Predictors of angiographically normal coronary arteries

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Coronary angiography (CAG) has been recommended for patients with well-established risk factors. However, striking rates of coronary angiograms were turning out to be normal and very little is known regarding the predictors of having normal coronary arteries. OBJECTIVES The primary objective of this study is to determine the predictors that increase the likelihood of having normal coronary arteries as seen in CAG. Methods This study analyzed 279 patients who underwent CAG from January 1, 2015 to December 31, 2019. The primary end point was to determine clinical and diagnostic predictors of having angiographically normal coronary arteries. Results In total, 46.9% of patients had a normal coronary angiogram. Multiple logistic regression showed that females are more likely to have normal coronary arteries (aOR- 4.6, 95% CI 2.25 – 9.53) as well as higher HDL-C (aOR- 1.027 95% CI 1.00-1.05). On the other hand, older age (aOR 0.936 95% CI 0.91-0.96) and diabetes mellitus (aOR- 0.946 95% CI 0.92-0.97) are less likely to have a normal angiogram. Overall, patients who had abnormal coronary angiograms were found to be older (63.47 years old versus 56.27 years old, p < 0.001), had greater proportions of males (71% vs 52%), with diabetes (39% vs 24%), a positive smoking history (41% vs 27%), higher Framingham score (29.7 [range 1.4–30] vs 15.9 [range 2.3–30], P <.001), higher WBC (8.1 vs 7.4, P = .018) and higher baseline creatinine (1.07 vs 0.95 mg/dl, P = .001) but noted to have lower HDL-C (40.1 vs 44.07 mg/dl, P = .003). Conclusion The female gender is highly predictive of having a normal angiogram while diabetes mellitus and older age are less likely to have a normal angiogram. A higher HDL-C is also associated with increased odds of a normal coronary angiogram.