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On the Natural Hist...
On the Natural History of Coronary Artery Disease : A Longitudinal Nationwide Serial Angiography Study
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- Mohammad, Moman A. (author)
- Lund University,Lunds universitet,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Molecular Cardiology,Lund University Research Groups,Skåne University Hospital
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- Stone, Gregg W. (author)
- The Zena and Michael A Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York City, NY, USA; Cardiovascular Research Foundation, New York City, NY, USA,Icahn Sch Med Mt Sinai, Zena & Michael Wiener Cardiovasc Inst, New York, NY 10029 USA.;Cardiovasc Res Fdn, New York, NY USA.
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- Koul, Sasha (author)
- Lund University,Lunds universitet,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Molecular Cardiology,Lund University Research Groups,Skåne University Hospital
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- Olivecrona, Göran K. (author)
- Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Bergman, Sofia (author)
- Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital
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- Persson, Jonas (author)
- Karolinska Institutet
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- Engstrøm, Thomas (author)
- The Heart Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark,Univ Copenhagen, Rigshosp, Heart Ctr, Copenhagen, Denmark.
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- Fröbert, Ole, 1964- (author)
- Örebro University,Örebro universitet,Institutionen för medicinska vetenskaper,Faculty of Health, Department of Cardiology, Örebro University, Örebro, Sweden; Department of Clinical Medicine, Aarhus University Health, Aarhus, Denmark,Örebro Univ, Fac Hlth, Dept Cardiol, Örebro, Sweden.;Aarhus Univ Hlth, Dept Clin Med, Aarhus, Denmark.
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- Jernberg, Tomas (author)
- Karolinska Institutet
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- Omerovic, Elmir, 1968 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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- James, Stefan, 1964- (author)
- Uppsala University,Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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- Bergström, Göran, 1964 (author)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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- Erlinge, David (author)
- Lund University,Lunds universitet,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Molecular Cardiology,Lund University Research Groups,Skåne University Hospital
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(creator_code:org_t)
- John Wiley & Sons, 2022
- 2022
- English.
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In: Journal of the American Heart Association. - : John Wiley & Sons. - 2047-9980. ; 11:21
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Abstract
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- Background: The long-term course of coronary atherosclerosis has not been studied in large nationwide cohorts. Understanding the natural history of coronary atherosclerosis could help identify patients at risk for future coronary events.Methods and Results: All coronary artery segments with <50% luminal stenosis in patients with a first-time coronary angiogram between 1989 and 2017 were identified (n=2 661 245 coronary artery segments in 248 736 patients) and followed until a clinically indicated angiography within 15 years was performed or until death or end of follow-up (April 2018) using SCAAR (Swedish Coronary Angiography and Angioplasty Registry). The stenosis progression and incidence rates were 2.6% and 1.45 (95% CI, 1.43-1.46) per 1000 segment-years, respectively. The greatest progression rate occurred in the proximal and middle segments of the left anterior descending artery. Male sex and diabetes were associated with a 2-fold increase in risk, and nearly 70% of new stenoses occurred in patients with baseline single-vessel disease (hazard ratio, 3.86 [95% CI, 3.69-4.04]). Coronary artery segments in patients with no baseline risk factors had a progression rate of 0.6% and incidence rate of 0.36 (95% CI, 0.34-0.39), increasing to 8.1% and 4.01 (95% CI, 3.89-4.14) per 1000 segment-years, respectively, in patients with ≥4 risk factors. The prognostic impact of risk factors on stenosis progression was greatest in younger patients and women.Conclusions: Coronary atherosclerosis progressed slowly but more frequently in the left coronary artery in men and in the presence of traditional risk factors. Coronary artery segments in patients without risk factors had little or no risk of stenosis progression, and the relative impact of risk factors appears to be of greater importance in younger patients and women. These findings help in the understanding the long-term course of coronary atherosclerosis.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Coronary artery disease
- ischemic heart disease
- natural history
- coronary artery disease
- ischemic heart disease
- natural history
Publication and Content Type
- ref (subject category)
- art (subject category)
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Mohammad, Moman ...
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Stone, Gregg W.
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Koul, Sasha
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Olivecrona, Göra ...
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Bergman, Sofia
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Persson, Jonas
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Engstrøm, Thomas
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Fröbert, Ole, 19 ...
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Jernberg, Tomas
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Omerovic, Elmir, ...
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James, Stefan, 1 ...
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Bergström, Göran ...
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Erlinge, David
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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Journal of the A ...
- By the university
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Örebro University
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Uppsala University
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Lund University
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Karolinska Institutet
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University of Gothenburg