Key result
Among patients with suspected cardiac chest pain, those with normal or near-normal coronary arteries were significantly more often female (54% vs 27%) compared to those with coronary stenosis.
Why the study?
What is the prevalence and what are the clinical characteristics of patients with suspected cardiac chest pain who have normal or near-normal coronary arteries on invasive angiography?
Observational (n=558)
No
What is the prevalence and what are the clinical characteristics of patients with suspected cardiac chest pain who have normal or near-normal coronary arteries on invasive angiography?
Answers are grounded in this paper and cite their sources.
Approximately 27% of patients undergoing invasive angiography for suspected cardiac chest pain have normal or near-normal coronaries, and these patients are more frequently young, female, and non-diabetic, suggesting non-invasive imaging may be a better first step for this demographic.
BACKGROUND: An important number of patients with suspected cardiac chest pain have non-obstructive coronary artery disease. Our purpose was to describe the clinical characteristics of patients with normal or near-normal coronary arteries in routine cardiological practice in a secondary care hospital. METHODS: In 2013, consecutive patients referred for invasive coronary angiography with suspected cardiac chest pain were analysed at a single-centre (Westfriesgasthuis, Hoorn, the Netherlands). Coronary arteries were defined as normal or near-normal if they showed no stenosis or only slight wall irregularities on visual assessment. Patients with a final non-cardiac diagnosis for the chest pain were excluded. RESULTS: A total of 558 patients were included. Of these, 151 (27%) showed normal or near-normal coronary arteries on visual assessment. This group of patients were significantly more often female (p < 0.001), younger (p < 0.001) and non-diabetic (p = 0.002). Forty percent of hospitalised patients who had normal or near-normal coronary arteries at coronary angiography showed an elevated troponin. CONCLUSION: In routine cardiological practice, around 1 out of 4 patients with suspected cardiac chest pain undergoing invasive angiography had normal or near-normal coronary arteries. We suggest that premenopausal women with suspected cardiac chest pain could be considered for non-invasive coronary imaging as a first step in clinical practice.
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Lange et al. (2017) conducted an observational in Suspected cardiac chest pain (n=558). Normal or near-normal coronary arteries vs. Coronary artery stenosis was evaluated on Female gender (p=<0.001). Among patients with suspected cardiac chest pain, those with normal or near-normal coronary arteries were significantly more often female (54% vs 27%) compared to those with coronary stenosis.
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