Lipid-Lowering Therapy and Progression of Coronary Atherosclerosis

An overview of all major angiographic lipid intervention trials. Basic mechanisms and methodological aspects, including biochemical as well as angiographic aspects, are discussed. A comparison of all available data permits an analysis to be made of what may currently be considered proved, which aspects merit further investigation, and which hypotheses should be rejected.

[1]  T. Carew,et al.  Measurement in vivo of irreversible degradation of low density lipoprotein in the rabbit aorta. Predominance of intimal degradation. , 1984, Arteriosclerosis.

[2]  J. Badimón,et al.  Atherosclerotic plaque rupture and thrombosis. Evolving concepts. , 1990, Circulation.

[3]  J. Herrick CLINICAL FEATURES OF SUDDEN OBSTRUCTION OF THE CORONARY ARTERIES , 1912 .

[4]  D. Janero Therapeutic potential of vitamin E in the pathogenesis of spontaneous atherosclerosis. , 1991, Free radical biology & medicine.

[5]  J. Eidt,et al.  Specific Platelet Mediators and Unstable Coronary Artery Lesions: Experimental Evidence and Potential Clinical Implications , 1989, Circulation.

[6]  D. Steinberg,et al.  Role of oxidized low density lipoprotein in atherogenesis. , 1991, The Journal of clinical investigation.

[7]  H. C. Stary Evolution and progression of atherosclerotic lesions in coronary arteries of children and young adults. , 1989, Arteriosclerosis.

[8]  Tracy Re,et al.  Age and fibroplasia as preconditions for atheronecrosis in human coronary arteries. , 1987 .

[9]  E. Falk Morphologic features of unstable atherothrombotic plaques underlying acute coronary syndromes. , 1989, The American journal of cardiology.

[10]  D H Blankenhorn,et al.  Reversal of Atherosis and Sclerosis: The Two Components of Atherosclerosis , 1989, Circulation.

[11]  D. Kramsch,et al.  The protein and lipid composition of arterial elastin and its relationship to lipid accumulation in the atherosclerotic plaque. , 1971, The Journal of clinical investigation.

[12]  T. Gross,et al.  Deaths due to accidents and violence in two recent trials of cholesterol-lowering drugs. , 1990, Archives of internal medicine.

[13]  I. Holme,et al.  An analysis of randomized trials evaluating the effect of cholesterol reduction on total mortality and coronary heart disease incidence. , 1990, Circulation.

[14]  J. Tijssen,et al.  Retardation and arrest of progression or regression of coronary artery disease: a review. , 1993, Progress in cardiovascular diseases.

[15]  J P Matts,et al.  Effect of partial ileal bypass surgery on mortality and morbidity from coronary heart disease in patients with hypercholesterolemia. Report of the Program on the Surgical Control of the Hyperlipidemias (POSCH) , 1990, The New England journal of medicine.

[16]  R. Ross,et al.  Synthesis of connective tissue macromolecules by smooth muscle. , 1979, International review of connective tissue research.

[17]  J. Deckers,et al.  Retardation of angiographic progression of coronary artery disease by nifedipine , 1990, The Lancet.

[18]  P. Dicorleto,et al.  Cultured endothelial cells produce a platelet-derived growth factor-like protein. , 1983, Proceedings of the National Academy of Sciences of the United States of America.

[19]  M. Hochberg NSAIDS: mechanisms and pathways of action. , 1989, Hospital practice.

[20]  A. Albers,et al.  Comparison of improved precipitation methods for quantification of high-density lipoprotein cholesterol. , 1985, Clinical chemistry.

[21]  J J Albers,et al.  Regression of coronary artery disease as a result of intensive lipid-lowering therapy in men with high levels of apolipoprotein B. , 1990, The New England journal of medicine.

[22]  B. G. Brown,et al.  Benefits of lipid-lowering therapy in men with elevated apolipoprotein B are not confined to those with very high low density lipoprotein cholesterol. , 1994, Journal of the American College of Cardiology.

[23]  C. Shear,et al.  Expanded clinical evaluation of lovastatin (EXCEL) study results: IV. Additional perspectives on the tolerability of lovastatin. , 1991, The American journal of medicine.

[24]  H. Hahmann,et al.  Progression and regression of minor coronary arterial narrowings by quantitative angiography after fenofibrate therapy. , 1991, The American journal of cardiology.

