Copyright © 1997 by the European Society of Cardiology.
© 1997 The European Society of Cardiology
Evolution of coronary atherosclerosis in patients with mild coronary artery disease studied by serial quantitative coronary angiography at 2 and 4 years follow-up
*Thoraxcenter, University Hospital Dijkzigt, Erasmus University Rotterdam, The Netherlands
Sint Antonius Hospital Nieuwegein, The Netherlands
Salgrenska Hospital Gothenburg, Sweden
Tour de Soins Normaux, C.H.U. Sart-Tilman Liège, Belgium
||Johann Wolfgang Goethe-Universität Frankfurt am Main, Germany
SOCAR SA Givrins, Switzerland
revised 13 September 1996; accepted 18 September 1996.
Correspondence: P. J. de Feyter, MD PhD, FESC, Catheterization Laboratory, Thoraxcenter Bd 416, University Hospital Dijkzigt, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
Abstract
AIMS: Angiographic studies on the natural course of both focal and diffuse coronary atherosclerosis have not been performed before, but can both be assessed by quantitative coronary angiography. The objective of this study was to describe the natural course of focal and diffuse coronary atherosclerosis over time.
METHODS AND RESULTS: In 129 patients with mild coronary artery disease, but not on lipid-lowering medication, three coronary angiograms were made each 2 years apart. Nine hundred and sixty five angiographically diseased and non-diseased segments were analysed by quantitative coronary angiography. Mean lumen diameter and minimal lumen diameter were used as measures of diffuse and focal coronary atherosclerosis.
Mean lumen diameter and minimum lumen diameter decreased by 0·02 and 0·03 mm per year. The rate of progresssion was similar in the angiographically non-diseased, as in the mildly and moderately diseased segments. Progression of diffuse coronary atherosclerosis was largest in severely stenosed lesions (percentage diameter stenosis 
50%) and in the right coronary artery with a loss of 0·19 mm and 0·16 mm in mean lumen diameter. Progression of focal disease was most prominent in new and mild lesions and the right coronary artery, with a decrease in minimum lumen diameter of 0·34 mm and 0·22 mm. In most subgroups, progression occurred gradually over time. On a per segment level, progression and the occurrence of new lesions occurred in 4·4% and 4·2%. Regression and disappearance of a lesions was found in 2·3% and 1·9%. On a per patient level, 36% were progressors, 12% had a mixed response, 36% were stable, and 16% were regressors.
CONCLUSION: Diffuse and focal coronary atherosclerosis progressed at the same rate in the first and second 2 years in stenosed and non-stenosed segments. The rate of coronary atherosclerosis progression was small, but was higher for focal than for diffuse disease. A minority of lesions progressed and spontaneous regression was rare.
Key Words: Coronary atherosclerosis • quantitative coronary angiography • natural history
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  F. Gradaus, K. Ivens, A. J. Peters, P. Heering, F.-C. Schoebel, B. Grabensee, and B.-E. Strauer Angiographic progression of coronary artery disease in patients with end-stage renal disease Nephrol. Dial. Transplant., June 1, 2001; 16(6): 1198 - 1202. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Pillay, Z. A. Abdul Hamid, D. Pillay, and Z. A. Abdul Hamid Spontaneous Regression of Ostial Coronary Artery Lesion Asian Cardiovasc Thorac Ann, December 1, 2000; 8(4): 364 - 365. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. S. Abizaid, G. S. Mintz, R. Mehran, A. Abizaid, A. J. Lansky, A. D. Pichard, L. F. Satler, H. Wu, C. Pappas, K. M. Kent, et al. Long-Term Follow-Up After Percutaneous Transluminal Coronary Angioplasty Was Not Performed Based on Intravascular Ultrasound Findings : Importance of Lumen Dimensions Circulation, July 20, 1999; 100(3): 256 - 261. [Abstract] [Full Text] [PDF]
|
|