title: Natural history of coronary atherosclerosis using quantitative angiography in men, and implications for clinical trials of coronary regression. The Harvard Atherosclerosis Reversibility Project Study Group.
abstract: Previous studies of the natural history of coronary disease generally relied on estimates of percent stenosis derived from visual assessment of the coronary angiogram. In a study of 26 patients, serial quantitative angiography was performed 3 years apart to determine changes in both absolute measurements of the luminal diameter and relative percent stenosis. Initially, the mean minimal diameter of 74 coronary obstructions was 1.94 +/- 0.09 mm, the mean "normal" reference diameter was 3.06 +/- 0.11 mm, and the mean percent stenosis was 37%. At follow-up, there was a mild reduction of 0.12 +/- 0.04 mm (6%) in the minimal diameter (p < 0.005), and an increase in percent stenosis to 39% (p = 0.03). The average diameter of 85 arterial segments without a focal obstruction either initially or at follow-up showed mild but significant progression (-0.11 +/- 0.04 mm; p = 0.02). Using a minimal change of 0.27 mm in arterial diameter as a categoric variable, progression occurred in 26% of 74 arterial segments, no significant change in 65%, and regression in 9%. The only significant determinant of disease progression was the initial severity of disease. Obstructed arteries with a larger initial minimal diameter and presumably milder disease progressed more rapidly than did those with a smaller diameter (r = -0.42; p = 0.0002). There was no effect of age on the rate of progression (r = 0.02; p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115.
authors.forename: P H
authors.initials: PH
authors.lastname: Stone
authors.forename: C M
authors.initials: CM
authors.lastname: Gibson
authors.forename: R C
authors.initials: RC
authors.lastname: Pasternak
authors.forename: K
authors.initials: K
authors.lastname: McManus
authors.forename: L
authors.initials: L
authors.lastname: Diaz
authors.forename: T
authors.initials: T
authors.lastname: Boucher
authors.forename: R
authors.initials: R
authors.lastname: Spears
authors.forename: T
authors.initials: T
authors.lastname: Sandor
authors.forename: B
authors.initials: B
authors.lastname: Rosner
authors.forename: F M
authors.initials: FM
authors.lastname: Sacks
mesh_terms: D006328:Cardiac Catheterization; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000628:therapy; D003331:Coronary Vessels / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D013997:Time Factors