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[Repeated coronarographies in 122 medically treated patients]
Insights
Repeat coronary angiography in 122 patients revealed significant coronary lesion progression in over half. Worsened left ventricular function was more common in patients with advanced coronary artery disease.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- Coronary artery disease (CAD) is a leading cause of mortality worldwide.
- Understanding the natural progression of CAD is crucial for effective patient management and treatment strategies.
Purpose of the Study:
- To evaluate changes in coronary angiography findings over time in patients with established CAD.
- To identify factors associated with disease progression or regression.
Main Methods:
- Retrospective analysis of 122 patients undergoing repeat coronary angiography.
- Exclusion of patients with normal coronary arteries.
- Categorization of patients into groups based on angiographic findings: unchanged, regression, or progression of coronary lesions.
Main Results:
- Over half of patients (56.6%) showed progression of coronary lesions.
- A smaller proportion experienced regression of lesions (9.8%), including recanalization in 3 cases.
- Worsening of left ventricular function was significantly more prevalent in patients with progressing CAD (21.7%) compared to those with stable or regressed disease (5.6%).
Conclusions:
- Coronary artery disease commonly progresses over time, as evidenced by repeat angiography.
- Progression of coronary lesions is associated with a higher incidence of left ventricular dysfunction.
- These findings underscore the importance of ongoing monitoring and aggressive management of CAD.
Abstract:
122 patients treated medically 115 men and 7 women aged 51.9 +/- 8.51 years (range 32 to 79 years) underwent repeat coronary angiography 34 +/- 26 months (1 month-11 years) after the initial investigation Patients with normal coronary arteries were excluded. The repeat investigation was performed for aggravation and persistance of symptoms in 74 cases, myocardial infarction in 14 cases, with a view to aortocoronary bypass in 23 cases, for cardiac failure in 8 cases and for ventricular arrhythmias in 3 cases. Three groups of patients could be distinguished: Group I: the coronary angiography was unchanged (41 patients, 33.6 p. 100). The interval between the two investigations was 30.7 +/- 24.8 months. Group II: the coronary lesions had regressed in 12 patients (9.8 p. 100). The interval between the two investigations was 29.4 +/- 23 months. The degree of stenosis was reduced in 6 cases; recanalisation of an occluded artery was demonstrated in 3 cases; coronary spasm was diagnosed in 3 cases. Paradoxically, 4 patients had developed lesions on other coronary segments. Group III: the coronary lesions had progressed in 69 patients (56.6 p. 100). The interval between the two investigations was 36.8 +/- 26.9 months. The progression was observed on a pre-existing stenosis in 51 cases and on an initially normal segment in 34 cases. Left ventricular function had worsened in 21.7 p. 100 of patients compared to only 5.6 p. 100 of patients in groups I and II (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)