Wang, T.K.M. and Oh, T.H.T. and Samaranayake, C.B. and Webster, M.W.I. and Stewart, J.T. and Watson, T. and Ellis, C. and Ruygrok, P.N. (2015) The utility of a ‘non-significant’ coronary angiogram. International Journal of Clinical Practice, 69 (12). pp. 1465-1472. ISSN 1368-5031, DOI https://doi.org/10.1111/ijcp.12723.
Full text not available from this repository.Abstract
Background Coronary angiography is the gold standard for assessing coronary artery disease (CAD). In many patients with chest pain, no or mild CAD (< 50% stenosis) is found. It is uncertain whether this 'non-significant' result influences management and outcomes. We reviewed characteristics and outcomes in a contemporary cohort of chest pain referrals who had mild or absent CAD on coronary angiography. Method All patients undergoing coronary angiography at Auckland City Hospital during July 2010-October 2011 were reviewed (n = 2983). Of these, 12.3% (n = 366) underwent coronary angiography for evaluation of chest pain and were found to have absent or mild CAD. These patients were followed up for 2.3 ± 0.6 years. Results Mean age was 60.0 ± 12.3 years, 56.1% were female. The ECG was abnormal in 55.0% of patients. Stress testing for inducible ischaemia was undertaken in 40.7% of patients and was abnormal in 57.7%. Following angiography, 43.2% had no changes to cardiac medications. Additional drug therapy (aspirin, statin, beta-blockers, ACE-inhibitor) was commenced in around 14.2-22.1% of cases. These drugs were discontinued in 4.1-8.2% of patients. Rates of major adverse cardiovascular events and readmissions with chest pain were 0.3% (1) and 1.9% (7) respectively at 30 days, and 1.9% (7) and 6.0% (22) at 1 year. Conclusion Although even non-obstructive atheroma may justify medical therapy to limit disease progression, our findings may suggest that in these cases, invasive coronary angiography, may not lead to the patient/physician reassurance justified by historical data.
| Item Type: | Article |
|---|---|
| Funders: | UNSPECIFIED |
| Uncontrolled Keywords: | Aged; Chest Pain; Coronary Angiography; Coronary Artery Disease; Disease Management; Emergency Service, Hospital; Female; Follow-Up Studies; Humans; Male; Middle Aged; Risk Assessment; Risk Factors |
| Subjects: | R Medicine |
| Divisions: | Faculty of Medicine |
| Depositing User: | Ms. Juhaida Abd Rahim |
| Date Deposited: | 28 Sep 2018 08:02 |
| Last Modified: | 28 Sep 2018 08:02 |
| URI: | http://eprints.um.edu.my/id/eprint/19473 |
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