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[Prognostic value of normal coronary angiography]
L Jacq1, C Chabredier-Paquot, M Pezzano
1Centre hospitalier sud-francilien, service de cardiologie, 51, boulevard Henri Dunant, 91108 Corbeil-Essonnes, France.
Annales De Cardiologie Et D'Angeiologie
|January 31, 2003
Summary
A normal coronary angiography, even with non-significant atheroma, rarely leads to acute coronary syndromes. This suggests a generally good prognosis for patients with seemingly normal coronary artery disease imaging.
Area of Science:
- Cardiology
- Diagnostic Imaging
Background:
- Coronary angiography is the gold standard for diagnosing coronary artery disease (CAD).
- The prognostic significance of a "normal" coronary angiogram, particularly with non-obstructive atheroma, remains debated.
- Plaque rupture risk is not solely determined by stenosis degree.
Purpose of the Study:
- To evaluate the prognosis of patients with normal or subnormal coronary angiograms.
- To assess the incidence of adverse cardiac events in this population.
Main Methods:
- Retrospective analysis of 136 normal/subnormal coronary angiograms (January-September 1997).
- Patients categorized by indication: CAD suspicion, preoperative valvulopathy angiography, angioplasty control.
- Follow-up of 108 patients for 18 +/- 3 months.
Main Results:
- 86% had strictly normal arteries, 37% had <50% stenosis.
- Eight non-coronary deaths occurred (postoperative, pulmonary embolism, neoplasm).
- No myocardial infarctions reported; one unstable angina documented.
Conclusions:
- Acute coronary syndromes are rare complications of "normal" coronary angiograms.
- Despite non-significant atheroma, prognosis is generally favorable.
- Further investigation may be warranted for specific subgroups.