Prognostic significance of a normal or nearly normal coronary arteriogram

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A group of 521 patients studied during a 19-month period beginning January 1964 had no evidence of severely obstructive coronary lesions: 357 had normal coronary arteriograms, 101 had lesions of less than 30% (mild), and 63 had obstructions of 30% to almost 50% (moderate) of the normal lumen diameter. All patients were followed up for 10 years or until death, except for one patient lost at 8 years. Death was probably due to coronary disease in 14 patients; two were thought to have had normal arteries arteriographically; mild disease was diagnosed in two; and ten had moderate lesions. Six deaths occurred within 5 years of arteriography, one in a patient thought to have normal arteries who died suddenly at 48 months. Gross survival at 10 years of the 458 patients who had normal or mildly narrowed arteries was 93.6%, and it was 74.6% for those 63 who had moderate lesions. Survival from coronary disease at 10 years was 99.2% and 83.5%, respectively. A coronary event was defined as any of the following: death probably due to coronary disease, transmural myocardial infarction, or arteriographically proved development of severe obstructive coronary lesions. Coronary events were encountered within 10 years in 2.1% of those who had normal arteries, 13.8% of the group having mild lesions, and 33.0% of those who had moderate lesions. Transmural myocardial infarction was diagnosed within 10 years of arteriography in 14 survivors: two had normal coronary arteriograms, eight had mild lesions, and four had moderate narrowing. Fifty-one patients had . . .



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