Abstract
BackgroundAn 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.MethodsIn 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.ResultsA 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.ConclusionIn 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.
Highlights
Stable angina pectoris and acute coronary syndrome (ACS) are two clinical manifestations of coronary artery disease (CAD)
In this paper we describe the clinical characteristics of consecutive patients with normal coronary arteries at invasive coronary angiography for suspected cardiac chest pain at a secondary care centre
The study population consisted of patients who were referred for coronary angiography because of suspected cardiac chest pain between January 1, 2013 and January 1, 2014 at the Westfriesgasthuis, a medium large secondary care centre in Hoorn, the Netherlands
Summary
Stable angina pectoris and acute coronary syndrome (ACS) are two clinical manifestations of coronary artery disease (CAD). Other studies and registries have shown that up to 39% of patients with suspected CAD may have visually normal or near-normal coronary arteries on invasive coronary angiography [9, 10]. In this paper we describe the clinical characteristics of consecutive patients with normal coronary arteries at invasive coronary angiography for suspected cardiac chest pain at a secondary care centre. 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. 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
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Schedule a callMore From: Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation
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