What are the angiographic and clinical predictors of coronary artery stenosis progression in patients with coronary artery disease?
Coronary artery stenosis progression is significantly associated with tubular stenosis with ulcerating plaques, presence of collateral circulation, and increasing number of coronary risk factors.
Comparison of sequential large film coronary angiograms was performed for 58 patients with coronary artery disease, and no coronary surgery, to determine the relationship between the location, type, and degree of stenoses and their tendency to progress. Of 230 stenoses, 76 (33%) showed progression and 154 (67%) remained stable on the follow-up studies. Progression occurred in 38 (66%) patients. A statistically significant higher tendency to progress was found with tubular stenosis with ulcerating plaques (100%) and stenoses with collateral circulation (58%). A significant linear trend for progression was also found with the increasing number of risk factors of coronary disease. The above-average progression tendency of stenoses of the right coronary artery, tubular irregular stenoses, and Grade 2 stenoses, was not statistically significant.
Rösch et al. (Tue,) studied this question.
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