{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,8]],"date-time":"2026-07-08T19:59:01Z","timestamp":1783540741753,"version":"3.55.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"21","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The long\u2010term course of coronary atherosclerosis has not been studied in large nationwide cohorts. Understanding the natural history of coronary atherosclerosis could help identify patients at risk for future coronary events.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">All coronary artery segments with &lt;50% luminal stenosis in patients with a first\u2010time coronary angiogram between 1989 and 2017 were identified (n=2\u2009661\u2009245 coronary artery segments in 248\u2009736 patients) and followed until a clinically indicated angiography within 15\u2009years was performed or until death or end of follow\u2010up (April 2018) using SCAAR (Swedish Coronary Angiography and Angioplasty Registry). The stenosis progression and incidence rates were 2.6% and 1.45 (95% CI, 1.43\u20131.46) per 1000 segment\u2010years, respectively. The greatest progression rate occurred in the proximal and middle segments of the left anterior descending artery. Male sex and diabetes were associated with a 2\u2010fold increase in risk, and nearly 70% of new stenoses occurred in patients with baseline single\u2010vessel disease (hazard ratio, 3.86 [95% CI, 3.69\u20134.04]). Coronary artery segments in patients with no baseline risk factors had a progression rate of 0.6% and incidence rate of 0.36 (95% CI, 0.34\u20130.39), increasing to 8.1% and 4.01 (95% CI, 3.89\u20134.14) per 1000 segment\u2010years, respectively, in patients with \u22654 risk factors. The prognostic impact of risk factors on stenosis progression was greatest in younger patients and women.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Coronary atherosclerosis progressed slowly but more frequently in the left coronary artery in men and in the presence of traditional risk factors. Coronary artery segments in patients without risk factors had little or no risk of stenosis progression, and the relative impact of risk factors appears to be of greater importance in younger patients and women. These findings help in the understanding the long\u2010term course of coronary atherosclerosis.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.026396","type":"journal-article","created":{"date-parts":[[2022,10,27]],"date-time":"2022-10-27T11:54:20Z","timestamp":1666871660000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":18,"title":["On the Natural History of Coronary Artery Disease: A Longitudinal Nationwide Serial Angiography Study"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4242-9801","authenticated-orcid":false,"given":"Moman A.","family":"Mohammad","sequence":"first","affiliation":[{"name":"Department of Cardiology Clinical Sciences, Lund University, Sk\u00e5ne University Hospital Lund Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3416-8210","authenticated-orcid":false,"given":"Gregg 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