Abstract
Background: Predicting whether a patient has multivessel coronary disease prior to invasive coronary angiography has potential clinical importance as it may help guide treatment decisions. We performed a prospective analysis of patients presenting to the catheter laboratory as an inpatient for possible acute coronary syndrome (ACS) to determine predictors of MVD. Methods: 2 independent observers who were blinded to the final diagnosis prospectively reviewed all in-patient angiograms undertaken for possible ACS. The number of diseased vessels (≥ 50% stenosis) were recorded. The definition of MVD in our study was a ≥ 2 vessels with > 50% stenosis. Patient history, demographics and clinical characteristics were collected Results: 303 patients were studied, 141 had MVD. Age was significantly higher in the MVD group (65 ± 11.3 vs. 60.7 ± 12.1). A history of recent chest pain (30% vs. 7%) and previous MI (24% vs. 4%) were also higher in the MVD group. Grace score was higher in the MVD group (98 vs. 83) as was the proportion of patients with NIDDM (19% vs. 4%). Logistic regression analysis was performed to examine predictors of MVD. Pre-treatment with aspirin (OR 4.7), a final diagnosis of ACS (OR 3.3) and the presence of NIDDM (OR 8.9) were independent predictors of multi-vessel coronary disease. Conclusion: In patients presenting to the cath lab, pre-treatment with aspirin, the presence of diabetes and a final diagnosis of ACS are independently predictive of MVD.
Published Version
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