(Circulation. 1999;100:903-909.)
© 1999 American Heart Association, Inc.
Clinical Investigation and Reports |
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
From the MUGIC Group: Multicenter Study Group in Gifu University and Affiliated Hospitals (Gifu University School of Medicine, Gifu Municipal Hospital, National Toyohashi-Higashi Hospital, Gifu Prefectural Hospital, and Matsunami General Hospital) on Cardiac Disease.
Correspondence to Hisayoshi Fujiwara, MD, Second Department of Medicine, Gifu University School of Medicine, 40 Tsukasa-machi, Gifu 500, Japan. E-mail gifuim-gif{at}umin.ac.jp
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 (
15% per year) in whom 4 serial
coronary arteriograms (CAGs) were performed at intervals of
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
NM in 13 vessels and
SSM in 1 vessel) and 22 type 2 vessels without marked progression
(SSS in 18 vessels, NSS 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.
Key Words: coronary disease • proteins • stenosis • angiography
This article has been cited by other articles:
 |
|
 |
|
  A. J. White, S. J. Duffy, A. S. Walton, J. F. Ng, G. E. Rice, S. Mukherjee, J. A. Shaw, G. L. Jennings, A. M. Dart, and B. A. Kingwell Matrix metalloproteinase-3 and coronary remodelling: Implications for unstable coronary disease Cardiovasc Res, September 1, 2007; 75(4): 813 - 820. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Konig and V. Klauss Virtual histology Heart, August 1, 2007; 93(8): 977 - 982. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Libby and P. Theroux Pathophysiology of Coronary Artery Disease Circulation, June 28, 2005; 111(25): 3481 - 3488. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Mikkelsson, M. Perola, and P. J. Karhunen Genetics of Platelet Glycoprotein Receptors: Risk of Thrombotic Events and Pharmacogenetic Implications Clinical and Applied Thrombosis/Hemostasis, April 1, 2005; 11(2): 113 - 125. [Abstract] [PDF]
|
|
|
|
 |
|
 O. Honda, S. Sugiyama, K. Kugiyama, H. Fukushima, S. Nakamura, S. Koide, S. Kojima, N. Hirai, H. Kawano, H. Soejima, et al. Echolucent carotid plaques predict future coronary events in patients with coronary artery disease J. Am. Coll. Cardiol., April 7, 2004; 43(7): 1177 - 1184. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Fujii, Y. Kobayashi, G. S. Mintz, H. Takebayashi, G. Dangas, I. Moussa, R. Mehran, A. J. Lansky, E. Kreps, M. Collins, et al. Intravascular Ultrasound Assessment of Ulcerated Ruptured Plaques: A Comparison of Culprit and Nonculprit Lesions of Patients With Acute Coronary Syndromes and Lesions in Patients Without Acute Coronary Syndromes Circulation, November 18, 2003; 108(20): 2473 - 2478. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F Crea and G A Lanza The elusive link between stenosis severity and prognosis in stable ischaemic heart disease Heart, September 1, 2003; 89(9): 961 - 962. [Full Text] [PDF]
|
|
|
|
|
|
R Bigi, L Cortigiani, P Colombo, A Desideri, J J Bax, and O Parodi Prognostic and clinical correlates of angiographically diffuse non-obstructive coronary lesions Heart, September 1, 2003; 89(9): 1009 - 1013. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Casscells, M. Naghavi, and J. T. Willerson Vulnerable Atherosclerotic Plaque: A Multifocal Disease Circulation, April 29, 2003; 107(16): 2072 - 2075. [Full Text] [PDF]
|
|
|
|
|
|
A. Maehara, G. S. Mintz, A. B. Bui, O. R. Walter, M. T. Castagna, D. Canos, A. D. Pichard, L. F. Satler, R. Waksman, W. O. Suddath, et al. Morphologic and angiographic features of coronary plaque rupture detected by intravascular ultrasound J. Am. Coll. Cardiol., September 4, 2002; 40(5): 904 - 910. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Kawasaki, H. Takatsu, T. Noda, K. Sano, Y. Ito, K. Hayakawa, K. Tsuchiya, M. Arai, K. Nishigaki, G. Takemura, et al. In Vivo Quantitative Tissue Characterization of Human Coronary Arterial Plaques by Use of Integrated Backscatter Intravascular Ultrasound and Comparison With Angioscopic Findings Circulation, May 28, 2002; 105(21): 2487 - 2492. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
U. E. Heidland and B. E. Strauer Left Ventricular Muscle Mass and Elevated Heart Rate Are Associated With Coronary Plaque Disruption Circulation, September 25, 2001; 104(13): 1477 - 1482. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Kawasaki, H. Takatsu, T. Noda, Y. Ito, A. Kunishima, M. Arai, K. Nishigaki, G. Takemura, N. Morita, S. Minatoguchi, et al. Noninvasive quantitative tissue characterization and two-dimensional color-coded map of human atherosclerotic lesions using ultrasound integrated backscatter: Comparison between histology and integrated backscatter images J. Am. Coll. Cardiol., August 1, 2001; 38(2): 486 - 492. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Ohtsuki, M. Hayase, K. Akashi, S. Kopiwoda, and H. W. Strauss Detection of Monocyte Chemoattractant Protein-1 Receptor Expression in Experimental Atherosclerotic Lesions: An Autoradiographic Study Circulation, July 10, 2001; 104(2): 203 - 208. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Ojio, H. Takatsu, T. Tanaka, K. Ueno, K. Yokoya, T. Matsubara, T. Suzuki, S. Watanabe, N. Morita, M. Kawasaki, et al. Considerable Time From the Onset of Plaque Rupture and/or Thrombi Until the Onset of Acute Myocardial Infarction in Humans : Coronary Angiographic Findings Within 1 Week Before the Onset of Infarction Circulation, October 24, 2000; 102(17): 2063 - 2069. [Abstract] [Full Text] [PDF]
|
|