Outcome in medically treated coronary artery disease. Ischemic events: nonfatal infarction and death.

Abstract

In this study we extended the characterization of outcome in 1214 medically treated patients with coronary disease by considering nonfatal infarction and death together as ischemic events. At 7 years, the cumulative event rate was 47% (18% for nonfatal infarction as the initial event and 29% for death as the initial event). In multivariable analysis of 81 baseline descriptors, 11 (six clinical and five catheterization) were independent predictors of events. Progressive chest pain, number of diseased vessels, left main stenosis and left ventricular (LV) function were the most important predictors. Progrressive pain was a more important predictor of total events than of survival alone. In patients with one-, two- or three-vessel disease and normal LV function, nonfatal infarcation accounted for at least 50% of initial events. In patients with left main disease or severe LV dysfunction, death was the predominant event. These results have important implications for interpreting the natural history of coronary artery disease.