Document Detail

Angiographic severity of coronary narrowing is a surrogate marker for the extent of coronary atherosclerosis.
MedLine Citation:
PMID:  8806334     Owner:  NLM     Status:  MEDLINE    
Most acute coronary events occur because of narrowings at sites of angiographically minor plaque. Despite this, angiograms are reported in terms of the number of coronary arteries with severe narrowings. Disease severity is correlated with prognosis, but this may simply be due to a strong positive correlation between the severity and extent of coronary atheroma. We therefore aimed to assess the relation between the severity and the extent of coronary atherosclerosis. Coronary angiograms of 350 consecutive patients referred for elective cardiac catheterization were analyzed. Two independent observers calculated the number of arteries with > or = 70% stenosis, a disease severity score, and an extent score (percentage of the coronary artery length with any luminal irregularity). There were no obstructive stenoses in 123 patients (35%); 91 (26%) had 1-vessel disease, 81 (23%) had 2-vessel disease, and 55 (16%) had 3-vessel coronary artery disease. The median severity score was 1 (lower, upper quartile 0, 3; range 0 to 8), and the median extent score was 66% (lower, upper quartile 32, 83; range 0% to 100%). There was a strong linear relation between severity score and extent score (r = 0.62, p < 0.001); however, the data were better described by 2 intersecting straight lines, with a steeper increase in disease severity when the extent score was between 80% and 90% (F1;121 = 6.9, p = 0.001). The severity of coronary disease is therefore significantly correlated with disease extent. This may explain the observed relation between the number of arteries with obstructive stenoses and subsequent risk, even though most events occur at sites of minor plaque.
A Nakagomi; D S Celermajer; T Lumley; S B Freedman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  78     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1996 Sep 
Date Detail:
Created Date:  1996-10-22     Completed Date:  1996-10-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  516-9     Citation Subset:  AIM; IM    
Department of Cardiology, Royal Prince Alfred Hospital, Camperdown, Sydney, Australia.
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MeSH Terms
Aged, 80 and over
Coronary Angiography*
Coronary Artery Disease / pathology,  radiography*
Middle Aged

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