In the twentieth century, ischemic heart disease (IHD) due to coronary atherosclerosis, also known as coronary heart disease (CHD) or coronary artery disease (CAD), has gained recognition as the leading cause of morbidity and mortality worldwide [[1], [2], [3]]. This recognition stimulated scientific and biomedical investigation of atherosclerosis, particularly epidemiologists focused on clinical features and pathologists focused on the disease process itself [4,5]. Autopsy-initiated pathological studies led to a characterization of the changes in the arterial wall linked to the natural history of atherosclerosis [[6], [7], [8], [9], [10], [11], [12]] Autopsy studies also were pivotal in elucidating the pathological substrate for the two major complications of atherosclerosis, namely acute myocardial infarction (AMI) and sudden cardiac death (SCD) [13,14]. The information was used to develop strategies to reduce morbidity and mortality from CAD [1]. Information from autopsy-initiated pathological studies also stimulated multifaceted research, leading to the current understanding of the pathobiology of atherosclerotic disease [[11], [12], [13], [14], [15], [16], [17], [18], [19]].

Historically, the autopsy has led to the discovery or the critical clarification of many human diseases and will continue to do so in the future [[20], [21], [22]]. Five years ago, we presented strong arguments for the continued importance of autopsies for understanding the pathogenesis of established and newly discovered diseases [23]. In companion reviews, we will focus specifically on the contributions of autopsy-based pathological studies to our contemporary understanding of the pathobiology of atherosclerotic disease (PartI) and its major manifestation of ischemic heart disease (Part II) [23].