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Repeat coronary angiography in patients with chest pain and previously normal coronary angiogram
W R Pitts1, R A Lange, J E Cigarroa
1Department of Internal Medicine, University of Texas Southwestern Medical Center, and Parkland Memorial Hospital, Dallas 75235, USA.
Insights
Patients with normal coronary angiograms experience excellent long-term survival. Repeat angiography showed minimal development of coronary artery disease, indicating a low risk of future cardiovascular events.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Diagnostic Imaging
Background:
- Chest pain is a common symptom prompting coronary angiography.
- Normal coronary angiograms in patients with chest pain suggest alternative diagnoses.
- Long-term prognosis for this patient group requires further elucidation.
Purpose of the Study:
- To assess the long-term risk of developing clinically significant atherosclerotic coronary artery disease in patients initially presenting with normal coronary angiograms.
- To evaluate the incidence of new coronary artery disease and adverse cardiovascular events in this cohort over time.
Main Methods:
- Retrospective analysis of patients who underwent initial coronary angiography.
- Follow-up coronary angiography performed on average 9 years after the initial procedure in a subset of patients.
- Assessment of clinical outcomes including myocardial infarction.
Main Results:
- Excellent long-term survival observed in patients with normal initial coronary angiograms.
- Out of 17 patients with repeat angiography, 15 showed no coronary artery disease.
- Two patients developed single-vessel coronary artery disease, with one experiencing a myocardial infarction.
Conclusions:
- Patients with normal coronary angiograms have a favorable long-term prognosis.
- Clinically significant atherosclerotic coronary artery disease is unlikely to develop over the ensuing years.
- The risk of major adverse cardiovascular events remains low in this population.
Abstract:
Patients with chest pain and normal coronary angiograms have excellent long-term survival and are unlikely over the ensuing years to develop clinically significant atherosclerotic coronary artery disease. Specifically, of the 17 subjects with a previously normal coronary angiogram who had repeat angiography an average of almost 9 years later, 15 showed no appearance of coronary artery disease and 2 developed single-vessel coronary artery disease, 1 of whom had a myocardial infarction.