Early coronary angiography improves long-term survival in unstable angina

Verghese Mathew, Michael E. Farkouh, Bernard J. Gersh, Charanjit S. Rihal, Guy S. Reeder, Diane E. Grill, Lynn H. Urban, Stephen L. Kopecky, James H. Chesebro, David R. Holmes

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Background: The role of early coronary angiography in the evaluation of patients with unstable angina has been controversial. This study was designed to determine the effect of early coronary angiography on long-term survival in patients with unstable angina. Methods: We reviewed the Olmsted County Acute Chest Pain Database, a population-based epidemiologic registry that includes all patients residing within Olmsted County who were seen for emergency department evaluation of acute chest pain from 1985 to 1992. Patients with symptoms consistent with myocardial ischemia qualifying as unstable angina were classified as undergoing early (≤7 days of index presentation) angiography or not. Results: A total of 2264 patients with symptoms consistent with unstable angina were identified with a mean duration of follow-up of 6 years; 892 underwent early angiography. Early angiography patients were younger; less likely to have heart failure; more likely to be male, hypercholesterolemic, and smokers; had prior coronary revascularization; and had a myocardial infarction at the index presentation. After baseline differences were controlled, early angiography was associated with a reduction in all-cause long-term mortality (relative risk 0.63, 95% Cl 0.53-0.74). Patients at intermediate or high risk for death or myocardial infarction at presentation were most likely to benefit from early angiography. Conclusion: Early angiography in the evaluation of patients with unstable angina was associated with a reduction in all-cause mortality, particularly in intermediate- and high-risk patients, in this retrospective population-based study.

Original languageEnglish (US)
Pages (from-to)768-774
Number of pages7
JournalAmerican Heart Journal
Volume142
Issue number5
DOIs
StatePublished - Jan 1 2001

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Early coronary angiography improves long-term survival in unstable angina'. Together they form a unique fingerprint.

  • Cite this

    Mathew, V., Farkouh, M. E., Gersh, B. J., Rihal, C. S., Reeder, G. S., Grill, D. E., Urban, L. H., Kopecky, S. L., Chesebro, J. H., & Holmes, D. R. (2001). Early coronary angiography improves long-term survival in unstable angina. American Heart Journal, 142(5), 768-774. https://doi.org/10.1067/mhj.2001.119126