[25]  R. Krauss,et al.  Effects of intensive multiple risk factor reduction on coronary atherosclerosis and clinical cardiac events in men and women with coronary artery disease. The Stanford Coronary Risk Intervention Project (SCRIP). , 1994, Circulation.

[26]  S. Azen,et al.  Triglyceride‐ and Cholesterol‐Rich Lipoproteins Have a Differential Effect on Mild/Moderate and Severe Lesion Progression as Assessed by Quantitative Coronary Angiography in a Controlled Trial of Lovastatin , 1994, Circulation.

[27]  G. Bondjers,et al.  Regional Accumulations of T Cells, Macrophages, and Smooth Muscle Cells in the Human Atherosclerotic Plaque , 1986, Arteriosclerosis.

[28]  J. Albers,et al.  Lipid Lowering and Plaque Regression New Insights Into Prevention of Plaque Disruption and Clinical Events in Coronary Disease , 1993, Circulation.

[29]  A. Bombard,et al.  Anti-inflammatory drugs in experimental atherosclerosis. Part 5. Influence of cortisone acetate on short-term and long-term cholesterol fluxes in atherosclerotic aorta. , 1984, Atherosclerosis.

[30]  W. Kannel,et al.  Serum cholesterol, lipoproteins, and the risk of coronary heart disease. The Framingham study. , 2020, Annals of internal medicine.

[31]  J. Butler,et al.  Anti-inflammatory drugs in experimental atherosclerosis. Part 6. Combination therapy with steroid and non-steroid agents. , 1985, Atherosclerosis.

[32]  P Théroux,et al.  A controlled clinical trial to assess the effect of a calcium channel blocker on the progression of coronary atherosclerosis. , 1990, Circulation.

[33]  G J Boerma,et al.  Effects of lipid lowering by pravastatin on progression and regression of coronary artery disease in symptomatic men with normal to moderately elevated serum cholesterol levels. The Regression Growth Evaluation Statin Study (REGRESS). , 1995, Circulation.

[34]  A. Cerami,et al.  Protein glycosylation and the pathogenesis of atherosclerosis. , 1985, Metabolism: clinical and experimental.

[35]  D. Kramsch Calcium antagonists and atherosclerosis. , 1985, Advances in experimental medicine and biology.

[36]  H. Taylor,et al.  Expanded clinical evaluation of lovastatin (EXCEL) study results. II. Assessment of the human lens after 48 weeks of treatment with lovastatin. , 1991, The American journal of cardiology.

[37]  R. Ross,et al.  Biochemical properties of the endothelium‐derived growth factor: Comparision to other growth factors , 1983, Journal of cellular physiology.

[38]  G. Watts,et al.  Independent associations between plasma lipoprotein subfraction levels and the course of coronary artery disease in the St. Thomas' Atherosclerosis Regression Study (STARS). , 1993, Metabolism: clinical and experimental.

[39]  I. Holme Relation of coronary heart disease incidence and total mortality to plasma cholesterol reduction in randomised trials: use of meta-analysis. , 1993, British heart journal.

[40]  A. Dobs,et al.  Efficacy and safety of pravastatin in patients with primary hypercholesterolemia. I. A dose-response study. , 1990, Atherosclerosis.

[41]  R. Gerrity,et al.  The role of the monocyte in atherogenesis: II. Migration of foam cells from atherosclerotic lesions. , 1981, The American journal of pathology.

[42]  D. Shapiro,et al.  Long-term safety and efficacy profile of simvastatin. , 1991, The American journal of cardiology.

[43]  A. Angelini,et al.  Factors influencing the presence or absence of acute coronary artery thrombi in sudden ischaemic death. , 1989, European heart journal.

[44]  S. Azen,et al.  Beneficial effects of colestipol-niacin on coronary atherosclerosis. A 4-year follow-up. , 1990, JAMA.

[45]  W. Castelli,et al.  Epidemiology of coronary heart disease: the Framingham study. , 1984, The American journal of medicine.

[46]  G. Watts,et al.  Metabolic determinants of the course of coronary artery disease in men. , 1994, Clinical chemistry.

[47]  M. Ruffer On arterial lesions found in Egyptian mummies (1580 B.C.—525 A.D.) , 1911 .

[48]  N. D. De Cesare,et al.  Comparison of nifedipine, propranolol and isosorbide dinitrate on angiographic progression and regression of coronary arterial narrowings in angina pectoris. , 1989, The American journal of cardiology.

[49]  J. Dumont Effect of cholesterol reduction by simvastatin on progression of coronary atherosclerosis: Design, baseline characteristics, and progress of the Multicenter Anti-Atheroma Study (MAAS). , 1993, Controlled clinical trials.

[50]  J. Salonen,et al.  Autoantibody against oxidised LDL and progression of carotid atherosclerosis , 1992, The Lancet.

[51]  S. J. Smith,et al.  The Centers for Disease Control-National Heart, Lung and Blood Institute Lipid Standardization Program. An approach to accurate and precise lipid measurements. , 1989, Clinics in laboratory medicine.

[52]  T Sandor,et al.  Quantitative angiographic and statistical methods to assess serial changes in coronary luminal diameter and implications for atherosclerosis regression trials. , 1992, The American journal of cardiology.

[53]  H. Pan,et al.  Concentrations of Pravastatin and Lovastatin in Cerebrospinal Fluid in Healthy Subjects , 1991, Clinical neuropharmacology.

[54]  R. Adelson,et al.  Low Rate of Treatment of Hypercholesterolemia by Cardiologists in Patients With Suspected and Proven Coronary Artery Disease , 1991, Circulation.

[55]  P J de Feyter,et al.  Quantitative coronary angiography to measure progression and regression of coronary atherosclerosis. Value, limitations, and implications for clinical trials. , 1991, Circulation.

[56]  Margaret S. Wu,et al.  Low density lipoprotein is protected from oxidation and the progression of atherosclerosis is slowed in cholesterol-fed rabbits by the antioxidant N,N'-diphenyl-phenylenediamine. , 1992, The Journal of clinical investigation.

[57]  M. Stadius,et al.  Evaluation of catheters and metallic catheter markers as calibration standard for measurement of coronary dimension. , 1990, Catheterization and cardiovascular diagnosis.

[58]  T. Craven,et al.  Prognostic Significance of Progression of Coronary Atherosclerosis , 1993, Circulation.

[59]  D. Waters,et al.  Effects of monotherapy with an HMG-CoA reductase inhibitor on the progression of coronary atherosclerosis as assessed by serial quantitative arteriography. The Canadian Coronary Atherosclerosis Intervention Trial. , 1994, Circulation.

[60]  R M Nerem,et al.  The pathogenesis of atherosclerosis: An overview , 1991, Clinical cardiology.

[61]  R. Furchgott Role of endothelium in responses of vascular smooth muscle. , 1983, Circulation research.

[62]  G. Watts,et al.  Effects on coronary artery disease of lipid-lowering diet, or diet plus cholestyramine, in the St Thomas' Atherosclerosis Regression Study (STARS) , 1992, The Lancet.

[63]  J. Saltiel,et al.  Clinical and angiographic correlates and prognostic significance of the coronary extent score. , 1988, The American journal of cardiology.

[64]  A. Chait Methods for assessing lipid and lipoprotein oxidation , 1992 .

[65]  D H Blankenhorn,et al.  Beneficial effects of combined colestipol-niacin therapy on coronary atherosclerosis and coronary venous bypass grafts. , 1987, JAMA.

[66]  Changes in sequential coronary arteriograms and subsequent coronary events. Surgical Control of the Hyperlipidemias (POSCH) Group. , 1992, JAMA.

[67]  M. Bourassa,et al.  Clinical and angiographic predictors of new total coronary occlusion in coronary artery disease: analysis of 313 nonoperated patients. , 1984, The American journal of cardiology.

[68]  W. Roberts,et al.  The frequency and significance of coronary arterial thrombi and other observations in fatal acute myocardial infarction: a study of 107 necropsy patients. , 1972, The American journal of medicine.

[69]  Steven E. Nissen,et al.  Intravascular Ultrasound Assessment of Lumen Size and Wall Morphology in Normal Subjects and Patients With Coronary Artery Disease , 1991, Circulation.

[70]  R. Jansen,et al.  Minimizing interlaboratory variation in routine assays of serum cholesterol through the use of serum calibrators. , 1986, Clinical chemistry.

