Angiographic Progression of Coronary Heart Disease in Unoperated Patients

Coronary angiographic examinations were repeated after periods ranging between 4 to 48 months (mean 32.7±21.2) in 73 patients with varying degrees of atherosclerotic heart disease. Angiograms were retrospectively evaluated for progression (increase by 25 % of degree of stenosis). Progression of the disease was noted in 38 patients while no progression was observed in 35 patients angiograms. There was no significant difference of family history smoking habit, blood cholesterol level, arterial blood pressure, obesity or age between the group with atherosclerotic progression and the nonprogressive group. Atherosclerotic progression frequency was significantly higher in patients with blood triglyceride level exceeding 200 mg/dl, in those with high Ieft ventricle performance score, in those with electrocardiographically confirmed myocardial infaretion prior to the first angiographic examination and in those with triple vessel disease. Progression was not different in the patients with single or double vessel disease or in those with angiographically normal coronary vessels. The time elapsed between the two studies was not effective on the progression. Control angiograms of all eight patients who had myocardial infarction in the period between the two angiographic controls showed atherosclerotic progression. This study revealed that atherosclerotic course has a great variability between patients, and it is difficult to predict which vessel segment with or without lesions will show atherosclerotic progression and over how long a period.