Association of Progression or Regression of Coronary Artery Atherosclerosis with Long-term Prognosis
Abstract Background The association between coronary atherosclerosis progression or regression and long-term prognosis remains poorly defined. We assessed the association of atherosclerosis progression or regression with long-term mortality and factors that promote angiographic progression or regres...
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| Veröffentlicht in: | The American heart journal 2016-07, Vol.177, p.9-16 |
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| creator | Ndrepepa, Gjin, MD Iijima, Raisuke, MD Kufner, Sebastian, MD Braun, Siegmund, MD Cassese, Salvatore, MD Byrne, Robert A., MD Sorges, Jonas Schulz-Schüpke, Stefanie, MD Hoppmann, Petra, MD Fussaro, Massimiliano, MD Laugwitz, Karl-Ludwig, MD Schunkert, Heribert, MD Kastrati, Adnan, MD |
| description | Abstract Background The association between coronary atherosclerosis progression or regression and long-term prognosis remains poorly defined. We assessed the association of atherosclerosis progression or regression with long-term mortality and factors that promote angiographic progression or regression of coronary atherosclerosis in patients with angiographically-proven coronary artery disease. Methods The study included 605 patients with coronary artery disease who underwent coronary angiography at baseline and at 2 years later. Pan-coronary artery tree quantitative coronary angiography was performed. Of 6259 coronary segments (10.3 lesions per patient) analyzed, 1790 non-stented segments with ≥25% diameter stenosis at baseline were included. Atherosclerosis progression or regression was defined as a decrease or increase in the mean minimal lumen diameter (MLD) of the non-stented segments of ≥0.2 mm in the 2-year angiography compared to baseline angiography. The primary outcome was all-cause mortality. Results Based on the change in mean MLD between baseline and 2-year angiography, patients were divided into 3 groups: the group with progression of atherosclerosis (n=53; 8.8%), group with no progression or regression of atherosclerosis (n=472; 78.0%) and the group with regression of atherosclerosis (n=80; 13.2%). There were 126 deaths over 8-year follow-up: 17 deaths among patients with progression, 103 deaths occurred among patients with no progression/regression and 6 deaths among patients with regression (Kaplan-Meier estimates of mortality, 37.5%, 25.2% and 8.9%, respectively; adjusted hazard ratio=1.16, 95% confidence interval 1.05 to 1.29, P=0.004 for 0.1 mm reduction in mean MLD). Conclusions Progression or regression of coronary atherosclerosis in non-treated coronary segments was significantly associated with 8-year mortality. |
| doi_str_mv | 10.1016/j.ahj.2016.03.016 |
| format | Article |
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We assessed the association of atherosclerosis progression or regression with long-term mortality and factors that promote angiographic progression or regression of coronary atherosclerosis in patients with angiographically-proven coronary artery disease. Methods The study included 605 patients with coronary artery disease who underwent coronary angiography at baseline and at 2 years later. Pan-coronary artery tree quantitative coronary angiography was performed. Of 6259 coronary segments (10.3 lesions per patient) analyzed, 1790 non-stented segments with ≥25% diameter stenosis at baseline were included. Atherosclerosis progression or regression was defined as a decrease or increase in the mean minimal lumen diameter (MLD) of the non-stented segments of ≥0.2 mm in the 2-year angiography compared to baseline angiography. The primary outcome was all-cause mortality. Results Based on the change in mean MLD between baseline and 2-year angiography, patients were divided into 3 groups: the group with progression of atherosclerosis (n=53; 8.8%), group with no progression or regression of atherosclerosis (n=472; 78.0%) and the group with regression of atherosclerosis (n=80; 13.2%). There were 126 deaths over 8-year follow-up: 17 deaths among patients with progression, 103 deaths occurred among patients with no progression/regression and 6 deaths among patients with regression (Kaplan-Meier estimates of mortality, 37.5%, 25.2% and 8.9%, respectively; adjusted hazard ratio=1.16, 95% confidence interval 1.05 to 1.29, P=0.004 for 0.1 mm reduction in mean MLD). Conclusions Progression or regression of coronary atherosclerosis in non-treated coronary segments was significantly associated with 8-year mortality.