How Long do Your Angiographically Normal Coronary Arteries Remain Normal? A Pilot Study

Abstract

Coronary atherosclerosis is a progressive disease. We sought to determine whether this fact also applies to patients at an advanced age with normal coronary arteries (NCAs) undergoing repeat catheterization at least 5 years later. Of the 189 patients who were found to have NCAs, 154 (81%) remained with NCAs and 35 (19%) developed obstructive coronary artery disease (OCAD). Development of OCAD was observed at all ages. Isolated risk factors were not associated with the appearance of OCAD, but the combination of diabetes mellitus with age >65 years or with smoking was associated with the appearance of OCAD (P = .04 for both). In conclusion, the finding of angiographically NCAs in elderly individuals does not prevent the later development of OCAD.

Keywords

normal coronary arteries atherosclerosis progression risk factors

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References

Bradley

Maddox

Stanislawski

. Normal coronary rates for elective angiography in the VA health care system: insights from the VA CART program. J Am Coll Cardiol. 2014;63(5):417–426.

Kemp

Kronmal

Vlietstra

Frye

. Seven year survival of patients with normal or near normal coronary arteriograms: a CASS registry study. J Am Coll Cardiol. 1986;7(3):479–483.

Douglas

Patel

Bailey

. Hospital variability in the rate of finding obstructive coronary artery disease at elective, diagnostic coronary angiography. J Am Coll Cardiol. 2011;58(8):801–809.

Levitt

Guo

Wijeysundera

. Predictors of normal coronary arteries at coronary angiography. Am Heart J. 2013;166(4):694–700.

Mintz

Painter

Pichard

. Atherosclerosis in angiographically “normal” coronary artery reference segments: an intravascular ultrasound study with clinical correlations. J Am Coll Cardiol. 1995;25(7):1479–1485.

Marchandise

Bourassa

Chaitman

Lesperance

. Angiographic evaluation of the natural history of normal coronary arteries and mild coronary atherosclerosis. Am J Cardiol. 1978;41(2):216–220.

Stone

Robinson

Lichtenstein

. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults: a report of the American college of cardiology/American heart association task force on practice guidelines. J Am Coll Cardiol. 2014;63(25 Pt B):2889–2934.