreased left ventricular ejection fraction were the independent predictors of long term mortality. Presence of sigma shaped RCA is associated with more severe form of coronary artery disease and worse clinical outcome in patients with inferior STEMI.

Successful percutaneous coronary intervention for chronic total occlusion of right coronary artery in patient with dextrocardia

Situs inversus with dextrocardia is rare congenital anomaly. Coronary artery disease in such patients is quite rare. We reported a 52-year-old man with dextrocardia and chronic total occlusion at the proximal right coronary artery just after conus branch and severe stenosis at the proximal left anterior descending artery. He underwent successful percutaneous coronary intervention with stenting of total occluded right coronary artery and simultaneously stenting of the proximal left anterior descending artery.

TCT-154: Prognostic Impact of Total Chronic Occlusion of The Right Coronary Artery in Patients Treated with Drug-Eluting stent for Unprotected Left Main Disease

TCT-154: Prognostic Impact of Total Chronic Occlusion of The Right Coronary Artery in Patients Treated with Drug-Eluting stent for Unprotected Left Main Disease

Difference in the topography of atherosclerosis in the left versus right coronary artery in patients referred for coronary angiography

BackgroundWe sought to determine the difference in the localization of coronary artery disease (CAD) between the left and right coronary artery system and investigate the effect of sex and age on that difference.MethodsWe retrospectively analyzed 17,323 consecutive angiographies from January 1st, 1984 to December 31st, 2003. The demographic parameters, in particular age and sex of the investigated cases as well as the angiographic results were recorded and summarized.ResultsOf 13,305 cases with CAD, 861 (6.5%) had right coronary artery (RCA)-only disease, 4,621 (34.7%) had left coronary artery (LCA)-only disease, while 7,823 (58.8%) cases had concomitant RCA and LCA disease. LCA-only disease was more frequent than RCA-only disease [LCA-only/RCA-only odds ratio (OR): 5.37, 95% CI: 4.99 to 5.77, p < 0.001]. Women were more likely to have LCA-only disease (men/women OR 0.75 95% CI: 0.68 to 0.82, p < 0.001) compared with men who were more likely to present with concomitant RCA and LCA disease (men/women OR 1.33 95% CI: 1.21 to 1.45, p < 0.001). RCA-only and LCA-only disease were both more frequent in patients aged from 51 to 60 years, while concomitant RCA and LCA disease in patients between 61 and 70 years of age.ConclusionsLCA-only disease is more frequent than RCA-only disease. Men have a higher probability than women to present with concomitant RCA and LCA disease while women are more likely than men to be found with LCA-only disease.

Assessment of right ventricle function during exercise echocardiography by using tissue Doppler imaging in patients with coronary artery disease

Assessing right ventricle (RV) function is difficult primarily because of its complex shape. Worsening RV function or dilatation during stress tests in patients with coronary artery disease may indicate proximal right coronary artery (RCA) narrowing. The aim of this study was to obtain quantitative diagnostic criteria for impaired RV function by tissue Doppler imaging (TDI) during exercise echocardiography, which could detect a significant lesion of the RCA in patients with coronary artery disease. We evaluated regional systolic and diastolic function using pulsed-wave TDI in two myocardial segments of the RV free wall during exercise stress tests in 160 patients with suspected coronary artery disease. The diagnostic criteria were obtained by comparing TDI and coronary angiography data. The accuracy, sensitivity, and specificity of the TDI diagnostic model for RCA disease were 81.1, 88.0, and 72.3%, respectively. TDI is a highly accurate method for the detection of RV dysfunction and RCA disease at rest and during exercise stress echocardiography in group of patients with known or suspected coronary artery disease.

Prognostic correlates of combined coronary flow reserve assessment on left anterior descending and right coronary artery in patients with negative stress echocardiography by wall motion criteria

Aims:To assess the prognostic correlates of Doppler echocardiographically derived coronary flow reserve (CFR) on two coronaries in patients with negative stress echo. Vasodilator stress echocardiography allows dual imaging of regional...