</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1016/j.ahj.2016.03.016</identifier><identifier>PMID: 27297844</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Body Mass Index ; Cardiovascular ; Clinical outcomes ; Comorbidity ; Coronary Angiography ; Coronary Artery Disease - diagnostic imaging ; Coronary Artery Disease - epidemiology ; Coronary Artery Disease - surgery ; Coronary Stenosis - diagnostic imaging ; Coronary Stenosis - epidemiology ; Coronary Stenosis - surgery ; Diabetes Mellitus - drug therapy ; Diabetes Mellitus - epidemiology ; Disease Progression ; Drug-Eluting Stents ; Female ; Humans ; Hypoglycemic Agents - therapeutic use ; Insulin - therapeutic use ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Mortality ; Overweight - epidemiology ; Percutaneous Coronary Intervention ; Prognosis ; Proportional Hazards Models ; Recovery of Function ; Risk Factors ; Stents ; Studies</subject><ispartof>The American heart journal, 2016-07, Vol.177, p.9-16</ispartof><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Jul 01, 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c469t-7bc13726fc5c70d72c3952cb8442b4bbd7753ce077d1c5a2fe0d3d3c9a735e593</citedby><cites>FETCH-LOGICAL-c469t-7bc13726fc5c70d72c3952cb8442b4bbd7753ce077d1c5a2fe0d3d3c9a735e593</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002870316300205$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27297844$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ndrepepa, Gjin, MD</creatorcontrib><creatorcontrib>Iijima, Raisuke, MD</creatorcontrib><creatorcontrib>Kufner, Sebastian, MD</creatorcontrib><creatorcontrib>Braun, Siegmund, MD</creatorcontrib><creatorcontrib>Cassese, Salvatore, MD</creatorcontrib><creatorcontrib>Byrne, Robert A., MD</creatorcontrib><creatorcontrib>Sorges, Jonas</creatorcontrib><creatorcontrib>Schulz-Schüpke, Stefanie, MD</creatorcontrib><creatorcontrib>Hoppmann, Petra, MD</creatorcontrib><creatorcontrib>Fussaro, Massimiliano, MD</creatorcontrib><creatorcontrib>Laugwitz, Karl-Ludwig, MD</creatorcontrib><creatorcontrib>Schunkert, Heribert, MD</creatorcontrib><creatorcontrib>Kastrati, Adnan, MD</creatorcontrib><title>Association of Progression or Regression of Coronary Artery Atherosclerosis with Long-term Prognosis</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>Abstract Background The association between coronary atherosclerosis progression or regression and long-term prognosis remains poorly defined. We assessed the association of atherosclerosis progression or regression with long-term mortality and factors that promote angiographic progression or regression of coronary atherosclerosis in patients with angiographically-proven coronary artery disease. Methods The study included 605 patients with coronary artery disease who underwent coronary angiography at baseline and at 2 years later. Pan-coronary artery tree quantitative coronary angiography was performed. Of 6259 coronary segments (10.3 lesions per patient) analyzed, 1790 non-stented segments with ≥25% diameter stenosis at baseline were included. Atherosclerosis progression or regression was defined as a decrease or increase in the mean minimal lumen diameter (MLD) of the non-stented segments of ≥0.2 mm in the 2-year angiography compared to baseline angiography. The primary outcome was all-cause mortality. Results Based on the change in mean MLD between baseline and 2-year angiography, patients were divided into 3 groups: the group with progression of atherosclerosis (n=53; 8.8%), group with no progression or regression of atherosclerosis (n=472; 78.0%) and the group with regression of atherosclerosis (n=80; 13.2%). There were 126 deaths over 8-year follow-up: 17 deaths among patients with progression, 103 deaths occurred among patients with no progression/regression and 6 deaths among patients with regression (Kaplan-Meier estimates of mortality, 37.5%, 25.2% and 8.9%, respectively; adjusted hazard ratio=1.16, 95% confidence interval 1.05 to 1.29, P=0.004 for 0.1 mm reduction in mean MLD). Conclusions Progression or regression of coronary atherosclerosis in non-treated coronary segments was significantly associated with 8-year mortality.