We studied the progression of atherosclerotic coronary lesions in 38 patients who had previously undergone angiography and were later hospitalized for an episode of unstable angina pectoris, and in 38 matched patients with stable angina who had also undergone prior catheterization. Patients with unstable angina and those with stable angina were similar in terms of age (mean, 49 and 50 years, respectively), number of risk factors (1.5 per patient in both groups), interval between studies (mean +/- S.D., 44 +/- 31 and 35 +/- 31 months, respectively), number of diseased vessels on the first angiogram (1.52 in both groups), and initial ejection fraction (65 and 63 per cent, respectively). Progression of coronary lesions was demonstrated in 29 of the 38 patients with unstable angina, as compared with 12 of the 38 with stable angina (P less than 0.0005). Progression to 70 per cent or more stenosis was recorded in 21 of the patients with unstable angina but in only 5 of those with stable angina (P less than 0.0005). Also more frequent in the patients with unstable angina were multifocal progression (11 vs. 2, P less than 0.01) and progression of the left main or preseptal left anterior descending artery or both (9 vs. 1, P less than 0.01). Thus, we have demonstrated by angiography that unstable angina is associated with progression in the extent and severity of coronary atherosclerosis.
This article has been cited by other articles:
Talwar, S, Karpha, M, Thomas, R, Vurwerk, C, Cox, I C, Burrell, C J, Motwani, J G, Gilbert, T J, Haywood, G A
(2005). Disease progression and adverse events in patients listed for elective percutaneous coronary intervention. Postgrad. Med. J.
81: 459-462
[Abstract][Full Text]
Goldstein, J. A.
(2002). Angiographic plaque complexity: the tip of the unstable plaque iceberg. J Am Coll Cardiol
39: 1464-1467
[Full Text]
Pasterkamp, G., Vink, A., Borst, C., Wascher, T. C., deCampo, A., Schmoelzer, I., Goldstein, J. A., Grines, C., O'Neill, W. W.
(2001). Multiple Complex Coronary Plaques in Patients with Acute Myocardial Infarction. NEJM
344: 527-528
[Full Text]
Goldstein, J. A., Demetriou, D., Grines, C. L., Pica, M., Shoukfeh, M., O'Neill, W. W.
(2000). Multiple Complex Coronary Plaques in Patients with Acute Myocardial Infarction. NEJM
343: 915-922
[Abstract][Full Text]
Ambrose, J. A., Dangas, G.
(2000). Unstable Angina: Current Concepts of Pathogenesis and Treatment. Arch Intern Med
160: 25-37
[Abstract][Full Text]
Guazzi, M. D., Bussotti, M., Grancini, L., De Cesare, N., Guazzi, M., Pera, I. L., Loaldi, A.
(1997). Evidence of Multifocal Activity of Coronary Disease in Patients With Acute Myocardial Infarction. Circulation
96: 1145-1151
[Abstract][Full Text]
Theroux, P., Kouz, S., Roy, L., Knudtson, M. L., Diodati, J. G., Marquis, J.-F., Nasmith, J., Fung, A. Y., Boudreault, J.-R., Delage, F., Dupuis, R., Kells, C., Bokslag, M., Steiner, B., Rapold, H. J.
(1996). Platelet Membrane Receptor Glycoprotein IIb/IIIa Antagonism in Unstable Angina: The Canadian Lamifiban Study. Circulation
94: 899-905
[Abstract][Full Text]
Waters, D., Lesperance, J., Gladstone, P., Boccuzzi, S. J., Cook, T., Hudgin, R., Krip, G., Higginson, L.
(1996). Effects of Cigarette Smoking on the Angiographic Evolution of Coronary Atherosclerosis: A Canadian Coronary Atherosclerosis Intervention Trial (CCAIT) Substudy. Circulation
94: 614-621
[Abstract][Full Text]
Ardissino, D., Merlini, P. A., Gamba, G., Barberis, P., Demicheli, G., Testa, S., Colombi, E., Poli, A., Fetiveau, R., Montemartini, C.
(1996). Thrombin Activity and Early Outcome in Unstable Angina Pectoris. Circulation
93: 1634-1639
[Abstract][Full Text]
Waters, D., Higginson, L., Gladstone, P., Boccuzzi, S. J., Cook, T., Lesperance, J.
(1995). Effects of Cholesterol Lowering on the Progression of Coronary Atherosclerosis in Women : A Canadian Coronary Atherosclerosis Intervention Trial (CCAIT) Substudy. Circulation
92: 2404-2410
[Abstract][Full Text]
Kaski, J. C., Chester, M. R., Chen, L., Katritsis, D.
(1995). Rapid Angiographic Progression of Coronary Artery Disease in Patients With Angina Pectoris : The Role of Complex Stenosis Morphology. Circulation
92: 2058-2065
[Abstract][Full Text]
Theroux, P.
(1995). Angiographic and Clinical Progression in Unstable Angina : From Clinical Observations to Clinical Trials. Circulation
91: 2295-2298
[Full Text]
Chen, L., Chester, M. R., Redwood, S., Huang, J., Leatham, E., Kaski, J. C.
(1995). Angiographic Stenosis Progression and Coronary Events in Patients With `Stabilized' Unstable Angina. Circulation
91: 2319-2324
[Abstract][Full Text]
Pearlman, J. D., Southern, J. F., Ackerman, J. L.
(1991). Nuclear Magnetic Resonance Microscopy of Atheroma in Human Coronary Arteries. ANGIOLOGY
42: 726-733
[Abstract]
Johnson, E., Ports, T.
(1988). Unstable Angina Pectoris: An Interventional Approach to Management. J Intensive Care Med
3: 202-214
[Abstract]
Hirsh, J., Cairns, J. A.
(1987). Analytic Reviews : Antithrombotic Tberapy in Acute Myocardial Infarction and Unstable Angina. J Intensive Care Med
2: 299-312