Invited commentary

Bilateral internal thoracic artery grafting (BITA) to the left anterior descending and circumflex coronary arteries offers the best long-term survival (after 10 years) and the lowest rates of reintervention in patients undergoing coronary artery bypass grafting surgery. The best graft for the right coronary artery in patients with three-vessel disease has not been confirmed. The right gastroepiploic artery (GEA), the radial artery, saphenous vein graft (SVG), and composite radial artery or internal thoracic artery grafts are the most frequent choices. Esaki and colleagues [1Esaki J. Koshiji T. Okamoto M. Tsukashita M. Ikuno T. Sakata R. Gastroepiploic artery grafting does not improve the late outcome in patients with bilateral internal thoracic artery grafting.Ann Thorac Surg. 2007; 83: 1024-1029Abstract Full Text Full Text PDF PubMed Scopus (21) Google Scholar] performed a retrospective study comparing 311 patients with three-vessel coronary artery disease who had BITA grafting to the left anterior descending and circumflex coronary arteries. The GEA was used in 99 patients. The SVG was used in 212 patients to bypass the right coronary artery. Although 7-year survival rates were excellent, no statistical difference in early and 7-year survival and freedom from cardiac events, reintervention, angina, or myocardial infarction was found between the two groups. Reasons offered by the authors for lack of improvement in the GEA group are that the long-term patency in the GEA is similar to the SVG, there are too few GEA patients, and the follow-up period is too short. I would agree that the follow-up period should be longer to make a definite decision on any distinct advantages to using the GEA. Not mentioned in the article is the incidence of suboptimal anastomoses, competition of flow, and new coronary artery lesions discovered on routine early or later coronary artery angiograms. Early correction of these causes of potential graft failure with the exception of competition of flow should improve long-term patency and outcomes, particularly in patients with all arterial coronary bypass grafts. These factors may have been helpful in obtaining the excellent early patency reported with the internal thoracic artery grafts. Gastroepiploic Artery Grafting Does Not Improve the Late Outcome in Patients With Bilateral Internal Thoracic Artery GraftingThe Annals of Thoracic SurgeryVol. 83Issue 3PreviewBilateral internal thoracic artery grafting in coronary artery bypass surgery has a better long-term outcome than single internal thoracic artery grafting. However, the efficacy of gastroepiploic artery (GEA) grafting in addition to bilateral internal thoracic artery grafting is still not well-established. Full-Text PDF

Correlation of ST Segment Elevation in Lead V1 and the Conal Branch of Right Coronary Artery in Patients with Acute Anterior Wall Myocardial Infarction

Background and Objectives：Dual blood supply to the anterior interventricular septum (IVS), derived from the septal branches of the left anterior descending artery (LAD) and the conal branch of the right coronary artery (RCA), may prevent ST segment elevation in lead V1 during an anterior acute myocardial infarction (AMI), and predict a favorable in-hospital clinical course. Subjects and Methods：The admission 12-lead electrocardiogram (ECG), and the coronary angiograms performed within 10 days of hospital admission, were evaluated in 67 patients with anterior wall AMI, as defined by a ST segment elevation ≥2mm in at least 2 of the V1 to 4 leads. The patients were divided into two groups according to the magnitude of the ST segment elevation in V1 lead：group 1 (ST 0.5 mm), reaching the IVS. Results：A large conal branch was found in 11 patients of each group 50 and 24%, respectively (p=0.04). There was no significant relation between the sites of the LAD lesion, whether proximal or distal to the first septal branch, and the presence of ST segment elevation in lead V1. The serum cardiac enzymes, Killip class and the incidence of in-hospital congestive heart failure, were not significantly different. Conclusion：The absence of ST segment elevation in lead V1 during an anterior AMI suggested that the IVS is protected by a large conal branch, in addition to the septal branch of the LAD, but this did not influence the in-hospital clinical course. (Korean Circulation J 2003;33 (10):871-877)

Comparison of short- and long-term benefits of reperfusion in single-vessel inferior wall acute myocardial infarction with and without right ventricular wall infarction

