How fast does coronary artery disease progress?

After acute coronary syndrome (ACS), the risk of cardiovascular death in community studies is 3 to 5% at 30 days and 5 to 8% at 6 months, and serious cardiovascular events occur in 15 and 20% of patients at 6 months. At the initial angiogram, most patients showed evidence of non-obstructive coronary heart disease and only 14 patients (5.4%) had disease-free coronary arteries. A number of factors can affect the rate of progression of coronary artery disease, including some that are under your control and others that are not. Angioplasty treatment showed greater progression in the native coronary arteries, especially in the left anterior descending territories and in the treated vessels.

New tools, such as angiotomography, could better define the relationship between the progression of coronary artery disease in multiarterial patients undergoing different treatment strategies. However, it is not clear whether these associations with clinical events are due to an effect on the progression of atherosclerosis or are the consequence of changes that could facilitate the development of an episode of acute thrombotic disease. Angiographs of the left and right coronary arteries were performed in 6 to 8 projections, including semiaxial projections. The mechanisms and natural history of the disease appear to differ between this population and older patients.

Progressive CAD was defined as a new obstructive CAD in a previously disease-free segment or a new obstruction in a previously non-obstructive segment in consecutive angiographic studies. Progressive stenotic lesions occur in an initially normal coronary segment or in a previously diseased vessel. On the other hand, the presence of collateral circulation (OR %3D 0.485; IC 0.266-0.88) was an independent protective factor against the progression of native CAD in patients with stable multivascular disease. The present study showed that patients who underwent PCI treatment were more likely to develop progression in the native coronary arteries than those who underwent CABG or MT, especially in the left anterior descending territories and in the vessels treated during a 5-year follow-up.

The frequency of progression of native coronary arteries after graft replacement or percutaneous intervention has been previously studied with short-term follow-up, focusing mainly on insufficient revascularization (for example, the rapid progression of a minor injury) and the appearance of new lesions in the form of intimate smooth protrusions in the arterial lumen. Some previous studies have shown that intensive monitoring of the lipid profile and blood pressure, controlling the causes through regular monitoring, and lifestyle control can slow the rate of progression or even promote the regression of atherosclerosis, control the causes through regular monitoring and lifestyle control. The Cox proportional risk method was used to develop a multivariate model of 5-year progression rates, which included variables such as sex, age, hypertension, hyperlipidemia, previous myocardial infarction, the medications used, diabetes, collateral circulation, the state of angina, the degree of coronary heart disease, treatment assignment and clinical events. Coronary artery disease rarely occurs in the first few decades of life, which explains why this population is underrepresented in clinical studies.

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