Prognosis of Coronary Heart Disease Patients Evaluated by Data Obtained by Invasive and Noninvasive Methods

Abstract

The natural course of coronary atherosclerotic heart disease may be considered from various standpoints. No controversy exists about the validity of both noninvasive and invasive methods in the evaluation of long-term prognosis of patients with coronary heart disease (CHD). But, similar to problems in the detection of CHD, indirect markers such as symptoms, electrocardiographic abnormalities and risk factors discriminate only roughly between low-risk and high-risk patients (Sigler 1951; Zukel et al. 1969). They are more likely to affect short-term rather than long-term prognosis (Humphries et al. 1974; Proudfit et al. 1978). There is no close correlation between the severity and extent of coronary artery sclerosis, the number of vessels diseased, and the involvement of the left ventricle which allows the physician to predict accurately the long-term course, especially after the disease has developed (Burggraf and Parker 1975; Humphries et al. 1974). The physician with invasive methods at his disposal focuses primarily on the “X-ray anatomy” of selective coronary angiography (Burggraf and Parker 1975; Bruschke et al. 1973; Hammermeister et al. 1979; Lichtlen 1977, 1977; Proudfit et al. 1978; Taylor et al. 1980).