Myocardial infarction, usually the result of thrombosis of a coronary artery, has steadily increased in incidence over the last 30 years, so that at present it is a leading cause of death in this country. The traditional assumptions have been that coronary thrombosis was primarily a complication of underlying atheroma, that the increasing incidence of myocardial infarction was a result of increasing severity of atherosclerosis in our population, partially the result of increased age of the individuals, and that a decrease in the incidence of myocardial infarction would result only from prevention of atheroma.
Several developments have occurred that cast some doubt on these assumptions. First, evidence has been obtained that an increase in severity of atherosclerosis has not occurred in Great Britain in the last 40 years.1 Second, there is the common observation that many patients with severe coronary atherosclerosis have no occlusive thrombosis and many with occlusive
HARTROFT WS, O'NEAL RM. Coronary Thrombosis: With Reference to Blood Lipid Levels in Rats on an Infarct-Producing Diet. Arch Surg. 1961;82(1):69–73. doi:10.1001/archsurg.1961.01300070073010
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