Importance of Identifying Left Main Coronary Artery Narrowing in Subsets of Patients with Coronary Artery Disease
Authors: STEPHEN E. EPSTEIN
Journal: Annals of Internal Medicine (1979)

Editorials1 August 1979Importance of Identifying Left Main Coronary Artery Narrowing in Subsets of Patients with Coronary Artery DiseaseSTEPHEN E. EPSTEIN, M.D.STEPHEN E. EPSTEIN, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-91-2-308 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAn important fact that has emerged from numerous studies conducted during the past decade is that all patients with coronary artery disease do not conveniently manifest a homogenous "natural history." Subgroups of patients can be identified with more ominous prognoses, thereby raising the possibility that such subgroups might benefit from prophylactic surgery. Although many factors predisposing to higher mortality have been implicated, the most powerful seem to be the functional status of the left ventricle and the number of vessels critically narrowed (1-4). Patients with left main coronary artery narrowing have a particularly poor prognosis (5-8), and in several...References1. BRUNSCHKE A, PROUDFIT W, and SONES F. Progress study of 590 consecutive nonsurgical cases of coronary disease followed 5-9 years: II. Ventriculographic and other correlations. Circulation. 1973;47:1154-63. CrossrefMedlineGoogle Scholar2. REEVES T, OBERMAN A, JONES W, and SHEFFIELD L. Natural history of angina pectoris. Am J Cardiol. 1974;33:423-30. CrossrefMedlineGoogle Scholar3. FRIESINGER G, PAGE E, and ROSS R. Prognostic significance of coronary arteriography. Trans Assoc Am Physicians. 1970;83:78-92. MedlineGoogle Scholar4. BURGGRAF G and PARKER J. Prognosis in coronary artery disease: angiographic hemodynamic, and clinical factors. Circulation. 1975;51:146-56. CrossrefMedlineGoogle Scholar5. TAKARO T, HULTGREN N, LIPTON M, and DETRE K. The VA cooperative randomized study of surgery for coronary arterial occlusive disease: II. 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Author, Article, and Disclosure InformationAuthors: STEPHEN E. EPSTEIN, M.D. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byGender Differences in Coronary Angiographic Findings from 1972 Through 1981 in Los Angeles, CaliforniaThe Cardiovascular SystemProspective evaluation of the left main coronary artery using digital two-dimensional echocardiographyAnatomic and prognostic implications of an early positive treadmill exercise testAngiographic prevalence of high-risk coronary artery disease in patient subsets (CASS).Accuracy of angiographic determination of left main coronary arterial narrowing. Angiographic--histologic correlative analysis in 28 patients. 1 August 1979Volume 91, Issue 2Page: 308-311KeywordsCoronary arteriesLeft ventricleMortalityStable coronary artery diseaseSurgery ePublished: 1 December 2008 Issue Published: 1 August 1979 PDF downloadLoading ...