</description><subject>Aged</subject><subject>Body Mass Index</subject><subject>Cardiovascular</subject><subject>Clinical outcomes</subject><subject>Comorbidity</subject><subject>Coronary Angiography</subject><subject>Coronary Artery Disease - diagnostic imaging</subject><subject>Coronary Artery Disease - epidemiology</subject><subject>Coronary Artery Disease - surgery</subject><subject>Coronary Stenosis - diagnostic imaging</subject><subject>Coronary Stenosis - epidemiology</subject><subject>Coronary Stenosis - surgery</subject><subject>Diabetes Mellitus - drug therapy</subject><subject>Diabetes Mellitus - epidemiology</subject><subject>Disease Progression</subject><subject>Drug-Eluting Stents</subject><subject>Female</subject><subject>Humans</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Insulin - therapeutic use</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Overweight - epidemiology</subject><subject>Percutaneous Coronary Intervention</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Recovery of Function</subject><subject>Risk Factors</subject><subject>Stents</subject><subject>Studies</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFUk2P1DAMjRCIHRZ-ABdUiQuXFidp6qmQkEYjvqSRQHyco9Z1d1I6zZJ0QPvvSXcWVtoDXPJs-fkp9rMQTyUUEmT1ciia_VCoFBagiwT3xEpCjXmFZXlfrABA5WsEfSYexTiktFLr6qE4U6hqXJflSnSbGD25ZnZ-ynyffQr-InCM12nIPvNt1mdbH_zUhKtsE2ZeYN5z8JHG5XUx--Xmfbbz00WeyodrrWkpPBYP-maM_OQGz8W3t2--bt_nu4_vPmw3u5zKqp5zbElqVFVPhhA6VKRro6hNH1Vt2bYdotHEgNhJMo3qGTrdaaob1IZNrc_Fi5PuZfA_jhxne3CReBybif0xWrmWsgZAA_-nYo1Ka12aRH1-hzr4Y5jSIAurQpTa6MSSJxalXcTAvb0M7pCWZSXYxS072OSWXdyyoG2C1PPsRvnYHrj72_HHnkR4dSJw2tpPx8FGcjwRdy4wzbbz7p_yr-900-gmR834na843k5ho7JgvyznslxLak0RGP0bXWa5vw</recordid><startdate>20160701</startdate><enddate>20160701</enddate><creator>Ndrepepa, Gjin, MD</creator><creator>Iijima, Raisuke, MD</creator><creator>Kufner, Sebastian, MD</creator><creator>Braun, Siegmund, MD</creator><creator>Cassese, Salvatore, MD</creator><creator>Byrne, Robert A., MD</creator><creator>Sorges, Jonas</creator><creator>Schulz-Schüpke, Stefanie, MD</creator><creator>Hoppmann, Petra, MD</creator><creator>Fussaro, Massimiliano, MD</creator><creator>Laugwitz, Karl-Ludwig, MD</creator><creator>Schunkert, Heribert, MD</creator><creator>Kastrati, Adnan, MD</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20160701</creationdate><title>Association of Progression or Regression of Coronary Artery Atherosclerosis with Long-term Prognosis</title><author>Ndrepepa, Gjin, MD ; Iijima, Raisuke, MD ; Kufner, Sebastian, MD ; Braun, Siegmund, MD ; Cassese, Salvatore, MD ; Byrne, Robert A., MD ; Sorges, Jonas ; Schulz-Schüpke, Stefanie, MD ; Hoppmann, Petra, MD ; Fussaro, Massimiliano, MD ; Laugwitz, Karl-Ludwig, MD ; Schunkert, Heribert, MD ; Kastrati, Adnan, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c469t-7bc13726fc5c70d72c3952cb8442b4bbd7753ce077d1c5a2fe0d3d3c9a735e593</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Body Mass Index</topic><topic>Cardiovascular</topic><topic>Clinical outcomes</topic><topic>Comorbidity</topic><topic>Coronary Angiography</topic><topic>Coronary Artery Disease - diagnostic imaging</topic><topic>Coronary Artery Disease - epidemiology</topic><topic>Coronary Artery Disease - surgery</topic><topic>Coronary Stenosis - diagnostic imaging</topic><topic>Coronary Stenosis - epidemiology</topic><topic>Coronary Stenosis - surgery</topic><topic>Diabetes Mellitus - drug therapy</topic><topic>Diabetes Mellitus - epidemiology</topic><topic>Disease Progression</topic><topic>Drug-Eluting Stents</topic><topic>Female</topic><topic>Humans</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Insulin - therapeutic use</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Overweight - epidemiology</topic><topic>Percutaneous Coronary Intervention</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Recovery of Function</topic><topic>Risk Factors</topic><topic>Stents</topic><topic>Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ndrepepa, Gjin, MD</creatorcontrib><creatorcontrib>Iijima, Raisuke, MD</creatorcontrib><creatorcontrib>Kufner, Sebastian, MD</creatorcontrib><creatorcontrib>Braun, Siegmund, MD</creatorcontrib><creatorcontrib>Cassese, Salvatore, MD</creatorcontrib><creatorcontrib>Byrne, Robert