We investigated the prognostic significance of new-onset angina in patients in whom coronary anatomic characteristics were known. New onset angina was defined as angina of less than 3 months duration. Consecutive patients (n = 1727) with significant coronary artery disease (diagnosed at cardiac catheterization) and who had not had a prior myocardial infarction or congestive heart failure were studied. In patients with new-onset angina (n = 329) there was a higher incidence of single-vessel disease (43% vs 27%) and a lower incidence of triple-vessel (23% vs Circulation 68, No. 5, 970-978, 1983. GIVEN THE MARKED variability in the natural history of coronary heart disease, clinicians have relied on the identification of prognostic factors to help guide therapeutic decisions. The severity of the symptoms, the location of coronary lesions, and left ventricular function are among the factors that are considered in the identification of patients at increased risk of a myocardial infarction or death." 2 Controversy has arisen