Prognostic assessment of selected clinical and ultrasonographic indices in patients with non-critical lesions in coronary angiography.

Abstract

Coronary heart disease is the leading cause of mortality, especially in industrialised countries. In the case of detection of significant lesions narrowing the vessel lumen, management is guided by recommendations of international cardiac societies, while in the case of non-critical lesions there are some doubts as to the further prognosis and identification of patients in whom accelerated progression of disease can be expected. The aim of this study was to evaluate the prognostic significance of selected clinical and ultrasonographic indices in patients with non-critical lesions in coronary angiography. In 100 symptomatic patients with non-critical stenosis in coronary arteries, cardiovascular events after one and three years of follow-up were assessed and analysed compared to a control group. During the follow-up period there were no deaths. In univariate analysis, factors associated with need for revascularisation in 4% of patients after one year and 7% at three years were: age (odds ratio [OR] 1.16, confidence interval [CI] 0.98-1.35; p = 0.04), fibrinogen concentration (OR 1.01, CI 1.00-1.02; p = 0.05), isovolumetric relaxation time [ms] (OR 1.07, CI 0.79-0.98; p = 0.04), and transmitral flow propagation velocity [cm/s] (OR 0.88, CI 1.01-1.12; p = 0.01). Nearly one third of patients with non-critical lesions despite optimal pharmacotherapy reported symptoms deteriorating quality of life. Factors predisposing to the occurrence of cardiovascular events in the 12 months of follow-up were: older age, higher plasma fibrinogen concentration, and impaired left ventricular filling pattern.