A., MD</creatorcontrib><creatorcontrib>Sorges, Jonas</creatorcontrib><creatorcontrib>Schulz-Schüpke, Stefanie, MD</creatorcontrib><creatorcontrib>Hoppmann, Petra, MD</creatorcontrib><creatorcontrib>Fussaro, Massimiliano, MD</creatorcontrib><creatorcontrib>Laugwitz, Karl-Ludwig, MD</creatorcontrib><creatorcontrib>Schunkert, Heribert, MD</creatorcontrib><creatorcontrib>Kastrati, Adnan, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ndrepepa, Gjin, MD</au><au>Iijima, Raisuke, MD</au><au>Kufner, Sebastian, MD</au><au>Braun, Siegmund, MD</au><au>Cassese, Salvatore, MD</au><au>Byrne, Robert A., MD</au><au>Sorges, Jonas</au><au>Schulz-Schüpke, Stefanie, MD</au><au>Hoppmann, Petra, MD</au><au>Fussaro, Massimiliano, MD</au><au>Laugwitz, Karl-Ludwig, MD</au><au>Schunkert, Heribert, MD</au><au>Kastrati, Adnan, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Association of Progression or Regression of Coronary Artery Atherosclerosis with Long-term Prognosis</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>2016-07-01</date><risdate>2016</risdate><volume>177</volume><spage>9</spage><epage>16</epage><pages>9-16</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><coden>AHJOA2</coden><abstract>Abstract Background The association between coronary atherosclerosis progression or regression and long-term prognosis remains poorly defined. We assessed the association of atherosclerosis progression or regression with long-term mortality and factors that promote angiographic progression or regression of coronary atherosclerosis in patients with angiographically-proven coronary artery disease. Methods The study included 605 patients with coronary artery disease who underwent coronary angiography at baseline and at 2 years later. Pan-coronary artery tree quantitative coronary angiography was performed. Of 6259 coronary segments (10.3 lesions per patient) analyzed, 1790 non-stented segments with ≥25% diameter stenosis at baseline were included. Atherosclerosis progression or regression was defined as a decrease or increase in the mean minimal lumen diameter (MLD) of the non-stented segments of ≥0.2 mm in the 2-year angiography compared to baseline angiography. The primary outcome was all-cause mortality. Results Based on the change in mean MLD between baseline and 2-year angiography, patients were divided into 3 groups: the group with progression of atherosclerosis (n=53; 8.8%), group with no progression or regression of atherosclerosis (n=472; 78.0%) and the group with regression of atherosclerosis (n=80; 13.2%). There were 126 deaths over 8-year follow-up: 17 deaths among patients with progression, 103 deaths occurred among patients with no progression/regression and 6 deaths among patients with regression (Kaplan-Meier estimates of mortality, 37.5%, 25.2% and 8.9%, respectively; adjusted hazard ratio=1.16, 95% confidence interval 1.05 to 1.29, P=0.004 for 0.1 mm reduction in mean MLD). Conclusions Progression or regression of coronary atherosclerosis in non-treated coronary segments was significantly associated with 8-year mortality.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27297844</pmid><doi>10.1016/j.ahj.2016.03.016</doi><tpages>8</tpages></addata></record> |
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| ispartof | The American heart journal, 2016-07, Vol.177, p.9-16 |
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| subjects | Aged Body Mass Index Cardiovascular Clinical outcomes Comorbidity Coronary Angiography Coronary Artery Disease - diagnostic imaging Coronary Artery Disease - epidemiology Coronary Artery Disease - surgery Coronary Stenosis - diagnostic imaging Coronary Stenosis - epidemiology Coronary Stenosis - surgery Diabetes Mellitus - drug therapy Diabetes Mellitus - epidemiology Disease Progression Drug-Eluting Stents Female Humans Hypoglycemic Agents - therapeutic use Insulin - therapeutic use Kaplan-Meier Estimate Male Middle Aged Mortality Overweight - epidemiology Percutaneous Coronary Intervention Prognosis Proportional Hazards Models Recovery of Function Risk Factors Stents Studies |
| title | Association of Progression or Regression of Coronary Artery Atherosclerosis with Long-term Prognosis |
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