The DOI matches its Crossref record; 24 of the 24 references it cites were found in a registry or an index.
Prognostic significance of progression of coronary atherosclerosis.
Open accessAbstract
BACKGROUND: Angiographic progression of coronary atherosclerosis is frequently observed in clinical practice and is used as an end point in clinical trials; however, its prognostic significance is unclear. METHODS AND RESULTS: Progression defined as an increase in diameter stenosis by > or = 15% of at least one coronary lesion was seen in 141 (42%) of 335 patients who underwent repeat coronary arteriography after a 2-year interval as part of clinical trial. Coronary lesions were measured quantitatively from comparable end-diastolic frames selected by a radiologist viewing each pair of films together. During a mean follow-up of 44 +/- 10 months after the second arteriogram, cardiac death occurred in 19 patients (5.7%), cardiac death or nonfatal infarction was seen in 40 cases (11.9%), and 90 patients (26.9%) underwent coronary revascularization. At least one end point event occurred in 112 of the 335 patients. Sixteen of the 19 cardiac deaths were in progressors, a relative risk of 7.3 (95% CI, 2.2-24.7; p < 0.001). The relative risk of cardiac death or nonfatal infarction for progressors was 2.3 (1.3-4.2, p = 0.009) and of any cardiac event was 1.7 (1.3-2.3, p < 0.001). A stepwise multivariable Cox regression model of time to event was used to assess the relative contribution of progression as a predictor of coronary events. Low ejection fraction (p = 0.001), progression (p = 0.001), and hypertension (p = 0.011) were retained as predictors of cardiac death. Angina and the number of diseased vessels were the strongest predictors of revascularization. CONCLUSIONS: Coronary progression is a strong, independent predictor of future coronary events, particularly cardiac death, and its use as a surrogate end point in clinical trials is justified.
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Cited by
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Effects of Estrogen Replacement on the Progression of Coronary-Artery Atherosclerosis
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Metadata
- Authors
- Waters, D., Craven, T. E., & Lespérance, J.
- Venue
- Circulation
- Published
- 1993-04
- Volume
- 87
- Issue
- 4
- Pages
- 1067-1075
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2019440423
- Cited by
- 277
- References
- 24
- FWCI
- 30.86
- Type
- journal article
- Language
- en
- Open access
- bronze
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