Clinical and angiographic predictors of new total coronary occlusion in coronary artery disease: Analysis of 313 nonoperated patients

doi:10.1016/S0002-9149(84)80063-6

The American Journal of Cardiology

Volume 54, Issue 10, 1 December 1984, Pages 1176-1181

https://doi.org/10.1016/S0002-9149(84)80063-6 Get rights and content

A new coronary artery occlusion was found in 98 of 313 consecutive patients (31%) with coronary artery disease treated medically who underwent catheterization twice, 39 ± 25 months apart. Multivariate logistic regression displayed 8 independent predictors of new occlusion. Four were available at the time of the second angiogram: the interval between the 2 studies (p = 0.005), a decrease in ejection fraction (p <0.01), the appearance of bundle branch block (p <0.01), and an interim myocardial infarction (p <0.05). Four other predictors were found at the time of the first angiogram: 2 anglographic characteristics, 1 related to the severity (presence of an 80% or greater luminal diameter narrowing of an artery supplying a non-akinetic left ventricular segment [p <0.005]) and 1 to the extent (count of the lesions narrowed 75% or less in luminal diameter in a 15-segment coding system [p <0.05]) of coronary artery disease, and 2 risk factors: smoking status (p <0.05) and male sex (p <0.05). The 140 male smokers with at least 80% diameter stenosis or at least 4 segments with moderate (75% or less) stenosis were at a higher risk of occlusion than the 173 other patients after intervals of less than 2 years (13 of 53 vs 7 of 74, p <0.001), 2 to 4 years (23 of 40 vs 10 of 47, p <0.005) and more than 4 years (27 of 47 vs 18 of 54, p <0.05). Thus, the appearance of a new occlusion, while strongly associated with new myocardial damage, can be predicted by a combination of 2 angiographic and 2 clinical characteristics at the time of the first evaluation.

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^*: This study was supported in part by a Fellowship award to Dr. Moise from the INSERM (Institut National de la Santé et de la Recherche médicale), Paris, France, and the FRSQ (Fonds de la Recherche en Santé du Québec), Québec, Canada.

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Clinical and angiographic predictors of new total coronary occlusion in coronary artery disease: Analysis of 313 nonoperated patients*

Early progression of coronary disease in patients assigned to medical therapy (abstr)

Circulation

The anatomic evolution of coronary artery disease demonstrated by coronary arteriography in 256 nonoperated patients

Circulation

Progression and regression of coronary arteriosclerosis: relation to risk factors

Am Heart J

Role of coronary arteriography in the evaluation of patients with coronary artery disease

Am J Med

Prevalence of total coronary occlusion during the early hours of transmural infarction

N Engl J Med

Coronary arteriography in acute transmural myocardial infarction

Am Heart J

Clinical and angiographic factors associated with progression of coronary artery disease

JACC

The National Heart, Lung, and Blood Institute Coronary Artery Surgery Study (CASS)

Circulation

Electrocardiographic grading codes

Circulation

Clinical pathologic correlates in acute myocardial infarction

Adv Cardiol

Selective coronary arteriography by the percutaneous femoral artery approach

Am J Roentgenol

A reporting system on patients evaluated for coronary artery disease. Report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association

Circulation

Natural history of ischemic heart disease in relation to arteriographic findings. A twelve year study of 224 patients

Circulation

Coronary Arteriography

The Analysis of Binary Data