[71]  L. Herbette,et al.  Comparison of location and binding for the positively charged 1,4-dihydropyridine calcium channel antagonist amlodipine with uncharged drugs of this class in cardiac membranes. , 1989, Molecular pharmacology.

[72]  Relationship of blood pressure, serum cholesterol, smoking habit, relative weight and ECG abnormalities to incidence of major coronary events: final report of the pooling project. The pooling project research group. , 1978, Journal of chronic diseases.

[73]  K. Herbaczyńska-Cedro,et al.  Nisoldipine inhibits lipid peroxidation induced by coronary occlusion in pig myocardium. , 1990, Cardiovascular research.

[74]  D. Steinberg Lipoproteins and atherosclerosis. A look back and a look ahead. , 1983, Arteriosclerosis.

[75]  J. Neaton,et al.  Serum cholesterol, blood pressure, cigarette smoking, and death from coronary heart disease. Overall findings and differences by age for 316,099 white men. Multiple Risk Factor Intervention Trial Research Group. , 1992, Archives of internal medicine.

[76]  J. Kluger Beyond cholesterol. , 1997, Time.

[77]  Ancel Keys Coronary heart disease in seven countries. , 1971, The Medical journal of Australia.

[78]  M. Nobuyoshi,et al.  Progression of coronary atherosclerosis: is coronary spasm related to progression? , 1991, Journal of the American College of Cardiology.

[79]  D. Kramsch,et al.  Biochemical and cytotoxic characteristics of an in vivo circulating oxidized low density lipoprotein (LDL-). , 1994, Journal of lipid research.

[80]  S. Shattock A Report upon the Pathological Condition of the Aorta of King Menephtah, Traditionally Regarded as the Pharaoh of the Exodus , 1909, Proceedings of the Royal Society of Medicine.

[81]  G. Möller,et al.  Multicentre Study of a New Enzymatic Method of Cholesterol Determination , 1984, Journal of clinical chemistry and clinical biochemistry. Zeitschrift fur klinische Chemie und klinische Biochemie.

[82]  S. Hunt,et al.  Progressive coronary luminal narrowing after cardiac transplantation. , 1990, Circulation.

[83]  A. Olsson Regression of femoral atherosclerosis. , 1991, Circulation.

[84]  V. Fuster,et al.  Angiographic progression of coronary artery disease and the development of myocardial infarction. , 1988, Journal of the American College of Cardiology.

[85]  N J Wald,et al.  By how much and how quickly does reduction in serum cholesterol concentration lower risk of ischaemic heart disease? , 1994, BMJ.

[86]  V. Fuster,et al.  Angiographic evolution of coronary artery morphology in unstable angina. , 1986, Journal of the American College of Cardiology.

[87]  R. Ross The pathogenesis of atherosclerosis--an update. , 1986, The New England journal of medicine.

[88]  T. Carew,et al.  Antiatherogenic effect of probucol unrelated to its hypocholesterolemic effect: evidence that antioxidants in vivo can selectively inhibit low density lipoprotein degradation in macrophage-rich fatty streaks and slow the progression of atherosclerosis in the Watanabe heritable hyperlipidemic rabbit. , 1987, Proceedings of the National Academy of Sciences of the United States of America.

[89]  T. W. Allen Effect of simvastatin on coronary atheroma , 1994 .

[90]  E L Bolson,et al.  Arteriographic assessment of coronary atherosclerosis. Review of current methods, their limitations, and clinical applications. , 1982, Arteriosclerosis.

[91]  G Bucolo,et al.  Quantitative determination of serum triglycerides by the use of enzymes. , 1973, Clinical chemistry.

[92]  W. Santamore,et al.  Can coronary angiography predict the site of a subsequent myocardial infarction in patients with mild-to-moderate coronary artery disease? , 1988, Circulation.

[93]  G. V. R. Born,et al.  INFLUENCE OF PLAQUE CONFIGURATION AND STRESS DISTRIBUTION ON FISSURING OF CORONARY ATHEROSCLEROTIC PLAQUES , 1989, The Lancet.

[94]  B. G. Brown,et al.  Effects of Intensive Lipid‐Lowering Therapy on the Coronary Arteries of Asymptomatic Subjects With Elevated Apolipoprotein B , 1993, Circulation.

[95]  B. Lewis,et al.  TOWARDS AN IMPROVED LIPID-LOWERING DIET: ADDITIVE EFFECTS OF CHANGES IN NUTRIENT INTAKE , 1981, The Lancet.

