Importance of risk factors in the angiographic progression of coronary artery disease

Although specific risk factors correlate with the development of clinical coronary events, little is known about their importance in patients with established coronary artery disease (CAD). A numerical scoring system was used to assess serial coronary angiograms in subjects who had detailed risk factor determinations. Strong linear correlations were demonstrated between the extent of progression of CAD and diastolic blood pressure (BP) (p = 0.002), systolic BP (p = 0.094), the number of cigarette pack-years smoked among current smokers (p = 0.022), fasting blood glucose level (p = 0.017) and low levels of physical activity at leisure (p = 0.097). This analysis of sequential coronary angiograms identifies BP, cigarette smoking, diabetes mellitus and physical activity as important risk factors in the progression of CAD. These variables merit attention in the management of patients with symptomatic CAD and in secondary coronary prevention trials investigating risk factor modification.