TY - JOUR
T1 - Natural history of patients with insignificant coronary artery disease
AU - Tavella, Rosanna
AU - Cutri, Natalie
AU - Tucker, Graeme
AU - Adams, Robert
AU - Spertus, John
AU - Beltrame, John F.
N1 - Funding Information:
The study was, in part, supported by an independent grant from Pfizer Australia. J.B. is supported by a South Australian Cardiovascular Research Development Program Fellowship.
PY - 2016/4
Y1 - 2016/4
N2 - Aims Approximately 30% of patients undergoing coronary angiography for chest pain have insignificant coronary artery disease (ICAD). The subsequent health status of these patients is largely unknown. The current study was a cross-sectional, longitudinal comparison of health status outcomes 12 months following angiography, in a cohort of patients with stable chest pain and ICAD to: (i) patients with significant coronary artery disease (CAD) and (ii) a healthy control cohort. Methods and results Patients undergoing elective angiography for chest pain were recruited and classified as CAD (coronary stenosis ≥50%) or ICAD. Clinical and health-related quality-of-life (HRQoL) data were collected at baseline, 1, 6, and 12 months following angiography. The 12-month health status was cross-sectionally compared with a healthy control group recruited from the same geographic zone. Among 758 patients undergoing coronary angiography, 253 (33%) had ICAD. Insignificant coronary artery disease patients were younger, more often female, and had less cardiac risk factors than CAD patients. At 12 months, 48% of ICAD and 59% of CAD patients were chest pain-free, and both groups had similar Short-Form 36 Physical Component Summary (PCS) scores (41 + 11 vs. 41 + 11 for ICAD and CAD patients, respectively, P . 0.05). However, at 12 months, both the ICAD and CAD patients had significantly lower PCS scores compared with healthy controls (41 + 11 vs. 49 + 11, P, 0.05 for both CAD and ICAD). Conclusion Although ICAD patients are frequently considered ‘normal' from a cardiac perspective, they often have residual chest pain and impaired HRQoL at 12 months. Novel strategies are needed to manage ICAD patients to improve health outcomes.
AB - Aims Approximately 30% of patients undergoing coronary angiography for chest pain have insignificant coronary artery disease (ICAD). The subsequent health status of these patients is largely unknown. The current study was a cross-sectional, longitudinal comparison of health status outcomes 12 months following angiography, in a cohort of patients with stable chest pain and ICAD to: (i) patients with significant coronary artery disease (CAD) and (ii) a healthy control cohort. Methods and results Patients undergoing elective angiography for chest pain were recruited and classified as CAD (coronary stenosis ≥50%) or ICAD. Clinical and health-related quality-of-life (HRQoL) data were collected at baseline, 1, 6, and 12 months following angiography. The 12-month health status was cross-sectionally compared with a healthy control group recruited from the same geographic zone. Among 758 patients undergoing coronary angiography, 253 (33%) had ICAD. Insignificant coronary artery disease patients were younger, more often female, and had less cardiac risk factors than CAD patients. At 12 months, 48% of ICAD and 59% of CAD patients were chest pain-free, and both groups had similar Short-Form 36 Physical Component Summary (PCS) scores (41 + 11 vs. 41 + 11 for ICAD and CAD patients, respectively, P . 0.05). However, at 12 months, both the ICAD and CAD patients had significantly lower PCS scores compared with healthy controls (41 + 11 vs. 49 + 11, P, 0.05 for both CAD and ICAD). Conclusion Although ICAD patients are frequently considered ‘normal' from a cardiac perspective, they often have residual chest pain and impaired HRQoL at 12 months. Novel strategies are needed to manage ICAD patients to improve health outcomes.
KW - Angiography
KW - Health outcomes
KW - Health status
KW - Insignificant coronary artery disease
KW - Quality of life
KW - Stable angina
UR - http://www.scopus.com/inward/record.url?scp=84978925239&partnerID=8YFLogxK
U2 - 10.1093/ehjqcco/qcv034
DO - 10.1093/ehjqcco/qcv034
M3 - Review article
AN - SCOPUS:84978925239
VL - 2
SP - 117
EP - 124
JO - European Heart Journal - Quality of Care and Clinical Outcomes
JF - European Heart Journal - Quality of Care and Clinical Outcomes
SN - 2058-5225
IS - 2
ER -