title: 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.
abstract: BACKGROUND
  The process of progression in coronary artery disease is unknown.
  
  
  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.
authors.affiliation: MUGIC Group: Multicenter Study Group in Gifu University and Affiliated Hospitals on Cardiac Disease, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Yokoya
authors.forename: H
authors.initials: H
authors.lastname: Takatsu
authors.forename: T
authors.initials: T
authors.lastname: Suzuki
authors.forename: H
authors.initials: H
authors.lastname: Hosokawa
authors.forename: S
authors.initials: S
authors.lastname: Ojio
authors.forename: T
authors.initials: T
authors.lastname: Matsubara
authors.forename: T
authors.initials: T
authors.lastname: Tanaka
authors.forename: S
authors.initials: S
authors.lastname: Watanabe
authors.forename: N
authors.initials: N
authors.lastname: Morita
authors.forename: K
authors.initials: K
authors.lastname: Nishigaki
authors.forename: G
authors.initials: G
authors.lastname: Takemura
authors.forename: T
authors.initials: T
authors.lastname: Noda
authors.forename: S
authors.initials: S
authors.lastname: Minatoguchi
authors.forename: H
authors.initials: H
authors.lastname: Fujiwara
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D002097:C-Reactive Protein / Q000378:metabolism*; D015986:Confounding Factors, Epidemiologic; D017023:Coronary Angiography; D003327:Coronary Disease / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D002097:C-Reactive Protein