title: Usefulness of a normal coronary angiogram in patients aged ≥65 years to foretell survival.
abstract: A normal coronary angiogram (CA) has been reported to confer a good prognosis. However, how this applies to patients aged ≥65 years is not well known. From 1986 to 1996, 11,625 patients aged ≥65 underwent coronary angiography. We identified 271 patients with either normal (NORM, n = 160) CA or <30% diameter stenosis disease (NEAR-NORM, n = 111). Using the Myocardial Infarction Data Acquisition System, we examined the probability of survival and the risk of developing an ischemic event or undergoing a revascularization procedure during an average of 15.1 ± 6.2 years (range 0.5 to 25.8 years). Matched actuarial subjects were used to compare survival to the general population. The incidence of an ischemic event was low (2.0 events per 100 persons/year for the NORM and 2.8 patients per 100 persons/year for the NEAR-NORM group, p = NS). Rates of revascularization were higher in the NEAR-NORM group compared to the NORM group (1 per 100 persons/year vs 0.5 per 100 persons/year, p = 0.04). During the 25.8-year follow-up, there were 77 deaths (48.4%) for the NORM and 64 (57.1%) for the NEAR-NORM group (χ2 = 1.7, NS). The NORM group survived 6,789 days, 1,517 more days than the actuarial subjects (95% confidence interval [CI] 1,072 to 1,956; p <0.0001) and the NEAR-NORM group survived 5,922 days, 875 more days (95% CI 368 to 1,376; p <0.005). In conclusion, patients with normal or near-normal CA at age ≥65 years have a low rate of myocardial ischemic events and have significantly longer survival than matched subjects from the general population.
authors.affiliation: Cardiovascular Institute, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey. Electronic address: moreyrae@rwjms.rutgers.edu.
authors.forename: Abel E
authors.initials: AE
authors.lastname: Moreyra
authors.affiliation: Saint Peter's University Hospital, New Brunswick, New Jersey.
authors.forename: Marinos
authors.initials: M
authors.lastname: Charalambous
authors.affiliation: Cardiovascular Institute, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.
authors.forename: Nora M
authors.initials: NM
authors.lastname: Cosgrove
authors.affiliation: Cardiovascular Institute, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.
authors.forename: Sheeva
authors.initials: S
authors.lastname: Rajaei
authors.affiliation: Cardiovascular Institute, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Cullen
authors.affiliation: Cardiovascular Institute, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.
authors.forename: Jerry Q
authors.initials: JQ
authors.lastname: Cheng
authors.affiliation: Cardiovascular Institute, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.
authors.forename: Alice
authors.initials: A
authors.lastname: David
authors.affiliation: Cardiovascular Institute, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.
authors.forename: William J
authors.initials: WJ
authors.lastname: Kostis
authors.affiliation: Cardiovascular Institute, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.
authors.forename: John B
authors.initials: JB
authors.lastname: Kostis
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006801:Humans; D015994:Incidence; D008297:Male; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000453:epidemiology; D009515:New Jersey / Q000453:epidemiology; D012016:Reference Values; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends