We developed a new angiographic score of the extent of coronary disease (extent score), which we compared with conventional stenosis and vessel scores that emphasize the severity of stenosis. Scores were determined in 132 patients (29 women, 103 men with a mean age of 55 +/- 10 years) who underwent elective coronary angiography. Risk factors were more closely related to the extent score than to either the stenosis or vessel scores (Total R2 = 0.35 versus 0.28 (p less than 0.001) and 0.25 (p less than 0.001), respectively). The extent score was more closely related to age (r = 0.30, p less than 0.05), than was either stenosis (r = 0.21 ns) or vessel score (r = 0.26, p less than 0.05). Apolipoprotein B was the strongest predictor of both extent and stenosis scores but was more closely related to the extent score (r = 0.36, p less than 0.05), even after correction for age and gender. This new angiographic score that assesses the extent of coronary disease is simple to perform and correlates better with age and lipoprotein risk factors than conventional scores do.