Analysis of the effectiveness of selection of women for coronarography in real clinical practice

Abstract

Objective: evaluation of the effectiveness of selection for coronary angiography of women who have applied to a cardiologist for thoracalgia and dorsalgia and regarded primarily as having a clinic of stable angina.Materials and methods. 108 women (median age 59.5) applying to cardiologist due to chest pain were included in a cross-sectional study and underwent coronary angiography. Subjects with identified clinically significant atherosclerotic coronary lesions were compared to persons with intact coronary arteries.Results. One-, two- and three-vessel lesions were diagnosed in accordingly 16; 21 and 26 % of patients. Intact coronary arteries were detected in 37 % subjects. In 17 of 40 persons with intact structure of the coronary arteries spasm of the coronary arteries was diagnosed. Odds ratio for atherosclerotic coronary arteries lesions in type 2 diabetic persons were 7.91 (1.74–36.00), for hypertension odds ratio 4.79 (1.52–15.01). Severe angina (3 and 4 functional class) was significantly more often diagnosed in women with identified coronary atherosclerosis. Severe coronary atherosclerosis was associated with absence of negative or doubtful results, whereas intact coronary vessels, negative and questionable results revealed more than half of the women. The obtained data reflect the relevance of the development of more effective algorithms for diagnosis of coronary artery disease in women, since the gender peculiarities of the formation of coronary atherosclerosis have been clearly confirmed in a number of large studies.Conclusion. Medical history, physical load tests results, and subject’s emotional status should be evaluated to assess the feasibility of coronary angiography.