Incidence of myocardial infarction correlated with venous and pulmonary thrombosis and embolism

A geographic study based on autopsies in Uganda, East Africa and St. Louis, U. S. A.
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      Recent autopsy records at Washington University in St. Louis and Makerere College in Uganda, East Africa were reviewed to determine the incidences of venous thrombi and pulmonary thromboembolic phenomena, as well as the incidences of myocardial infarcts, in three groups of patients: (1) St. Louis white patients, (2) St. Louis Negroes, and (3) Uganda Negroes.
      The incidence of myocardial infarcts was high in St. Louis white patients, intermediate in St. Louis Negroes and practically nil in Uganda Negroes; the only infarct found in Uganda among 1,427 patients over forty years of age was a small healed one.
      The incidence of venous thrombi and pulmonary thromboembolic phenomena closely paralleled the incidence of myocardial infarcts in the three groups.
      The studies reported herein suggest that differences in the general tendency of the blood to clot and/or lyse account, at least in part, for the differences in the incidences of coronary thrombosis and myocardial infarction that exist between autopsied Ugandans and St. Louisans. Further investigation must be carried out utilizing many technics before the suggestion can be established as fact. Other studies will then be necessary to determine the precise nature of the difference and the reason for it, i.e., dietary, emotional or genetic.
      Probable, but as yet unestablished, differences in the degree of atherosclerosis present in the three groups may also contribute to the differences in incidences of myocardial infarction, but since the local factor of atherosclerosis is not present in veins, it could not account for the observed differences in evidences of venous thrombosis.
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