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Efficacy of Patient Selection for Diagnostic Coronary Angiography in Suspected Coronary Artery Disease.
Costa Filho, Francisco Flávio; Chaves, Áurea Jacob; Ligabó, Lourenço Teixeira; Santos, Eduardo Moreira Dos; Silva, Danillo Taiguara da; Puzzi, Marcelo Aguiar; Braga, Sérgio Luiz; Abizaid, Alexandre; Sousa, Amanda Gmr.
Afiliación
  • Costa Filho FF; Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil.
  • Chaves ÁJ; Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil.
  • Ligabó LT; Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil.
  • Santos EM; Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil.
  • Silva DT; Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil.
  • Puzzi MA; Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil.
  • Braga SL; Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil.
  • Abizaid A; Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil.
  • Sousa AG; Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil.
Arq Bras Cardiol ; 105(5): 466-71, 2015 Nov.
Article en En, Pt | MEDLINE | ID: mdl-26312552
BACKGROUND: Guidelines recommend that in suspected stable coronary artery disease (CAD), a clinical (non-invasive) evaluation should be performed before coronary angiography. OBJECTIVE: We assessed the efficacy of patient selection for coronary angiography in suspected stable CAD. METHODS: We prospectively selected consecutive patients without known CAD, referred to a high-volume tertiary center. Demographic characteristics, risk factors, symptoms and non-invasive test results were correlated to the presence of obstructive CAD. We estimated the CAD probability based on available clinical data and the incremental diagnostic value of previous non-invasive tests. RESULTS: A total of 830 patients were included; median age was 61 years, 49.3% were males, 81% had hypertension and 35.5% were diabetics. Non-invasive tests were performed in 64.8% of the patients. At coronary angiography, 23.8% of the patients had obstructive CAD. The independent predictors for obstructive CAD were: male gender (odds ratio [OR], 3.95; confidence interval [CI] 95%, 2.70 - 5.77), age (OR for 5 years increment, 1.15; CI 95%, 1.06 - 1.26), diabetes (OR, 2.01; CI 95%, 1.40 - 2.90), dyslipidemia (OR, 2.02; CI 95%, 1.32 - 3.07), typical angina (OR, 2.92; CI 95%, 1.77 - 4.83) and previous non-invasive test (OR 1.54; CI 95% 1.05 - 2.27). CONCLUSIONS: In this study, less than a quarter of the patients referred for coronary angiography with suspected CAD had the diagnosis confirmed. A better clinical and non-invasive assessment is necessary, to improve the efficacy of patient selection for coronary angiography.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Angiografía Coronaria / Selección de Paciente Tipo de estudio: Diagnostic_studies / Evaluation_studies / Guideline / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En / Pt Revista: Arq Bras Cardiol Año: 2015 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Brasil
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Enfermedad de la Arteria Coronaria / Angiografía Coronaria / Selección de Paciente Tipo de estudio: Diagnostic_studies / Evaluation_studies / Guideline / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En / Pt Revista: Arq Bras Cardiol Año: 2015 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Brasil