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Suspected coronary artery disease and myocardial infarction with normal coronary angiography: A heterogeneous but benign condition?
MedLine Citation:
PMID:  23453533     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION: Previous follow-up studies of patients with symptoms and/or non-invasive tests suggestive of ischemia or an acute coronary syndrome and a normal coronary angiogram have reported a good prognosis. OBJECTIVES: The aim of this study was to evaluate the clinical characteristics and outcome of a cohort of patients with suspected ischemic heart disease and normal coronary arteries. METHODS: A clinical follow-up was performed of 607 patients (mean age 62±11 years) with symptoms or non-invasive tests suggestive of ischemia (544) or myocardial infarction (63) and normal coronary angiography. The occurrence of major cardiac events or of readmission due to chest pain was recorded during a mean follow-up of 33.6±9.5 months after angiography. RESULTS: Patients with myocardial infarction were older (65.4±11.1 vs. 61.9±10.7, p=0.05), and the majority were women (68.3%). Hypertension was reported by 65.5% of patients, diabetes by 17.9%, dyslipidemia by 58.6%, smoking by 14% and family history of coronary artery disease in 11%. During follow-up no patient died from cardiovascular causes; three patients (0.5%) suffered myocardial infarction and 50 (8.3%) had recurrent chest pain leading to emergency admission. Patients with myocardial infarction had more events (20.6%) than those referred for angiography due to symptoms and/or positive non-invasive tests for ischemia (7.4%) (log-rank chi-square test: 13.6, p<0.0005). CONCLUSION: The incidence of risk factors was high. Our data suggest that patients with a normal angiogram had a good prognosis in spite of their baseline clinical presentation. A significant number of patients showed persistence of symptoms.
Authors:
Nádia Moreira; Maria João Vidigal Ferreira; Francisco Soares; Beatriz Santos; Ana Miranda; Lino Gonçalves; Luís Providência
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-27
Journal Detail:
Title:  Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology     Volume:  -     ISSN:  0870-2551     ISO Abbreviation:  Rev Port Cardiol     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-3-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8710716     Medline TA:  Rev Port Cardiol     Country:  -    
Other Details:
Languages:  ENG; POR     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.
Affiliation:
Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal. Electronic address: nadia.moreira5@gmail.com.
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