Related Experiment Videos
Prognostic importance of anginal symptoms in angiographically defined coronary artery disease
Insights
Patients with coronary artery disease (CAD) but no chest pain (angina) had a better 7-year prognosis than those with angina. Angina presence independently predicts worse outcomes in CAD patients.
Area of Science:
- Cardiology
- Clinical Medicine
- Prognostic Research
Background:
- Coronary artery disease (CAD) affects millions globally.
- Prognostic factors in CAD are crucial for patient management.
- The role of anginal symptoms as an independent prognostic marker requires further elucidation.
Purpose of the Study:
- To assess the prognostic significance of anginal symptoms in patients with angiographically confirmed coronary artery disease.
- To compare the long-term outcomes of asymptomatic versus symptomatic CAD patients with similar coronary anatomy and ventricular function.
Main Methods:
- A cohort of 44 asymptomatic CAD patients was selected from the Duke Harvard Collaborative Data Bank.
- These patients were matched with 127 symptomatic CAD patients based on coronary anatomy and ventricular function.
- A 7-year follow-up period was utilized to collect mortality data.
Main Results:
- Asymptomatic CAD patients demonstrated a significantly better 7-year prognosis compared to symptomatic patients.
- The annual mortality rate was 2.7% in the asymptomatic group versus 5.4% in the symptomatic group (P < 0.05).
- Even in asymptomatic patients with three-vessel disease, the annual mortality rate approached 5%, indicating a non-benign prognosis.
Conclusions:
- The presence of anginal symptoms appears to be an important independent correlate of prognosis in patients with coronary artery disease.
- Absence of angina does not rule out significant coronary artery disease or guarantee a benign prognosis.
- Anginal symptoms provide valuable prognostic information beyond coronary anatomy and ventricular function in CAD patients.
Abstract:
To evaluate the prognostic importance of anginal symptoms, 44 patients with angiographically defined coronary artery disease and no anginal symptoms at time of cardiac catheterization were selected from the Duke Harvard Collaborative Data Bank. They were "matched" with 127 symptomatic patients in the Data Bank who had similar coronary anatomy and ventricular function. Follow-up data indicated that the patients without anginal symptoms had a significantly better prognosis over a 7 year period than did those with symptoms: Annual mortality in the asymptomatic group was 2.7 percent compared with 5.4 percent in the group with angina (P 0.05). Although the patient population was a highly selective one and the matching categories were relatively broad, these results suggest that the presence of anginal symptoms may be an important independent correlate of prognosis in patients with coronary artery disease. The absence of angina did not preclude the presence of multivessel disease and did not necessarily imply a benign prognosis, because the yearly mortality rate was nearly 5 percent in the subgroup of asymptomatic patients with three vessel disease.