Repeat Coronary Angiography in Patients Aged over 50 Years with Previously Normal/Non-Obstructive Coronary...

Area of Science:

• Cardiology
• Interventional Cardiology
• Preventive Cardiology

Background:

• A significant proportion of patients undergoing coronary angiography (CAG) have normal or non-obstructive coronary artery disease (NOCAD).
• Long-term outcomes and re-catheterization rates in patients over 50 with NOCAD are not well-defined.

Purpose of the Study:

• To evaluate the incidence of repeat catheterization and long-term outcomes in patients over 50 years old with NOCAD.
• To identify predictors of repeat CAG and assess the appropriateness of repeat procedures.

Main Methods:

• Retrospective analysis of patients over 50 with NOCAD undergoing their first CAG between 2008-2019.
• Evaluation of baseline characteristics, risk factors, CAG indications, and outcomes of repeat CAG.
• Assessment of pharmacotherapy in patients undergoing repeat procedures.

Main Results:

• Of 1939 patients with NOCAD, 90% did not undergo repeat CAG.
• Repeat CAG was performed in 10% of patients; 7% had futile procedures, and 3% led to angioplasty.
• Factors associated with repeat CAG included male gender, obesity, hypertension, diabetes, smoking, paroxysmal atrial fibrillation, and hyperlipidemia. 85% of the interventional group had suboptimal statin/aspirin use.

Conclusions:

• Non-obstructive coronary artery disease is a frequent finding.
• The threshold for repeat angiography should be higher, primarily for troponin-positive cases.
• Patients with NOCAD require risk-profile-based management, not false reassurance from a single negative angiography.