C linical and electrocardiographic evidence of right ventricular (RV) infarct and/or ischemia occurs in 30% to 50% of patients with inferior wall acute myocardial infarction (AMI). RV extension is associated with increased short-term cardiovascular morbidity and mortality because it leads to ventricular dysfunction and low cardiac output. Acute reperfusion in these patients can diminish short-term complications and mortality rate by reducing infarct size. However, many previously reported patients with RV infarction have had multivessel disease and/or prior AMI in other territories, which further complicate the potential benefit of acute coronary reperfusion of the “culprit” lesion and the long-term prognosis of RV dysfunction. This study was designed to assess the shortand long-term effects of immediate reperfusion of the single-vessel right coronary artery in patients with inferior wall AMI with and without RV infarction.

Augmentation of ST segment elevation in the electrocardiographic leads V1-V3 and induction of ventricular fibrillation by intracoronary injection of ergonovine maleate or acetylcholine to the right coronary artery in patients with Brugada syndrome

Augmentation of ST segment elevation in the electrocardiographic leads V1-V3 and induction of ventricular fibrillation by intracoronary injection of ergonovine maleate or acetylcholine to the right coronary artery in patients with Brugada syndrome

Importance of the Conal Branch of the Right Coronary Artery in Patients With Acute Anterior Wall Myocardial Infarction: Electrocardiographic and Angiographic Correlation

Objectives. This study assessed prospectively the correlation between the conal branch of the right coronary artery and the pattern of ST segment elevation in leads V1and V3R during anterior wall acute myocardial infarction (AMI).Background. The traditional electrocardiographic (ECG) definition of anteroseptal AMI—ST segment elevation in leads V1to V3—has recently been challenged. The significance of ST segment elevation in lead V1during anterior wall AMI is unclear.Methods. The admission 12-lead ECG with additional lead V3R and the coronary angiograms performed within 10 days of hospital admission were evaluated in 28 consecutive patients (mean age ± SD 62 ± 9 years) admitted to the coronary care unit with anterior wall AMI. Patients were classified into two groups according to the magnitude of ST segment elevation in lead V1: group A (elevation ≥1.5 mm, n = 12) and group B (elevation <1.5 mm, n = 16). Two types of conal branch were identified: small (not reaching the interventricular septum [IVS]) and large (reaching the IVS).Results. ST segment elevation in lead V3R was found in 11 (92%) and 6 (37%) patients from group A and group B, respectively (p < 0.001); a small conal branch was seen in 10 (83%) and 3 (19%) patients, respectively (p < 0.001). Ten patients (all from group B) had a large conal branch.Conclusions. ST segment elevation in lead V1in the admission ECG of patients with anterior wall AMI is strongly related to ST segment elevation in lead V3R and is associated with a small conal branch. Our findings suggest that lead V1reflects the right paraseptal area supplied by the septal branches of the left anterior descending coronary artery (LAD), alone or together with the conal branch. The absence of ST segment elevation in lead V1during anterior AMI suggests that the IVS is protected by a large conal branch in addition to the septal branches of the LAD (double circulation).(J Am Coll Cardiol 1997;29:506–11)

Regression of coronary artery dimensions after successful aortic valve replacement.

