Abstract
Background: The current gold standard for the diagnosis of stable coronary artery disease (CAD) is invasive coronary angiography. But a large proportion of patients undergoing coronary angiography don’t have obstructive coronary artery disease. Objective: The aim of the present study was to evaluate the diagnostic performance of invasive coronary angiography for patients without known coronary artery disease presenting with stable chest pain syndrome at two hospitals structures in Senegal. Method: We conducted a prospective, descriptive, and analytical study from March 1, 2019, to December 31, 2020 in the Cardiology Departments of General Hospital Idrissa Pouye (HOGIP) and Aristide Le Dantec Hospital (HALD). During the study period a cohort of patients referred to angiography coronary for diagnostic CAD because of suspected stable angina were enrolled. Demographic characteristics, risk factors, symptoms, and noninvasive test results were correlated with the presence of obstructive coronary artery disease. Results: A total of 143 patients were included in our study with a median age of 60.91 ± 10.58 years; men were 96 (67.13%) and women 47 (32.87%). The prevalence of hypertension was 60.84%; diabetes was 34.27%; dyslipidemia was 32.17% and sedentary was 26.57% in our study population. Typical and atypical angina symptoms were present in 37.76% (n = 54) and 49.65% (n = 71) respectively, while 10.49% had dyspnea. Coronary angiography revealed 59 (41.26%) patients with no CAD as well as 27 (18.88%) with one-vessel; 28 (19.58%) with two-vessel, and 29 (20.28%) with three-vessel disease. Independent predictive factors for stable angina with the presence of obstructive lesion were: patient age (OR, 2.36; 95% CI, 1.05 - 5.29; p = 0.036); male gender (OR, 1.6; 95% CI, 0.72 - 3.57; p = 0.24); diabetes (OR, 2.14; 95% CI, 0.96 - 4.75; p = 0.06) and necrosis Q waves (4.75; CI, 0.98 - 23.09; p = 0.05). Conclusion: In our study, more than half of the patients (58.74%) referred for coronary angiography had a confirmed diagnosis. A better clinical and non-invasive assessment is needed to improve the efficiency of patient selection for coronary angiography.
Highlights
An accurate diagnosis is very important for appropriate treatment and estimation of prognosis in patients with ischemic heart disease
The aim of the present study was to evaluate the diagnostic performance of invasive coronary angiography for patients without known coronary artery disease presenting with stable chest pain syndrome at two hospitals structures in Senegal
The current guidelines recommend for patients in stable clinical condition, invasive coronary angiography is only necessary in patients with suspected coronary artery disease in cases of inconclusive non-invasive testing or, exceptionally, in patients from particular professions, due to regulatory issues
Summary
An accurate diagnosis is very important for appropriate treatment and estimation of prognosis in patients with ischemic heart disease. In the diagnostic approach to myocardial ischemia in stable angina pectoris, several registries or studies have shown that invasive angiographic procedure of some patients with abnormal noninvasive testing does not always reveal the presence of significant lesions on coronary angiography and it’s sometimes susceptible to complications [2] [3] [4] [5]. For of all these observations, the practice of this examination is formalized by numerous recommendations of learned societies and relating to its indications, its relevance and possible results [2] [3].
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call