Yield of elective coronary angiography; gender differences, patient history, risk factors and angiographic findings in a primary care population

Abstract

Objective To assess yield of elective coronary angiography and gender differences in primary care patients suspected to have stable coronary artery disease (SCAD). Design Information was gathered from an angiography registry, referral texts of the general practitioners and medical records made by the cardiologists in secondary care. Setting Angiography registry data analyses of the Turku University Hospital, Finland, in the year 2011. Subjects Two hundred forty-six patients who were referred from primary care to secondary care and underwent coronary angiography for suspected SCAD symptoms. Main outcome measures Gender differences and diagnostic yield of coronary angiography for obstructive CAD. Results Obstructive CAD was identified in 73%, more often in males than in females (51% vs. 84%, p < 0.001). Thirteen per cent of the patients were over 80 years of age, and 94% of them had obstructive CAD. The prevalence of hypertension was 60%, treatment goal was achieved by 25%. Conclusion The diagnostic yield of elective coronary angiography was low in women compared to men although there were no substantial differences in evidence-based medication, risk factors or anticipated angina symptoms between genders.Key Points Coronary artery disease (CAD) is the leading cause of death globally. Invasive cardiology has expanded rapidly since the 1990s. Among symptomatic primary care patients who underwent elective coronary angiography in secondary care, obstructive CAD was identified in 73% Diagnostic yield of coronary angiography was low in women compared to men. GPs treat their male and female patients suspected of having stable CAD equitably regarding evidence-based medication.

Keywords

• coronary artery disease
• elective coronary angiography
• stable coronary artery disease symptoms
• primary care
• pre-test probability