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Factors That Impact the Decision to Perform Left Ventriculography in Coronary Artery Disease
Claudia de Castro Lima Santos1, Ricardo Peixoto Oliveira2, Joberto Sena2
1Escola Bahiana de Medicina e Saúde Pública, Salvador, BA - Brasil.
Insights
Chronic coronary syndrome increases the likelihood of left ventriculography in patients undergoing coronary angiography. However, known ventricular function, hypertension, prior CABG, and higher creatinine levels decrease its use.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Medical Decision Making
Background:
- Left ventriculography is an invasive diagnostic tool for assessing left ventricular systolic function.
- Its use has declined due to risks and the availability of noninvasive alternatives.
Purpose of the Study:
- To identify independent factors influencing the decision to perform left ventriculography in patients with coronary artery disease.
- To understand the clinical predictors for utilizing this invasive procedure.
Main Methods:
- Retrospective analysis of electronic medical records from 600 patients undergoing coronary angiography.
- Multivariate analysis was employed to assess associations between 21 variables and ventriculography performance.
Main Results:
- Chronic coronary syndrome was independently associated with a higher likelihood of left ventriculography (OR 1.72).
- Conversely, known ventricular function (OR 0.58), history of hypertension (OR 0.58), prior CABG (OR 0.31), and elevated creatinine (OR 0.42) were associated with decreased likelihood.
Conclusions:
- Chronic coronary syndrome is a key predictor for performing left ventriculography during coronary angiography.
- Factors such as pre-existing ventricular function data, hypertension, prior bypass surgery, and renal function influence the decision against its use.
Background:
Left ventriculography is an invasive method for assessment of left ventricular systolic function. Since the advent of noninvasive methods, its use has been questioned, as it carries some risk to the patient.
Objective:
To assess which factors are independently associated with the decision to perform ventriculography in patients with coronary artery disease.
Methods:
Analytical, retrospective, database review study of electronic medical records comparing 21 predefined variables of interest among patients undergoing coronary angiography. P-values <0.05 were considered significant.
Results:
We evaluated 600 consecutive patients undergoing coronary angiography. Left ventriculography was performed in the majority of cases (54%). After multivariate analysis, patients with chronic coronary syndrome (OR 1.72; 95% CI: 1.20-2.46; p < 0.01) were more likely to undergo the procedure. Patients with known ventricular function (OR 0.58; 95% CI: 0.40-0.85; p < 0.01); those with a history of CABG (OR 0.31; 95% CI: 0.14-0.69; p < 0.01) or hypertension (OR 0.58; 95% CI: 0.36-0.94; p = 0.02); and those with higher creatinine levels (OR 0.42; 95% CI: 0.26-0.69; p < 0.01) had greater odds of not undergoing ventriculography.
Conclusions:
In patients undergoing coronary angiography, a diagnosis of chronic coronary syndrome was independently associated with greater likelihood of left ventriculography, while having previously determined ventricular function, a history of hypertension or CABG, and higher creatinine levels were associated with a decreased likelihood of undergoing this procedure.
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