Suspected coronary artery disease and myocardial infarction with normal coronary angiography: A heterogeneous but benign condition?
Introduction: Previous follow-up studies of patients with symptoms and/or non-invasive tests suggestive of ischemia or an acute coronary syndrome and a normal coronary angiogram have reported a good prognosis. Objectives: The aim of this study was to evaluate the clinical characteristics and outcome...
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Elsevier
2013-03-01
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Series: | Revista Portuguesa de Cardiologia |
Online Access: | http://www.sciencedirect.com/science/article/pii/S0870255113000255 |
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Article |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Nádia Moreira Maria João Vidigal Ferreira Francisco Soares Beatriz Santos Ana Miranda Lino Gonçalves Luís Providência |
spellingShingle |
Nádia Moreira Maria João Vidigal Ferreira Francisco Soares Beatriz Santos Ana Miranda Lino Gonçalves Luís Providência Suspected coronary artery disease and myocardial infarction with normal coronary angiography: A heterogeneous but benign condition? Revista Portuguesa de Cardiologia |
author_facet |
Nádia Moreira Maria João Vidigal Ferreira Francisco Soares Beatriz Santos Ana Miranda Lino Gonçalves Luís Providência |
author_sort |
Nádia Moreira |
title |
Suspected coronary artery disease and myocardial infarction with normal coronary angiography: A heterogeneous but benign condition? |
title_short |
Suspected coronary artery disease and myocardial infarction with normal coronary angiography: A heterogeneous but benign condition? |
title_full |
Suspected coronary artery disease and myocardial infarction with normal coronary angiography: A heterogeneous but benign condition? |
title_fullStr |
Suspected coronary artery disease and myocardial infarction with normal coronary angiography: A heterogeneous but benign condition? |
title_full_unstemmed |
Suspected coronary artery disease and myocardial infarction with normal coronary angiography: A heterogeneous but benign condition? |
title_sort |
suspected coronary artery disease and myocardial infarction with normal coronary angiography: a heterogeneous but benign condition? |
publisher |
Elsevier |
series |
Revista Portuguesa de Cardiologia |
issn |
0870-2551 |
publishDate |
2013-03-01 |
description |
Introduction: Previous follow-up studies of patients with symptoms and/or non-invasive tests suggestive of ischemia or an acute coronary syndrome and a normal coronary angiogram have reported a good prognosis. Objectives: The aim of this study was to evaluate the clinical characteristics and outcome of a cohort of patients with suspected ischemic heart disease and normal coronary arteries. Methods: A clinical follow-up was performed of 607 patients (mean age 62 ± 11 years) with symptoms or non-invasive tests suggestive of ischemia (544) or myocardial infarction (63) and normal coronary angiography. The occurrence of major cardiac events or of readmission due to chest pain was recorded during a mean follow-up of 33.6 ± 9.5 months after angiography. Results: Patients with myocardial infarction were older (65.4 ± 11.1 vs. 61.9 ± 10.7, p=0.05), and the majority were women (68.3%). Hypertension was reported by 65.5% of patients, diabetes by 17.9%, dyslipidemia by 58.6%, smoking by 14% and family history of coronary artery disease in 11%. During follow-up no patient died from cardiovascular causes; three patients (0.5%) suffered myocardial infarction and 50 (8.3%) had recurrent chest pain leading to emergency admission. Patients with myocardial infarction had more events (20.6%) than those referred for angiography due to symptoms and/or positive non-invasive tests for ischemia (7.4%) (log-rank chi-square test: 13.6, p<0.0005). Conclusion: The incidence of risk factors was high. Our data suggest that patients with a normal angiogram had a good prognosis in spite of their baseline clinical presentation. A significant number of patients showed persistence of symptoms. Resumo: Introdução: Estudos prévios de seguimento de doentes com sintomas e/ou testes não invasivos sugestivos de isquemia ou com síndrome coronária aguda e coronariografia normal têm revelado um bom prognóstico. Objetivos: Avaliar as características clínicas e o resultado de um grupo de doentes com suspeita de doença cardíaca isquémica e coronariografia normal. Métodos: Seguimento clínico de 607 doentes (idade média 62 ± 11 anos) com sintomas e/ou testes não invasivos sugestivos de isquemia (544) ou enfarte agudo do miocárdio (EAM) (63) e coronariografia normal. Registou-se a ocorrência de eventos cardíacos major ou a readmissão por dor torácica durante um período médio de seguimento de 33,6 ± 9,5 meses após a angiografia. Resultados: Os doentes com EAM eram mais velhos (65,4 ± 11,1 versus 61,9 ± 10,7, p = 0,05) e a maioria mulheres (68,3%). 65,5% dos indivíduos tinham história de hipertensão, referiam diabetes 17,9%, dislipidemia 58,8%, tabagismo 14% e história familiar de doença coronária 11%. Durante o seguimento, nenhum doente morreu de causas cardiovasculares, 3 tiveram EAM (0,5%) e 50 tiveram recorrência de dor torácica causando readmissão no serviço de urgência (8,3%). Doentes com EAM tiveram mais eventos (20,6%) do que os referenciados para angiografia devido aos sintomas e/ou teste não invasivo positivo para isquemia (7,4%) (logrank chi-square = 13,6, p < 0,0005). Conclusão: A incidência de fatores de risco nesta população é elevada. Os nossos resultados sugerem que doentes com coronariografia normal, independentemente da apresentação inicial, têm bom prognóstico. Um número significativo de doentes tem persistência dos sintomas. Keywords: Myocardial ischemia, Coronary angiography, Prognosis, Palavras-chave: Isquémia miocárdica, Angiografia coronária, Prognóstico |