[96]  S L Winters,et al.  Angiographic morphology and the pathogenesis of unstable angina pectoris. , 1985, Journal of the American College of Cardiology.

[97]  B. Rifkind,et al.  The value of lowering cholesterol after myocardial infarction. , 1990, The New England journal of medicine.

[98]  G. Block,et al.  The effects of simvastatin and pravastatin on objective and subjective measures of nocturnal sleep: a comparison of two structurally different HMG CoA reductase inhibitors in patients with primary moderate hypercholesterolaemia. , 1993, British journal of clinical pharmacology.

[99]  W. Mack,et al.  The influence of diet on the appearance of new lesions in human coronary arteries. , 1990, JAMA.

[100]  J. Vane,et al.  Differential formation of prostacyclin (PGX or PGI2) by layers of the arterial wall. An explanation for the anti-thrombotic properties of vascular endothelium. , 1977, Thrombosis research.

[101]  T. Nikkari,et al.  Glycosaminoglycans and Apolipoproteins B and A‐l in Human Aortas: Chemical and Immunological Analysis of Lesion‐Free Aortas from Children and Adults , 1987, Arteriosclerosis.

[102]  M. Palmer Clinical Trials: A Practical Approach , 1985 .

[103]  G. Watts,et al.  Nutrient intake and progression of coronary artery disease. , 1994, The American journal of cardiology.

[104]  M. Fisher,et al.  Effects of therapy with cholestyramine on progression of coronary arteriosclerosis: results of the NHLBI Type II Coronary Intervention Study. , 1984, Circulation.

[105]  S. Ellis,et al.  Design and recruitment in the United States of a multicenter quantitative angiographic trial of pravastatin to limit atherosclerosis in the coronary arteries (PLAC I). , 1993, The American journal of cardiology.

[106]  A. Hamsten Coagulation factors and hyperlipidaemia , 1991 .

[107]  W. Mack,et al.  Beneficial Effects of Colestipol‐Niacin Therapy on the Common Carotid Artery. Two‐ and Four‐Year Reduction of Intima‐Media Thickness Measured by Ultrasound , 1993, Circulation.

[108]  N L Geller,et al.  The analysis of multiple endpoints in clinical trials. , 1987, Biometrics.

[109]  M. Hochberg NSAIDS: patterns of usage and side effects. , 1989, Indian Journal of Medical Sciences.

[110]  R. Krauss,et al.  Coronary Artery Disease Regression: Convincing Evidence for the Benefit of Aggressive Lipoprotein Management , 1994, Circulation.

[111]  B Buis,et al.  Diet, lipoproteins, and the progression of coronary atherosclerosis. The Leiden Intervention Trial. , 1985, The New England journal of medicine.

[112]  M. Law,et al.  Assessing possible hazards of reducing serum cholesterol , 1994, BMJ.

[113]  Asb CAN LIFESTYLE CHANGES REVERSE CORONARY HEART DISEASE. , 1990 .

[114]  N. Kalant,et al.  Interaction of Native and Cell‐modified Low Density Lipoprotein with Collagen Gel , 1988, Arteriosclerosis.

[115]  S. Halstead,et al.  Specific lethality of silica for human peripheral blood mononuclear phagocytes, in vitro. , 1978, Journal of immunological methods.

[116]  K. Gould,et al.  Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial , 1990, The Lancet.

[117]  P. Henriksson,et al.  The antioxidant butylated hydroxytoluene protects against atherosclerosis. , 1991, Arteriosclerosis and thrombosis : a journal of vascular biology.

[118]  P. D. Henry,et al.  Suppression of atherogenesis in cholesterol-fed rabbit treated with nifedipine. , 1981, The Journal of clinical investigation.

[119]  E. Alderman,et al.  Development of new coronary atherosclerotic lesions during a 4-year multifactor risk reduction program: the Stanford Coronary Risk Intervention Project (SCRIP). , 1994, Journal of the American College of Cardiology.

[120]  E. Anggard,et al.  Vitamin E: the evidence for an anti-atherogenic role. , 1993, Artery.

[121]  L. Kuller,et al.  SERUM CHOLESTEROL, BLOOD PRESSURE, AND MORTALITY: IMPLICATIONS FROM A COHORT OF 361 662 MEN , 1986, The Lancet.

