To what degree is amelioration of angina following coronary revascularization associated with improvement in myocardial perfusion?
OBJECTIVE
To examine the association between changes in chest pain and changes in perfusion following revascularization as assessed by clinical evaluation and myocardial perfusion imaging (MPI) in patients with stable angina.


METHODS
In a prospective series of 380 patients (58.8 +/- 8.8 years) referred to angiography because of known or suspected stable angina, changes in chest discomfort and changes in perfusion after 2 years were assessed in 144 patients, who underwent revascularization, and 236, who did not. The decision to treat invasively was made without knowledge of the result of MPI.


RESULTS
In revascularized patients, the presence of typical/atypical angina was reduced from 93% to 36% and the improvement was associated with improvement in perfusion. A small improvement in perfusion induced a high frequency of change from angina to no pain, whereas a further reduction caused little extra change. In non-revascularized patients the change in chest discomfort was not related to changes in perfusion, which were rarely present.


CONCLUSIONS
Alleviation of chest discomfort 2 years after revascularization is associated with improvements in perfusion. This association appeared to be an all-or-nothing phenomenon. Non-revascularized patients also exhibited improvements in chest discomfort despite insignificant changes in perfusion.
Johansen
Allan
A
Department of Nuclear Medicine, Odense University Hospital, Odense, Denmark. allan.johansen@dadlnet.dk
Høilund-Carlsen
Poul F
PF
Vach
Werner
W
Christensen
Henrik W
HW
Møldrup
Mette
M
Haghfelt
Torben
T
D000368:Aged; D000787:Angina Pectoris / Q000628:therapy*; D000792:Angiography / Q000379:methods; D002637:Chest Pain; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000379:methods*; D009206:Myocardium / Q000473:pathology*; D010477:Perfusion; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome