Is There an Indication for Coronary Angiography in Patients Under 60 Years of Age with No or Minimal Angina Pectoris After a First Myocardial Infarction?

Overview

Journal Br Heart J

Specialty Cardiology & Vascular Diseases

Date 1985 Jan 1

PMID 3966949

Citations 6

Authors

T W Veenbrink

T van der Werf

P W Westerhof

E O Robles De Medina

F L Meijler

Affiliations

Soon will be listed here.

Abstract

Coronary angiography and exercise stress tests were performed in 91 consecutive patients under 60 years of age having either no or only mild angina pectoris with or without medication after a first myocardial infarction. Nine (10%) patients had angiographic high risk coronary artery disease defined as three vessel disease, left main stenosis, or proximal stenosis of the left anterior descending artery. Eighteen patients had a positive electrocardiographic exercise stress test including eight of the nine patients with angiographic high risk coronary artery disease. It may be concluded therefore that coronary angiography to detect high risk coronary artery disease in this group can be restricted to patients with a positive exercise stress test. This policy would obviate the need for about 80% of coronary angiograms performed in this age group.

Citing Articles

Association between fibrinogen level and the severity of coronary stenosis in 418 male patients with myocardial infarction younger than 35 years old.

Gao X, Zhou B, Zhang M, Zhao X, Qing P, Zhu C Oncotarget. 2017; 8(46):81361-81368.

PMID: 29113395 PMC: 5655290. DOI: 10.18632/oncotarget.18578.

First myocardial infarction in patients under 60 years old: the role of exercise tests and symptoms in deciding whom to catheterise.

Cross S, Lee H, Kenmure A, Walton S, Jennings K Br Heart J. 1993; 70(5):428-32.

PMID: 8260273 PMC: 1025354. DOI: 10.1136/hrt.70.5.428.

Post-infarction exercise testing in patients under 55 years. Relation between ischaemic abnormalities and the extent of coronary artery disease.

Peart I, Seth L, Albers C, Odemuyiwa O, Hall R Br Heart J. 1986; 55(1):67-74.

PMID: 3947484 PMC: 1232070. DOI: 10.1136/hrt.55.1.67.

Coronary thrombolysis.

de Bono D Br Heart J. 1987; 57(4):301-5.

PMID: 3555565 PMC: 1277167. DOI: 10.1136/hrt.57.4.301.

Does beta adrenergic blockade influence the prognostic implications of post-myocardial infarction exercise testing?.

Murray D, Tan L, Salih M, Weissberg P, Murray R, Littler W Br Heart J. 1988; 60(6):474-9.

PMID: 2906251 PMC: 1224886. DOI: 10.1136/hrt.60.6.474.

References

MASTER A, GELLER A . The extent of completely asymptomatic coronary artery disease. Am J Cardiol. 1969; 23(2):173-9. DOI: 10.1016/0002-9149(69)90064-2. View

Martin C, McConahay D . Maximal treadmill exercise electrocardiography. Correlations with coronary arteriography and cardiac hemodynamics. Circulation. 1972; 46(5):956-62. DOI: 10.1161/01.cir.46.5.956. View

Froelicher Jr V, Yanowitz F, Thompson A, Lancaster M . The correlation of coronary angiography and the electrocardiographic response to maximal treadmill testing in 76 asymptomatic men. Circulation. 1973; 48(3):597-604. DOI: 10.1161/01.cir.48.3.597. View

Piessens J, Van Mieghem W, Kesteloot H, De Geest H . Diagnostic value of clinical history, exercise testing and atrial pacing in patients with chest pain. Am J Cardiol. 1974; 33(3):351-6. DOI: 10.1016/0002-9149(74)90315-4. View

SHELDON W, Rincon G, Pichard A, Razavi M, Cheanvechai C, Loop F . Surgical treatment of coronary artery disease: pure graft operations, with a study of 741 patients followed 3--7 yr. Prog Cardiovasc Dis. 1975; 18(3):237-53. DOI: 10.1016/0033-0620(75)90013-4. View

