title: Association of chest pain versus dyspnea as presenting symptom for coronary angiography with demographics, coronary anatomy, and 2-year mortality.
abstract: BACKGROUND
  The association of chest pain versus dyspnea with demographics, coronary angiographic findings, and outcomes of patients undergoing coronary angiography is unknown.
  
  
  METHODS
  We studied 1,053 patients who had coronary angiography to investigate the association of chest pain versus dyspnea with demographics, coronary angiographic findings, and outcomes.
  
  
  RESULTS
  Of 1,053 patients, 654 (62%) had chest pain, 229 (22%) had dyspnea, and 117 (11%) had chest pain and dyspnea. Patients with dyspnea were older (p < 0.0001) and had higher serum creatinine (p = 0.0011), lower left ventricular ejection fraction (LVEF) (p < 0.0001), more cardiogenic shock (p = 0.0004), less obstructive coronary artery disease (CAD) (p < 0.0001), less percutaneous coronary intervention (p < 0.0001), and similar 2-year mortality. Stepwise Cox regression analysis showed no significant difference in mortality between chest pain and dyspnea. Significant risk factors for time to death were age (hazard ratio (HR) = 1.07, p < 0.0001), serum creatinine (HR = 1.5, p < 0.0001), body mass index (HR = 0.93, p = 0.005), and obstructive CAD graft (HR = 3.2, p = 0.011).
  
  
  CONCLUSIONS
  Patients undergoing coronary angiography presenting with dyspnea were older and had higher serum creatinine, lower LVEF, more frequent cardiogenic shock, less obstructive CAD, and less percutaneous coronary intervention compared to patients presenting with chest pain but similar 2-year mortality.
authors.affiliation: Cardiology Division, Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Paudel
authors.affiliation: Cardiology Division, Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
authors.forename: Natalia
authors.initials: N
authors.lastname: Beridze
authors.affiliation: Cardiology Division, Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
authors.forename: Wilbert S
authors.initials: WS
authors.lastname: Aronow
authors.affiliation: Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Chul
authors.initials: C
authors.lastname: Ahn
authors.affiliation: Cardiology Division, Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
authors.forename: Abdallah
authors.initials: A
authors.lastname: Sanaani
authors.affiliation: Cardiology Division, Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
authors.forename: Pallak
authors.initials: P
authors.lastname: Agarwal
authors.affiliation: Cardiology Division, Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
authors.forename: Kim
authors.initials: K
authors.lastname: Farell
authors.affiliation: Cardiology Division, Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
authors.forename: Diwakar
authors.initials: D
authors.lastname: Jain
authors.affiliation: Cardiology Division, Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Timmermans
authors.affiliation: Cardiology Division, Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
authors.forename: Howard A
authors.initials: HA
authors.lastname: Cooper
authors.affiliation: Cardiology Division, Department of Medicine, Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
authors.forename: Julio A
authors.initials: JA
authors.lastname: Panza
keywords: chest pain; coronary angiography; dyspnea