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[Slowing the progression and regression of the basic arteriosclerotic process]
1Abt. Innere Medizin III (Kardiologie), Medizinische Universitätsklinik Heidelberg.
Zeitschrift Fur Kardiologie
|January 1, 1993
Summary
Interventions can slow coronary artery disease progression, but regression is unlikely. Clinical events depend on factors beyond coronary artery disease morphology.
Area of Science:
- Cardiology
- Medical Interventions
- Atherosclerosis Research
Background:
- Coronary artery disease (CAD) progression affects nearly half of patients within five years under "usual care".
- Developing interventions to slow CAD progression and reduce clinical events is clinically justified.
Purpose of the Study:
- To evaluate the efficacy of risk factor reduction and calcium channel blockers in retarding CAD progression.
- To assess the impact of these interventions on clinical events.
Main Methods:
- Review of studies assessing interventions for CAD progression.
- Assessment of CAD progression using digital angiography.
- Analysis of clinical event frequency in intervention and control groups.
Main Results:
- Both risk factor reduction and calcium channel blockers demonstrated a capacity to retard CAD progression.
- The observed morphological changes were minimal (below 0.5 mm), approaching the variability of quantitative coronary angiography.
- Calcium channel blockers primarily affected new or minimal lesions.
- Clinical events were reduced in only two studies, while four intervention groups showed an increase.
Conclusions:
- Risk factor reduction and calcium channel blockers can slow CAD progression, but significant regression is not achieved.
- The frequency of clinical events is influenced by factors independent of morphological changes in CAD.