Incidence and Progression of Coronary Artery Disease

Abstract

The incidence and progression of coronary artery disease was investigated in 1,263 patients. Clinical diagnosis of significant disease was not confirmed by cine coronary arteriography in 32% of males and 63% of females. Silent, clinically significant disease was detected in 6% of males and 3% of females studied for other reasons. False-positive clinical diagnoses are common, especially in females, while silent coronary artery disease (false-negatives) is uncommon. Serial cine coronary angiograms demonstrated the disease progressed in 78% of patients affected at inception of the study; 95% of patients with normal coronary arteries remained free of disease during the observation period (up to 11, average of 3 years). Apparently, the disease begins at a young age in predisposed people and progresses rapidly in three out of four. Patients with normal coronary arteries have an excellent chance of remaining free of the disease for many years. Demonstration of normal coronary arteries and efficient left ventricles in patients suspected of having the disease enhances the socioeconomic value of coronary arteriography.