One-year clinical outcome after emergency hospitalisation for suspected acute coronary syndrome -- a comparative analysis with respect to angiographic findings.
BACKGROUND
Among patients with suspected acute coronary syndromes (ACS) referred for urgent coronary angiography there are some with normal angiograms.


OBJECTIVE
To compare, with respect to angiographic findings, one-year clinical outcomes in patients hospitalised for suspected ACS.


METHODS
Between January 2001 and December 2003 emergency angiography was performed in 1169 patients. It revealed no significant coronary lesions in 97 (8.3%) cases, of these 40 being women and 57 men with a mean age of 55+/-15 yrs (Group 1). Sixty consecutive patients with ACS (20 women and 40 men with a mean age of 54+/-9 yrs) and significant coronary artery disease (CAD) confirmed by angiography were the study controls (Group 2). Demographic data, CAD risk factors, angiographic findings, ECG and echocardiographic data as well as laboratory test results were analysed. In a long-term follow-up, the prevalence of recurrent angina and all-cause mortality were assessed.


RESULTS
There were no significant differences in patients' demographics between the two groups with the exception of arterial hypertension, which was more frequent in group 1. In group 1 the diagnosis of ACS was established in 14.5% cases, X syndrome in 14.4%, Prinzmetal angina in 4.1%, myocarditis in 6.1% and pulmonary thromboembolization in 5.1%. A definite diagnosis was not related to the cardiovascular disease in 36%. No complications were observed in the late follow-up of group 1 patients.


CONCLUSIONS
Apparently normal angiograms are relatively common in patients referred for emergency coronary angiography. In patients without significant CAD on their angiograms the clinical outcome is favourable, without major adverse cardiovascular events in the long-term follow-up.
Kulawik
Tomasz
T
Department of Invasive Cardiology, Central Hospital of the Ministery of Internal Affaires and Administration, Warsaw, Poland.
Pawłowski
Tomasz
T
Piasecki
Adam
A
Rdzanek
Hanna
H
Rzezak
Jarosław
J
Gil
Robert J
RJ
D000208:Acute Disease; D000328:Adult; D000787:Angina Pectoris / Q000000981:diagnostic imaging* / Q000453:epidemiology; D002637:Chest Pain / Q000453:epidemiology; D015897:Comorbidity; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013577:Syndrome; D016896:Treatment Outcome