Selective coronary arteriography in young men. A follow-up of 449 patients

The prognosis for 449 young men with normal, mildly abnormal, and obstructive arteriograms with and without internal mammary artery implants was studied. Prognosis for patients with normal arteriograms was good in regard to incidence of infarction and mortality. In 30 patients with mildly abnormal arteriograms there appeared to be a relatively higher incidence of myocardial infarction, although the total number of patients in this category was small. In 116 young men with obstructive coronary disease the 5-year survival rate was 66.8%. The 5-year mortality in patients with single vessel involvement was 8.8% and in those with multiple vessel disease mortality was 37%. The mortality was 6.8% each year among survivors in this group of patients with both single and multiple vessel disease. The prognosis was worse when there was multiple vessel involvement, when there was generalized decrease in contractility shown by the left ventriculogram, or when the electrocardiogram showed evidence of myocardial infarction. The influence of internal mammary artery implantation could not be accurately assessed because of the small number of cases and the substantial number of patients who did not have postoperative internal mammary arteriography.