Indications for coronary angiography: changes in laboratory practice over a decade

The indications for coronary angiography have been changing in recent years. To characterize these changes, we examined the records of Mayo Clinic patients referred for 400 coronary angiography procedures in 1973 and 1983 (200 procedures in each study year). We retrospectively assigned patients to one of seven general indication categories to determine the changes in indications used for referral during that decade. We observed a relative increase in angiographic studies related to acute myocardial infarction and percutaneous transluminal coronary angioplasty and a relative decrease in studies for nonspecific chest pain. No change was noted in the relative frequencies of indications related to assessment of anginal chest pain, possible coronary artery disease but no chest pain, assessment after coronary artery bypass grafting procedures, major ventricular arrhythmias, and investigational protocols. We believe that the differences noted primarily reflect the accumulation of new knowledge and new technologic capabilities.