Natural history of patients with insignificant coronary artery disease

Rosanna Tavella, Natalie Cutri, Graeme Tucker, Robert Adams, John Spertus, John F. Beltrame

Research output: Contribution to journalReview articlepeer-review

44 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)117-124
Number of pages8
JournalEuropean Heart Journal - Quality of Care and Clinical Outcomes
Issue number2
Publication statusPublished or Issued - Apr 2016
Externally publishedYes


  • Angiography
  • Health outcomes
  • Health status
  • Insignificant coronary artery disease
  • Quality of life
  • Stable angina

ASJC Scopus subject areas

  • Health Policy
  • Cardiology and Cardiovascular Medicine

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