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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
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Clinical usefulness of coronary angiography in patients with left ventricular dysfunction

Rodrigo Morel Vieira de Melo1, Eduardo França Pessoa de Melo, Bruno Biselli

  • 1Instituto do Coração (InCor), Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. vieirademelorm@gmail.com

Arquivos Brasileiros De Cardiologia
|April 14, 2012
PubMed

Insights

Coronary angiography in heart failure patients is not beneficial when indicated solely by risk factors. Diagnostic angiography is only useful when patients present with symptoms of ischemic heart disease.

Area of Science:

  • Cardiology
  • Internal Medicine

Background:

  • Coronary angiography is often used to diagnose ischemic heart disease in heart failure patients of unknown etiology.
  • The clinical utility of this diagnostic approach remains unclear.

Purpose of the Study:

  • To determine the prevalence of ischemic heart disease in heart failure patients with reduced ejection fraction using angiographic criteria.
  • To assess the impact of these findings on therapeutic decisions.

Main Methods:

  • 107 outpatients with heart failure and systolic dysfunction underwent coronary angiography.
  • Patients were divided into two groups: symptomatic (Group 1) and those with >2 risk factors (Group 2).
  • Exclusion criteria included known coronary artery disease, Chagas disease, congenital or valve disease, and prior cardiac transplantation.

Main Results:

  • Ischemic heart disease prevalence was 9.3% (10 patients), exclusively in Group 1 (p=0.0001).
  • Only 3.7% of patients were referred for coronary artery bypass grafting (CABG).
  • Procedure-related complications occurred in 2.8% of patients.

Conclusions:

  • Coronary angiography in heart failure patients with unknown etiology did not demonstrate clinical benefit when indicated solely by risk factors.
  • The diagnostic strategy is more effective when guided by patient symptoms suggestive of ischemic heart disease.
Abstract

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