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Type: Journal article
Title: Natural history of patients with insignificant coronary artery disease
Author: Tavella, R.
Cutri, N.
Tucker, G.
Adams, R.
Spertus, J.
Beltrame, J.F.
Citation: European Heart Journal - Quality of Care and Clinical Outcomes, 2016; 2(2):117-124
Publisher: Oxford University Press
Issue Date: 2016
ISSN: 2058-5225
Statement of
Rosanna Tavella, Natalie Cutri, Graeme Tucker, Robert Adams, John Spertus and John F. Beltrame
Abstract: Aims: Approximately 30% of patients undergoing coronary angiography for chest pain have insignificant coronary artery disease (ICAD). The subsequent health status of these patients is largely unknown. The current study was a cross-sectional, longitudinal comparison of health status outcomes 12 months following angiography, in a cohort of patients with stable chest pain and ICAD to: (i) patients with significant coronary artery disease (CAD) and (ii) a healthy control cohort. Methods and Results: Patients undergoing elective angiography for chest pain were recruited and classified as CAD (coronary stenosis ≥50%) or ICAD. Clinical and health-related quality-of-life (HRQoL) data were collected at baseline, 1, 6, and 12 months following angiography. The 12-month health status was cross-sectionally compared with a healthy control group recruited from the same geographic zone. Among 758 patients undergoing coronary angiography, 253 (33%) had ICAD. Insignificant coronary artery disease patients were younger, more often female, and had less cardiac risk factors than CAD patients. At 12 months, 48% of ICAD and 59% of CAD patients were chest pain-free, and both groups had similar Short-Form 36 Physical Component Summary (PCS) scores (41 ± 11 vs. 41 ± 11 for ICAD and CAD patients, respectively, P > 0.05). However, at 12 months, both the ICAD and CAD patients had significantly lower PCS scores compared with healthy controls (41 ± 11 vs. 49 ± 11, P < 0.05 for both CAD and ICAD). Conclusion: Although ICAD patients are frequently considered 'normal' from a cardiac perspective, they often have residual chest pain and impaired HRQoL at 12 months. Novel strategies are needed to manage ICAD patients to improve health outcomes.
Keywords: Insignificant coronary artery disease; stable angina; angiography; health status; health outcomes; quality of life
Rights: Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email:
DOI: 10.1093/ehjqcco/qcv034
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