Cigarette smoking and coronary artery disease. A macroscopic and microscopic study.

Vascular changes in the coronary arteries and intramyocardial arteries and arteriole were studied in 1,056 men in relation to the effects of cigarette smoking and to age. The analysis was based on both macroscopic and microscopic studies, and the pathologist was unaware of the identity of the cases. The macroscopic study found a greater association with atheroma than a previous study taken from autopsies. The microscopic study found moderate and advanced fibrous intimal thickening of the coronary arteries to be more frequent in smokers and related to the amount or degree of cigarette smoking. The increase in fibrous intimal thickening was greater for intramyocardial arteries than for subepicardial arteries. The most marked difference by smoking habits was found in the myocardial arterioles. Advanced hyaline thickening was found in 90.7 percent of those smoking two or more packs of cigarettes per day, in 48.4 percent of those smoking less than one pack per day, and not in any of those who never smoked regularly.