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

Article

关键词: C-REACTIVE PROTEIN;    ACUTE MYOCARDIAL-INFARCTION;    UNSTABLE ANGINA;    DISEASE;    ATHEROSCLEROSIS;    PATHOGENESIS;   

DOI  :  10.1161/01.CIR.100.9.903

来源: SCIE

【 摘 要 】

Background-The process of progression in coronary artery disease is unknown. Methods and Results-The subjects were 36 patients with 36 objective vessels with clinically significant progression of coronary artery disease (greater than or equal to 15% per year) in whom 4 serial coronary arteriograms (CAGs) were performed at intervals of approximate to 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: greater than or equal to 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 GAG) 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 GAG). 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.

【 授权许可】

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