Detection of coronary atherosclerosis before 45 or 50 years of age. Value of skin biopsy
Bonnet, J.; Larrue, J.; Colle, J.P.; Bricaud, H.
Archives des Maladies du Coeur et des Vaisseaux 76(12): 1391-1398
1983
ISSN/ISBN: 0003-9683 PMID: 6422875 Document Number: 218318
A three year prospective study was undertaken to determine the possible relationship of coronary atherosclerosis in subjects under 50 years of age, confirmed by coronary angiography, and structural changes of the connective tissue dystrophy. The independence of the histological changes with respect to other cardiovascular risk factors was also evaluated. The study was carried out by a double blind technique between the histological and clinical results. We present our preliminary results in 88 male patients, 64 with atherosclerosis and 24 controls. Histological abnormalities were found in 81.25% of patients with atherosclerosis compared to 33.3% in the control subjects. Accelerated skin aging, a simple diagnosis, requires only light microscopy for diagnosis and seems to be the simplest and most reliable screening test. It is found in 61% of atherosclerotic patients in the general population and in 74% of coronary patients under 45 years of age, independently of other risk factors especially cigarette smoking. As a screening test for coronary atherosclerosis before 45 years of age, the sensitivity was found to be 74.2% and specificity 57.1%, the predictive value being 79.3%. Connective tissue dystrophy needs electronic microscopy and seems to be less reliable in the detection of atherosclerosis as this condition is usually found in patients over 45 years of age. However, these changes are related to atherosclerosis and not to age. This study shows that skin biopsy in the search of accelerated skin aging, enables atherosclerosis to be detected simply and reliably, independently of other risk factors. This test, by defining the individual structural risk, is a method of following the progression or regression of atherosclerosis and so help control treatment.