Progression of coronary artery disease in patients with chest pain and normal or intraluminal disease on arteriography.

The incidence of progression of coronary artery disease (CAD) in symptomatic patients was determined from serial coronary arteriograms in 27 patients with normal coronary arteries on initial study, in 17 patients with intraluminal disease (narrowings less than or equal to 20%) (ILD), and in 125 patients with occlusive disease (CAD) on the first arteriogram. Interval between arteriograms ranged from 9 months to 13 years. The normal patients progressed less frequently (14.8%) than did either the ILD patients (58.8%) or CAD patients (60%) (p less than 0.001). The incidence of progression was the same in those with ILD and CAD. These data suggest that patients with normal coronaries rarely progress to CAD and then only rarely in less than 4 years. However, ILD is a serious finding on arteriography and progresses to occlusive disease frequently in symptomatic patients. Repeat coronary arteriography is warranted at short intervals in symptomatic patients with ILD.