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Risk factor analysis of troponin-negative chest-pain patients who underwent cardiac catheterization

James Samuel1, Jemi Samuel, Jose Missri

  • 1Department of Cardiovascular Medicine, St. Vincent's Medical Center, University of Connecticut School of Medicine, USA.

Connecticut Medicine
|March 1, 2008
PubMed

Insights

In chest-pain patients with negative troponins and positive myocardial perfusion imaging, a history of coronary artery disease (CAD), hypertension (HTN), and age over 60 are key predictors of significant coronary artery disease found during cardiac catheterization.

Area of Science:

  • Cardiology
  • Diagnostic Imaging
  • Nuclear Medicine

Background:

  • Myocardial perfusion imaging (MPI) stress testing aids prognosis in patients with known coronary artery disease (CAD).
  • Identifying pretest risk factors can minimize false-positive results from nuclear stress tests.

Purpose of the Study:

  • To identify pretest risk factors for significant coronary artery disease (CAD) in chest-pain patients with negative troponins who had a positive MPI study.
  • To improve the accuracy of risk stratification in patients undergoing cardiac catheterization after non-invasive cardiac testing.

Main Methods:

  • Retrospective analysis of chest-pain patients with negative troponins and positive MPI results.
  • Correlation of pretest clinical factors with angiographic findings of significant CAD.

Main Results:

  • 60% of patients with a positive MPI showed significant CAD on coronary angiography.
  • A history of CAD (P = .0017), hypertension (HTN) (P = .047), and age > 60 years (P = .0325) were significantly associated with positive angiogram findings.

Conclusions:

  • History of CAD, HTN, and age over 60 are significant predictors of obstructive CAD in troponin-negative patients with positive MPI.
  • These factors can aid in risk stratification and guide the need for cardiac catheterization in this patient group.
Abstract

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