Relationship of amyloid deposits in the human aorta to aortic atherosclerosis: a postmortem study of 100 individuals over 60 years of age

Elderly humans often exhibit amyloid deposits at autopsy, most commonly localized in the heart, aorta, pancreatic islets, cerebral cortex, or meningeal vasculature. In an attempt to explore the possible relationship between aortic amyloid deposition and atherosclerosis, thoracic and abdominal aortas from 100 autopsied individuals over 60 yr old were assessed for atheromatous lesions, using a grid counting method, and multiple histologic sections from normal and atheromatous areas were examined for the presence of amyloid. Although atherosclerosis was clearly more extensive in the abdominal, compared with the thoracic, aorta, amyloid deposits occurred with equal frequency in the 2 aortic segments. Furthermore, although the pattern and severity of atherosclerosis in the 50 patients over 80 was no different from that observed in the 50 younger patients, amyloid deposition was much more extensive in the older group. Amyloid tended to deposit in areas of intimal abnormality, but there was no clear relation to the atherosclerotic process. Aortic amyloid deposition was often associated with cardiac amyloidosis (p<0.005), but no such relation was observed for either cerebrovascular or pancreatic islet amyloid. This apparent disparity of organ involvement in senile amyloid accumulation requires further investigation.