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Canadian Cardiovascular Society classification of effort angina: an angiographic correlation

Venkatesan Sangareddi1, Anand Chockalingam, G Gnanavelu

  • 1Department of Cardiology, Madras Medical College and Research Institute, Chennai, India.

Coronary Artery Disease
|March 17, 2004
PubMed

Insights

The Canadian Cardiovascular Society classification (CCSC) for angina shows little correlation with coronary artery disease severity. Angina presence, not CCSC grade, should guide decisions for coronary angiography.

Area of Science:

  • Cardiology
  • Diagnostic Imaging
  • Clinical Medicine

Background:

  • The Canadian Cardiovascular Society classification (CCSC) is the standard for grading angina in chronic stable angina patients.
  • The predictive value of CCSC for coronary artery disease (CAD) severity is not well-established.

Purpose of the Study:

  • To investigate the relationship between clinical angina grade (CCSC) and the angiographic severity of underlying coronary artery disease.
  • To assess the utility of CCSC in predicting CAD extent and severity.

Main Methods:

  • Analysis of 493 patients with stable angina undergoing coronary angiography (1998-2001).
  • Patients were classified by anginal grade and number of diseased vessels.
  • Significant lesions defined as ≥50% narrowing (left main) or ≥70% (coronaries).
  • Chi-squared test used for statistical analysis (P<0.05 significant).

Main Results:

  • No significant difference in single-, double-, or triple-vessel disease incidence across CCSC classes.
  • Class 1 angina patients had less left main trunk disease compared to Class 4.
  • Class 3 and 4 patients showed significantly fewer normal coronary angiograms.

Conclusions:

  • Generally weak correlation between CCSC and CAD severity, with an exception for left main disease.
  • The presence or absence of angina, rather than its CCSC grade, should guide the decision for coronary angiography.
Abstract

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