Bourassa M, Noble J . Complication rate of coronary arteriography. A review of 5250 cases studied by a percutaneous femoral technique. Circulation. 1976; 53(1):106-14. DOI: 10.1161/01.cir.53.1.106. View

Stuart R, ELLESTAD M . Upsloping S-T segments in exercise stress testing. Six year follow-up study of 438 patients and correlation with 248 angiograms. Am J Cardiol. 1976; 37(1):19-22. DOI: 10.1016/0002-9149(76)90493-8. View

Brown B, Bolson E, Frimer M, DODGE H . Quantitative coronary arteriography: estimation of dimensions, hemodynamic resistance, and atheroma mass of coronary artery lesions using the arteriogram and digital computation. Circulation. 1977; 55(2):329-37. DOI: 10.1161/01.cir.55.2.329. View

Miller R, DeMaria A, Vismara L, Salel A, Maxwell K, Armsterdam E . Chronic stable inferior myocardial infarction: unsuspected harbinger of high-risk proximal left coronary arterial obstruction amenable to surgical revascularization. Am J Cardiol. 1977; 39(7):954-60. DOI: 10.1016/s0002-9149(77)80207-5. View

10.

Chaitman B, Waters D, Corbara F, Bourassa M . Prediction of multivessel disease after inferior myocardial infarction. Circulation. 1978; 57(6):1085-90. DOI: 10.1161/01.cir.57.6.1085. View

11.

Castellanet M, Greenberg P, ELLESTAD M . Comparison of S-T segment changes on exercise testing with angiographic findings in patients with prior myocardial infarction. Am J Cardiol. 1978; 42(1):29-35. DOI: 10.1016/0002-9149(78)90980-3. View

12.

Paine T, Dye L, Roitman D, Sheffield L, Rackley C, Russell Jr R . Relation of graded exercise test findings after myocardial infarction to extent of coronary artery disease and left ventricular dysfunction. Am J Cardiol. 1978; 42(5):716-23. DOI: 10.1016/0002-9149(78)90089-9. View

13.

Davis K, Kennedy J, Kemp Jr H, JUDKINS M, GOSSELIN A, Killip T . Complications of coronary arteriography from the Collaborative Study of Coronary Artery Surgery (CASS). Circulation. 1979; 59(6):1105-12. DOI: 10.1161/01.cir.59.6.1105. View

14.

Gerson M, Phillips J, Morris S, MCHENRY P . Exercise-induced U-wave inversion as a marker of stenosis of the left anterior descending coronary artery. Circulation. 1979; 60(5):1014-20. DOI: 10.1161/01.cir.60.5.1014. View

15.

Rahimtoola S . Coronary arteriography in asymptomatic patients after myocardial infarction. The need to distinguish between clinical investigation and clinical care. Chest. 1980; 77(1):53-7. DOI: 10.1378/chest.77.1.53. View

16.

Turner J, Rogers W, MANTLE J, Rackley C, Russell Jr R . Coronary angiography soon after myocardial infarction. Chest. 1980; 77(1):58-64. DOI: 10.1378/chest.77.1.58. View

17.

Rijneke R, Ascoop C, Talmon J . Clinical significance of upsloping ST segments in exercise electrocardiography. Circulation. 1980; 61(4):671-8. DOI: 10.1161/01.cir.61.4.671. View

18.

Lahiri A, Balasubramanian V, Millar Craig M, Crawley J, Raftery E . Exercise-induced ST segment elevation. Electrocardiographic, angiographic, and scintigraphic evaluation. Br Heart J. 1980; 43(5):582-8. PMC: 482345. DOI: 10.1136/hrt.43.5.582. View

19.

Weiner D, McCabe C, Ryan T . Identification of patients with left main and three vessel coronary disease with clinical and exercise test variables. Am J Cardiol. 1980; 46(1):21-7. DOI: 10.1016/0002-9149(80)90600-1. View

20.

Hammermeister K, DeRouen T, DODGE H . Effect of coronary surgery on survival in asymptomatic and minimally symptomatic patients. Circulation. 1980; 62(2 Pt 2):I98-102. View