Can total coronary occlusions be predicted from a previous coronary arteriogram?

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Abstract
We studied the site, severity, and coronary angiographic morphology of coronary lesions and their ability to predict progression of coronary narrowing and obstruction of coronary arteries. Twenty‐six patients who had 94 lesions at the time of first angiography were followed for a mean of 29 ± 17 (SD) months. Progression of disease jor obstructions of vessel occurred in 11 lesions (12%): eight new total obstructions (8.5%) and three subtotal (3%). Narrowings of >75% of the luminal diameter were more likely to become totally obstructed than less severe narrowings (P = 0.01), but three total occlusions occurred at sites where mild disease had been present previously. Lesions in patients with double or triple vessel disease showed a marginally greater tendency to become totally occluded than in patients with single vessel disease (P < 0.1). We found no relationship between new total obstructions and the angiographic morphology of the lesion (smooth or irregular) nor with its length or position in the artery or the extent of atheroma in the vessel.