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Ten-year follow-up of 601 nonsurgical cases of angiographically documented coronary disease

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Abstract

A group of 601 consecutive patients who had significant coronary artery disease when studied between January 1963 and July 1965, and who were not subsequently operated on forms the basis of this study. A 100%, 10-year follow-up could be achieved.

All available clinical parameters and various combinations of parameters were related to prognosis. In this communication we will discuss only the parameter that had our primary interest, namely the angiographic findings. Five- and 10-year survival rates were 62% and 41% respectively for the entire group. Almost all deaths were of cardiac origin. The coronary arteriograms were first divided according to the number of major branches showing 50% or more narrowing (Fig. 1). In patients with single-vessel disease, mortality was relatively low during the initial years of follow-up (2.4% per year during the first 4 years), but became less favorable later (5.2% per year during the next 6 years). Single-vessel obstructions affecting the right coronary artery were associated with a higher survival than those affecting the anterior descending artery (80.8% and 53.7%, 10-year survival respectively). With regard to the localization of isolated obstructions of the anterior descending artery, no difference could be demonstrated between lesions proximal and distal to the first septal perforator and first diagonal branch. The subgroup of isolated circumflex lesions was too small to warrant adequate statistical analysis.

In patients with obstructions of two arteries, 5- and 10-year mortality rates were 61.8% and 45.4% respectively; in those with obstructions of three arteries, survival rates were 46.7% and 23.6% . . .


 

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