Key result
Guideline-based management leaves ~52% of stable obstructive CAD patients event-free and angina-free at one year.
Why the study?
Little research existed on the evolution of stable angina in ambulatory patients without coronary antecedents and with obstructive coronary disease.
Observational (n=84)
Yes
In a Senegalese cohort of patients with stable angina and newly diagnosed obstructive CAD, over 40% remained symptomatic at one year despite management, highlighting the need for improved risk factor control.
Over 40% remain symptomatic at 1 year despite management; hypothesis-generating for optimized risk factor control in stable obstructive CAD.
Background: CAD management is important in prevention of disease progression. But we have very little study or research on the evolution of stable angina in amulatory patients without coronary antecedents and with obstructive coronary disease. Purpose: The objective of our study was to analyze the clinical and angiographic profil of patients with stable chest pain and to assess their angina status one year outcomes. Patients and methods: All patients who presented with symptomatic angina pectoris and/or signs of ischemia and first diagnosis of obstructive CAD in the Cardiology Departments of Idrissa Pouye General Hospital and Aristide Le Dantec National University Hospital Center of Dakar, from March 01, 2019 to December 31, 2020 were selected. The clinical characteristics, initial angiographic findings, therapeutic strategy and outcome within the first year were analyzed. Results: During the study period, 84 outpatients presenting with symptomatic stable chest pain and first obstructive coronary artery disease were selected. The mean age was 63.01± 9.37 years. Male preponderance was observed with 63(75%) patients; Clinical symptoms were dominated by typical pain with 46.4% (n=39) ; the risk factors were dominated by hypertension 61.9% (n=52); diabetes 41.7% (n=35) and dyslipidemia 33.3% (n=28). During follow-up, 10 patients (11.90%) remained untraceable while 9 patients (10.71%) were not available for check-up; 3 patients (3.57%) died during follow-up. Only 62 patients (73.80) could be evaluated; among those who were alive and controlled, 26 patients (41.93%) with angina at baseline still had angina symptoms, 2 patients (3.22%) had undergone myocardial infarction; one (1.61%) had undergone urgent revascularization; one (1.61%) patient developed heart failure. Finally 32 patients (51.61%) were event-free and angina-free Conclusion: The management of outpatients with stable chest pain and first obstructive CAD appears favourable, with good adherence to guideline-based therapies one year outcomes. Stable chest pain is not associated with an increased risk for adverse cardiovascular outcomes but there remains room for improvement in terms of risk factor control.
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Hessou et al. (2022) conducted an observational in Stable angina pectoris with obstructive coronary artery disease (n=84). Standard management for stable angina with obstructive CAD was evaluated on Angina status and major adverse cardiac events at 1 year. Among outpatients with stable chest pain and newly diagnosed obstructive coronary artery disease, 51.6% of evaluated patients were event-free and angina-free at one year follow-up.
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