Document Detail

Process of progression of coronary artery lesions from mild or moderate stenosis to moderate or severe stenosis: A study based on four serial coronary arteriograms per year.
MedLine Citation:
PMID:  10468519     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The process of progression in coronary artery disease is unknown. METHODS AND RESULTS: The subjects were 36 patients with 36 objective vessels with clinically significant progression of coronary artery disease (>/=15% per year) in whom 4 serial coronary arteriograms (CAGs) were performed at intervals of approximately 4 months in a 1-year period. The degree of progression of percent stenosis between each of 2 serial CAGs was classified as marked (M: >/=15%), slight (S: 5% to 14%), and no progression (N: <5%). From the pattern of progression, the 36 vessels were classified as 14 type 1 vessels with marked progression (N-->N-->M in 13 vessels and S-->S-->M in 1 vessel) and 22 type 2 vessels without marked progression (S-->S-->S in 18 vessels, N-->S-->S in 4). Percent stenosis at the first, second, third, and final CAGs was 44+/-14%, 46+/-13%, 46+/-13%, and 88+/-10% (P<0.05 versus first CAG) in type 1 vessels and 44+/-11%, 50+/-9%, 59+/-9%, and 67+/-9% in type 2 vessels (P<0.05 for second, third, and final CAGs versus first CAG). Type 1 vessels featured the sudden appearance of severe stenosis due to marked progression, angina pectoris, or myocardial infarction (71%) and Ambrose type II eccentric lesions indicating plaque rupture or thrombi (57%). Type 2 vessels featured continuous slight progression of stenosis with smooth vessel walls; angina pectoris (14%) occurred when the percent stenosis reached a severe level. An increase in serum C-reactive protein was observed only in the type 2 vessel group, which suggests a relation between continuous slight progression and inflammatory change. CONCLUSIONS: Two types of stenosis progression provide a new insight into the mechanism of coronary artery disease.
K Yokoya; H Takatsu; T Suzuki; H Hosokawa; S Ojio; T Matsubara; T Tanaka; S Watanabe; N Morita; K Nishigaki; G Takemura; T Noda; S Minatoguchi; H Fujiwara
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  Circulation     Volume:  100     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  1999 Aug 
Date Detail:
Created Date:  1999-09-14     Completed Date:  1999-09-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  903-9     Citation Subset:  AIM; IM    
MUGIC Group: Multicenter Study Group in Gifu University and Affiliated Hospitals on Cardiac Disease, Japan.
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MeSH Terms
Angina Pectoris / etiology,  pathology,  radiography
C-Reactive Protein / metabolism*
Confounding Factors (Epidemiology)
Coronary Angiography
Coronary Disease / blood,  complications,  pathology*,  radiography*
Disease Progression
Middle Aged
Myocardial Infarction / etiology,  pathology,  radiography
Risk Factors
Severity of Illness Index
Reg. No./Substance:
9007-41-4/C-Reactive Protein

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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