title: Progression of coronary artery disease is dependent on anatomic location and diameter. The INTACT investigators.
abstract: OBJECTIVE
  This study represents the first prospective, quantitative analysis of the association of progression of coronary atherosclerosis with anatomic site and diameter.
  
  
  BACKGROUND
  The progressive course of coronary artery disease has been documented in many angiographic follow-up trials.
  
  
  METHODS
  The data of 348 patients with coronary artery disease from the International Nifedipine Trial on Antiatherosclerotic Therapy (INTACT) were reviewed. Standardized coronary angiograms were taken 3 years apart and were analyzed quantitatively. The coronary tree was subdivided into 25 segments. The progression of 1,063 preexisting coronary stenoses and the appearance of 247 newly formed stenoses was assessed in relation to the mean diameter of segments (< 2 mm, 2 to 3 mm, > 3 mm) and to their position in the coronary tree (proximal, mid, distal) and in the three major coronary arteries.
  
  
  RESULTS
  Decreases in the minimal diameter of preexisting stenoses were largest in segments that were > 3 mm in diameter (mean +/- SD 0.23 +/- 0.5 mm vs. 0.10 +/- 0.4 mm and 0.02 +/- 0.3 mm, p < 0.001), in a proximal position (0.14 +/- 0.5 mm vs. 0.09 +/- 0.4 mm and 0.06 +/- 0.3 mm, p = 0.081) and in the right coronary artery (0.14 +/- 0.4 mm vs. 0.07 +/- 0.4 mm and 0.07 +/- 0.3 mm, p < 0.01). Changes in percent diameter stenosis of preexisting stenoses were lowest in segments that were < 2 mm in diameter and in a distal position (p = NS). The number of new stenoses/segment was lowest in segments that were < 2 mm in diameter (44 of 1,756 vs. 139 of 1,967 and 64 of 1,125, p < 0.001) and in a distal position (77 of 2,370 vs. 84 of 1,193 and 86 of 1,285, p < 0.001) and was highest in segments of the right coronary artery (100 of 1,546 vs. 66 of 1,496 and 72 of 1,492, p = 0.044).
  
  
  CONCLUSIONS
  Progression of coronary artery disease occurs most frequently in coronary segments that are > 2 mm in diameter, in a proximal or midartery position and in the right coronary artery.
authors: Division of Cardiology, Hannover Medical School, Germany.
authors: S
authors: S
authors: Jost
authors: J W
authors: JW
authors: Deckers
authors: P
authors: P
authors: Nikutta
authors: W
authors: W
authors: Rafflenbeul
authors: B
authors: B
authors: Wiese
authors: H
authors: H
authors: Hecker
authors: P
authors: P
authors: Lippolt
authors: P R
authors: PR
authors: Lichtlen
mesh_terms: D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D003331:Coronary Vessels / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies