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Artigo Acesso aberto Produção Nacional Revisado por pares
BIBTEX RIS

Efficacy of Patient Selection for Diagnostic Coronary Angiography in Suspected Coronary Artery Disease

2015; Sociedade Brasileira de Cardiologia (SBC); Linguagem: Inglês

10.5935/abc.20150099

ISSN

1678-4170

Autores

Francisco Flávio Costa Filho, Áurea J. Chaves, Lourenço Teixeira Ligabó, Eduardo Moreira dos Santos, Danillo Taiguara da Silva, Marcelo Aguiar Puzzi, Sérgio Braga, Alexandre Abizaid, Amanda Gmr Sousa,

Tópico(s)

Coronary Interventions and Diagnostics

Resumo

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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