The effect of regression of myocardial hypertrophy on coronary artery dimensions was evaluated in patients with aortic valve disease who underwent valve replacement. Cross-sectional area (CSA) of the three major coronary arteries (left anterior descending [LAD], left circumflex [LCx], and right coronary artery) was determined by quantitative coronary arteriography in 15 patients with aortic valve disease before and 38 months (range, 14-113 months) after successful aortic valve replacement. Twelve normal subjects served as controls. Left ventricular (LV) angiographic mass was calculated according to the method of Rackley. CSA of the left coronary artery was larger in aortic valve disease than in controls (LAD, 15 versus 8 mm2, p less than 0.001; LCx, 14 versus 6 mm2, p less than 0.001). After valve replacement, CSA of the left coronary artery decreased (LAD, 12 mm2, p less than 0.05 versus before surgery; LCx, 11 mm2, p less than 0.05 versus before surgery) but remained significantly larger than in controls. CSA of the right coronary artery in patients with aortic valve disease was not different from controls. LV muscle mass was significantly increased in aortic valve disease patients before (364 g) and after (250 g) valve replacement compared with controls (135 g). The appropriateness of coronary artery size with respect to muscle mass was evaluated by normalizing CSA of the left coronary artery (LAD + LCx) per 100 g of LV muscle mass (mm2/100 g). This index amounted to 11 mm2/100 g in controls, to 8 mm2/100 g in preoperative patients (p less than 0.05 versus controls), and to 10 mm2/100 g in postoperative patients with aortic valve disease (p = NS versus controls). In patients with aortic valve disease, CSA of the proximal LAD and LCx is increased, but this increase is not sufficient to keep CSA per 100 g of LV mass within normal limits. The postoperative decrease in muscle mass is associated with a decrease in the size of LAD and LCx, whereas the size of the right coronary artery remains unchanged. In contrast to the preoperative state, the residually hypertrophied LV myocardium after aortic valve replacement is supplied by an enlarged but adequately sized LAD and LCx.

Long-term follow-up of PTCA of the right coronary artery with shepherd's crook morphology.

The authors evaluated the long-term outcome of percutaneous transluminal coronary angioplasty (PTCA) of the right coronary artery in patients with shepherd's crook morphology (51 patients) compared to a control group (53 patients) matched for lesion location, date of procedure, age, and gender. The primary success rate was lower (86% v 98%; P = .03) in the shepherd's crook group than in the control group. At a mean follow-up of 29 months, there was one death in each group. The restenosis rate was 18% in the shepherd's crook group and 21% in the control group; repeat PTCA (14% v 15%) and bypass surgery (2% v 6%) rates were also similar in both groups. The data suggest that PTCA of right coronary arteries with shepherd's crook morphology has a significantly lower primary success rate but similar long-term outcome when compared to PTCA of right coronary arteries without this anatomic variation.

Atherosclerosis of the aorta and coronary vessels of the heart in cases of various diseases

The authors investigated the occurrence of atherosclerosis in “healthy” people (selected accidental deaths), in people, who died of complications due to atherosclerosis, and in some diseases: i.e. , diabetes, hypertensive disease, renal hypertension and malignant tumours. In their observations, they used the visuo-planimetric method of estimation of vascular atherosclerotic changes recommended by the WHO. In diabetics under the age of 50, extensive atherosclerosis was found in only 16 of the 38 patients. In some of these 16 cases, the duration of diabetes was over 8 years (in 8 cases). The accelerated development of atherosclerotic changes (mostly fibrous plaques) was usually observed in 1 or 2 vessels out of the 5 studied. In some instances, despite a long duration of diabetes in young people, the authors did not note any accelerated development of atherosclerotic changes as compared with the control groups. In people of 50 years of age and over, atherosclerotic changes in diabetics were as pronounced as in those who died of atherosclerosis unattended with diabetes. Hypertension of any etiology (essential, renal) involves a more pronounced atherosclerosis of the aorta than found in healthy people or those who died of complications due to atherosclerosis unattended with hypertension. The average area of atherosclerotic changes in the right coronary artery in patients with essential hypertension is larger than in persons who died of complications due to atherosclerosis but did not suffer from hypertension. The differences in the descending branch of the left coronary artery are less pronounced, although there is a tendency towards more severe lesions of this vessel in patients with essential hypertension, especially in men. In patients 30–39 years of age suffering from symptomatic renal hypertension, atherosclerosis of the aorta is more intensive than in patients with essential hypertension. There is also a tendency towards an increase in the area of atherosclerosis of the coronary arteries in patients suffering from symptomatic hypertension, especially between the ages of 30 and 39. After 40, the intensity of atherosclerosis in these two groups is essentially the same. In cases of new malignant growths, atherosclerotic changes in the aorta and coronary arteries were less prevalent than in cases of other ailments studied (diabetes, essential hypertension, symptomatic hypertension). In their prevalence, however, they differed little from atherosclerotic changes in healthy people.