[Progression of coronary sclerosis. Studies in 19 patients over a 6-year period using quantitative coronary...

The characteristics of progressive coronary artery disease as judged from sequential angiography were quantitatively analysed in 19 patients with stable angina in whom coronary angiograms were repeated after 64-104 months (average 76.5 months). The diameters of at most 15 corresponding segments were measured with a vernier caliper (accuracy: 0.05 mm) at identical sites and in the same projections. Considering the error in measurement (less than 10%) and spontaneous changes in smooth muscle tone only a diameter decrease of greater than 20% and/or every transition to an occlusion were recorded as progression. The progression over a 6-year interval was predominately characterized by: A large amount of total occlusions (61% of all progressive stenoses), relatively independent of the initial degree of stenosis. A large amount of newly developed obstructions which are more severe in coronary arteries already segmentally diseased at the onset, indicating a diffuse intramural disease of the entire vessel. A different pattern of progression in the 3 main coronary arteries. No influence of risk factors on natural history.