url |
http://www.sciencedirect.com/science/article/pii/S0870255113000255 |
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doaj-bdbfcde4d65c4ddba0488ae43eecbe492020-11-25T02:36:53ZengElsevierRevista Portuguesa de Cardiologia0870-25512013-03-01323205210Suspected coronary artery disease and myocardial infarction with normal coronary angiography: A heterogeneous but benign condition?Nádia Moreira0Maria João Vidigal Ferreira1Francisco Soares2Beatriz Santos3Ana Miranda4Lino Gonçalves5Luís Providência6Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Corresponding author.Faculdade de Medicina, Universidade de Coimbra, Coimbra, PortugalCentro Hospitalar e Universitário de Coimbra, Coimbra, PortugalFaculdade de Medicina, Universidade de Coimbra, Coimbra, PortugalFaculdade de Medicina, Universidade de Coimbra, Coimbra, PortugalFaculdade de Medicina, Universidade de Coimbra, Coimbra, PortugalFaculdade de Medicina, Universidade de Coimbra, Coimbra, PortugalIntroduction: Previous follow-up studies of patients with symptoms and/or non-invasive tests suggestive of ischemia or an acute coronary syndrome and a normal coronary angiogram have reported a good prognosis. Objectives: The aim of this study was to evaluate the clinical characteristics and outcome of a cohort of patients with suspected ischemic heart disease and normal coronary arteries. Methods: A clinical follow-up was performed of 607 patients (mean age 62 ± 11 years) with symptoms or non-invasive tests suggestive of ischemia (544) or myocardial infarction (63) and normal coronary angiography. The occurrence of major cardiac events or of readmission due to chest pain was recorded during a mean follow-up of 33.6 ± 9.5 months after angiography. Results: Patients with myocardial infarction were older (65.4 ± 11.1 vs. 61.9 ± 10.7, p=0.05), and the majority were women (68.3%). Hypertension was reported by 65.5% of patients, diabetes by 17.9%, dyslipidemia by 58.6%, smoking by 14% and family history of coronary artery disease in 11%. During follow-up no patient died from cardiovascular causes; three patients (0.5%) suffered myocardial infarction and 50 (8.3%) had recurrent chest pain leading to emergency admission. Patients with myocardial infarction had more events (20.6%) than those referred for angiography due to symptoms and/or positive non-invasive tests for ischemia (7.4%) (log-rank chi-square test: 13.6, p<0.0005). Conclusion: The incidence of risk factors was high. Our data suggest that patients with a normal angiogram had a good prognosis in spite of their baseline clinical presentation. A significant number of patients showed persistence of symptoms. Resumo: Introdução: Estudos prévios de seguimento de doentes com sintomas e/ou testes não invasivos sugestivos de isquemia ou com síndrome coronária aguda e coronariografia normal têm revelado um bom prognóstico. Objetivos: Avaliar as características clínicas e o resultado de um grupo de doentes com suspeita de doença cardíaca isquémica e coronariografia normal. Métodos: Seguimento clínico de 607 doentes (idade média 62 ± 11 anos) com sintomas e/ou testes não invasivos sugestivos de isquemia (544) ou enfarte agudo do miocárdio (EAM) (63) e coronariografia normal. Registou-se a ocorrência de eventos cardíacos major ou a readmissão por dor torácica durante um período médio de seguimento de 33,6 ± 9,5 meses após a angiografia. Resultados: Os doentes com EAM eram mais velhos (65,4 ± 11,1 versus 61,9 ± 10,7, p = 0,05) e a maioria mulheres (68,3%). 65,5% dos indivíduos tinham história de hipertensão, referiam diabetes 17,9%, dislipidemia 58,8%, tabagismo 14% e história familiar de doença coronária 11%. Durante o seguimento, nenhum doente morreu de causas cardiovasculares, 3 tiveram EAM (0,5%) e 50 tiveram recorrência de dor torácica causando readmissão no serviço de urgência (8,3%). Doentes com EAM tiveram mais eventos (20,6%) do que os referenciados para angiografia devido aos sintomas e/ou teste não invasivo positivo para isquemia (7,4%) (logrank chi-square = 13,6, p < 0,0005). Conclusão: A incidência de fatores de risco nesta população é elevada. Os nossos resultados sugerem que doentes com coronariografia normal, independentemente da apresentação inicial, têm bom prognóstico. Um número significativo de doentes tem persistência dos sintomas. Keywords: Myocardial ischemia, Coronary angiography, Prognosis, Palavras-chave: Isquémia miocárdica, Angiografia coronária, Prognósticohttp://www.sciencedirect.com/science/article/pii/S0870255113000255 |