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[Frequency, localization and severity of coronary artery stenoses in correlation to age (author's transl)]
Insights
Coronary artery stenosis incidence increases with age, but severity does not. Coronary anatomy is independent of age, suggesting suitability for bypass grafting in all age groups.
Area of Science:
- Cardiology
- Gerontology
- Vascular Medicine
Background:
- Coronary artery disease (CAD) is a leading cause of mortality worldwide.
- Age is a known risk factor for CAD, but its specific impact on coronary stenosis characteristics requires further elucidation.
- Understanding age-related changes in coronary anatomy is crucial for treatment planning, particularly for interventions like coronary bypass grafting.
Purpose of the Study:
- To investigate the correlation between age and the incidence, localization, and severity of coronary stenoses in different patient groups.
- To determine if coronary artery anatomy is age-dependent in patients with symptomatic coronary artery disease.
- To assess the implications of age on coronary anatomy for surgical interventions such as coronary bypass grafting.
Main Methods:
- Retrospective analysis of angiograms from three patient groups: valvular/congenital heart disease (Group I), coronary heart disease without infarction (Group II), and post-myocardial infarction (Group III).
- Assessment of coronary stenosis incidence, number, localization, and severity.
- Correlation of stenosis characteristics with patient age and a validated coronary sclerosis score.
Main Results:
- In Group I, stenosis incidence and number increased with age, but severity did not. Group III showed less significant age dependency for stenosis number, with no age-severity correlation.
- No age correlation was found for stenosis parameters in Group II. Coronary sclerosis score significantly increased with age in Groups I and III.
- Stenoses were predominantly in proximal coronary vessels across all groups and ages. Symptomatic coronary anatomy was independent of age.
Conclusions:
- Stenosing coronary sclerosis is not solely age-induced but results from prolonged risk factor exposure.
- Coronary anatomy in symptomatic patients, including those with myocardial infarction, is not age-dependent.
- Coronary bypass grafting is a viable option for elderly patients, as their coronary anatomy is comparable to younger patients.
Abstract:
Angiograms of three different groups of patients were examined as to incidence, localization and severity of regional and overall coronary stenoses in correlation to age (group I = 217 patients with valvular and congenital heart disease, 174 patients with coronary heart disease without [group II] and after infarction [group III = 251 patients]). In group I the incidence and number of stenoses increased significantly with age, but not the severity of stenoses. In group III the age dependency of the number of stenoses was less significant and again there was no age correlation to the severity of stenoses. In group II no correlation of the examined parameters to age was found. Judging the severity of coronary sclerosis by a special score, there was a significant increase in group II compared to I and in III compared to II. Furthermore, this coronary score correlated to age in group I and III. In all three groups the stenoses were most frequently found in the proximal parts of the vessels independent from age. Stenosing coronary sclerosis is not an age-induced disease. Its more frequent incidence in older patients is caused by the longer lasting effect of risk factors with aging. Once symptomatic with angina pectoris, the coronary anatomy, does not depend on age. Thus regarding coronary anatomy, coronary bypass grafting should be equally possible in the elderly patients as in the younger ones. In patients with myocardial infarction, the number of diseased vessels increased with age.