Progression of coronary artery disease is dependent on anatomic location and diameter

Abstract Objectives . This study represents the first prospective, quantitative analysis of the association of progression of coronary atherosclerosis with anatomic site and diameter. Background . The progressive course of coronary artery disease has been documented in many angiographic follow-up trials. Methods . The data of 348 patients with coronary artery disease from the International Nifedipine Trial on Antiatherosclerotic Therapy (INTACT) were reviewed. Standardized coronary angiograms were taken 3 years apart and were analyzed quantitatively. The coronary tree was subdivided into 25 segments. The progression of 1,063 preexisting coronary stenoses and the appearance of 247 newly formed stenoses was assessed in relation to the mean diameter of segments ( 3 mm) and to their position in the coronary tree (proximal, mid, distal) and in the three major coronary arteries. Results . Decreases in the minimal diameter of preexisting stenoses were largest in segments that were >3 mm in diameter (mean ± SD 0.23 ± 0.5 mm vs. 0.10 ± 0.4 mm and 0.02 ± 0.3 mm, p Conclusions . Progression of coronary artery disease occurs most frequently in coronary segments that are >2 mm in diameter, in a proximal or midartery position and in the right coronary artery.