Fifteen years survival of patients with nonsignificant atherosclerotic changes of coronary arteries



Year of publication 2014
Type Conference abstract
Description Hemodynamically nonsignificant atherosclerotic plaques are often found in pa- tients indicated for coronary angiography. The aim of our study was to compare the fifteen years survival among patients with nonsignificant stenoses of coronary artery disease, patients with significant coronary artery stenoses and individuals with smooth coronary arteries diagnosed by coronary angiography. Elective coronary angiography was performed in 671 consecutive patients with symptoms of coronary artery disease in 1998. Patients with other cardiac dis- eases were excluded from the trial. So, the final sample consisted of 600 in- dividuals, of whom 489 had angiographic evidence of significant coronary artery disease (at least one diameter stenosis ? 50%), 42 minor atherosclerotic changes (diameter stenosis < 50%) and 69 smooth coronary artery. Gehan - Wilcoxon test with Bonferonniho correction and the Cox proportional hazards model were used to compare the survival rates in 3 groups of patients. We have found statistically significantly higher fifteen years survival for individu- als with smooth coronary arteries (87%), compared with patients with significant coronary artery stenoses (61%) (Pcorr < 0.0001) and also with coronary artery ir- regularities (62%) (Pcorr < 0.01). In contrast, there was no statistical difference in survival between patients with significant atherosclerotic coronary artery disease and patients with insignificant changes. The differences were statistically signifi- cant even after including the effects of age and gender (smooth coronary arteries vs significant stenoses: p < 0.05, HR 2.25; smooth coronary artery vs insignificant atherosclerotic changes: p < 0.05, HR 2.57). The results of our study indicate that long-term prognosis of patients with insignifi- cant atherosclerotic changes is significantly worse than in individuals with smooth coronary arteries and roughly corresponds to patients with significant coronary artery disease. This finding supports the need for aggressive anti-atherosclerotic drug therapy in such individuals.

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