Quantitative coronary angiography to measure progression and regression of coronary atherosclerosis. Value, limitations, and implications for clinical trials.

July 1, 1991CirculationOpen Access

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Key Points

To review the value, limitations, and clinical trial implications of quantitative coronary angiography for assessing the progression and regression of coronary atherosclerotic lesions.
Synthesized findings from five primary prevention trials (two dietary, three pharmacological) evaluating hypercholesterolemia reduction on coronary heart disease incidence.
Evaluated clinical trials utilizing serial coronary angiography to quantify anatomical changes in coronary artery disease following lipid-lowering interventions.
Primary prevention trials showed significant reductions in coronary heart disease incidence and morbidity across dietary and pharmacological arms, though without convincing reductions in total mortality.
Combined lifestyle interventions, notably in the Oslo Heart Study, produced substantial joint reductions in cardiovascular morbidity and mortality via smoking cessation and diet-induced cholesterol reduction.
Repeated coronary angiography trials demonstrated that lowering cholesterol significantly decreases lesion progression while increasing the frequency of atherosclerotic lesion regression.

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Review

QCA trial endpoints warrant cautious interpretation; leaves open optimal imaging standardization for atherosclerosis progression studies.

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Feyter et al. (1991) studied this question.

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