Progress Study of 590 Consecutive Nonsurgical Cases of Coronary Disease Followed 5-9 Years

The clinical progress was studied in a series of 590 patients documented to have significant obstructive disease by coronary arteriography. Ventriculographic findings, age, history, cigarette smoking, hypertension, serum cholesterol, and diabetes were correlated with prognosis. In categories separated on the basis of left ventricular angiogram the 5-year cardiac mortality rates ranged from 25% among patients with normal left ventricles to 69% among patients with dilated and generally poorly contracting left ventricles. Combining the results of coronary and left ventricular angiography yielded a better prediction than either method separately. Most of the other parameters studied were related to a certain extent to mortality, but their predictive power was limited and could partly or entirely be explained by the associated obstructions of the coronary arteries or the condition of the left ventricle. The most significant clinical determinants were the history, the electrocardiogram, and the presence of diabetes mellitus. Particularly high mortality was found in patients with congestive heart failure or electrocardiographic conduction disturbances.