Coronary arteriography in 486 patients--arteriographic pathology and prognosis

The coronary arteriographic findings and prognosis in a series of 486 non-surgically treated patients were analyzed. A semiselective injection was used. The number and causes of deaths were obtained from the census registry after a follow-up period of 7--12 years. The material comprised normal arteriograms in 26% of the patients, wall irregularities at most in 17%, obstruction of at least half the diameter in 37%, and unclassifiable arteriograms in 19%. A mean of 1.8 obstructed arteries per patient was found in the group with obstructive arterial lesions and among these patients the left anterior descending artery was most often engaged. In the same group the cardiac mortality at seven years was 20%. There were no significant differences between deceased and survivors with regard to clinical data. The arteriograms themselves offered more information about the prognosis. Normal arteries or wall irregularities at most implied excellent prognosis with regard to death in coronary heart disease. The seven-year mortality was 36% among patients with coronary artery occlusions, which is significantly higher than 14% among those with arterial stenosis. Materials from the USA and Canada have displayed a much higher mortality than our study in spite of comparable arteriographic findings.