[122]  Expanded clinical evaluation of lovastatin (EXCEL) study results: IV. Additional perspectives on the tolerability of lovastatin. , 1991, The American journal of medicine.

[123]  D. Kramsch,et al.  Regression of atherosclerosis: which components regress and what influences their reversal. , 1992, Wiener klinische Wochenschrift.

[124]  H. Buchwald,et al.  Reduction of atherosclerosis with nonsteroidal anti-inflammatory drugs. , 1993, The Journal of surgical research.

[125]  V. Fuster,et al.  Insights into the pathogenesis of acute ischemic syndromes. , 1988, Circulation.

[126]  Vitamin E consumption and the risk of coronary disease in women. , 1993 .

[127]  D H Blankenhorn,et al.  Prediction of angiographic change in native human coronary arteries and aortocoronary bypass grafts. Lipid and nonlipid factors. , 1990, Circulation.

[128]  S. Azen,et al.  Planning and Evaluation of Studies on Atherosclerosis in Controlled Clinical Trials , 1984 .

[129]  E. Alderman,et al.  Coronary artery quantitation and data management system for paired cineangiograms. , 1991, Catheterization and cardiovascular diagnosis.

[130]  H. Hodis,et al.  Arterial imaging and atherosclerosis reversal , 1994 .

[131]  K. Prasad,et al.  Oxygen free radicals and hypercholesterolemic atherosclerosis: effect of vitamin E. , 1993, American heart journal.

[132]  Stanley Azen,et al.  Coronary Angiographic Changes with Lovastatin Therapy: The Monitored Atherosclerosis Regression Study (MARS) , 1993, Annals of Internal Medicine.

[133]  E. Falk Unstable angina with fatal outcome: dynamic coronary thrombosis leading to infarction and/or sudden death. Autopsy evidence of recurrent mural thrombosis with peripheral embolization culminating in total vascular occlusion. , 1985, Circulation.

[134]  R. Levy,et al.  Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. , 1972, Clinical chemistry.

[135]  M. Haberland,et al.  Malondialdehyde-altered protein occurs in atheroma of Watanabe heritable hyperlipidemic rabbits. , 1988, Science.

[136]  P. Trinder Determination of Glucose in Blood Using Glucose Oxidase with an Alternative Oxygen Acceptor , 1969 .

[137]  J. Manson,et al.  Antioxidants and cardiovascular disease: a review. , 1993, Journal of the American College of Nutrition.

[138]  R. Poston,et al.  Immunity and inflammation in the pathogenesis of atherosclerosis. A review. , 1974, Atherosclerosis.

[139]  D. Janero,et al.  Antiperoxidant effects of dihydropyridine calcium antagonists. , 1989, Biochemical pharmacology.

[140]  M. Brown,et al.  Lipoprotein metabolism in the macrophage: implications for cholesterol deposition in atherosclerosis. , 1983, Annual review of biochemistry.

[141]  M. Oliver SERUM CHOLESTEROL-THE KNAVE OF HEARTS AND THE JOKER , 1981, The Lancet.

[142]  A. Ooshima,et al.  Probucol prevents the progression of atherosclerosis in Watanabe heritable hyperlipidemic rabbit, an animal model for familial hypercholesterolemia. , 1987, Proceedings of the National Academy of Sciences of the United States of America.

[143]  W. Mack,et al.  One‐Year Reduction and Longitudinal Analysis of Carotid Intima‐Media Thickness Associated With Colestipol/Niacin Therapy , 1993, Stroke.

[144]  J. Deslypere,et al.  Biological markers of dietary intake, with emphasis on fatty acids. , 1991, Annals of nutrition & metabolism.

[145]  D. B. Weinstein,et al.  Antiatherogenic properties of calcium antagonists. , 1987, The American journal of cardiology.

[146]  E. Bixler,et al.  Effects of lovastatin and pravastatin on sleep efficiency and sleep stages , 1991, Clinical pharmacology and therapeutics.

[147]  W. Little,et al.  Angiographic assessment of the culprit coronary artery lesion before acute myocardial infarction. , 1990, The American journal of cardiology.

[148]  Jan J. Gerbrands,et al.  Computer assisted analysis of the severity of obstructions from coronary cineangiograms: a methodological review , 1984 .