Diagnostic utility of chest pain characteristics in discriminating obstructive coronary artery disease: A 'Historic' Dilemma
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Tarih
2019
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Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Chest pain (CP) is the major presenting symptom of coronary artery disease (CAD) wherein history remains to be a fundamental and challenging diagnostic step. Despite the clarity of ‘typical’ CP characteristics in guidelines; interpretation and description of CP by patients are open to wide variations. The aim of this study was to define the components of CP that most closely associate to presence of obstructive CAD and determine the influence of gender on CP features. Herein, consecutive patients with suspected stable CAD who were scheduled for a coronary angiography(CAG) were prospectively enrolled. The data on demographic and pain characteristics were collected by a questionnaire. Patients were categorized into ‘CAD’ and ‘Normal’ groups with respect to presence of obstructive CAD in CAG. Among 402 patients, 86 had chest discomfort or equivalent symptoms but denied ‘CP’. Patients with CAD were more commonly male; with older age, lower BMI, more frequent prior revascularization, clopidogrel use, higher creatinine and lower HDL levels. When classical features of CP such as quality; location, duration, relationship to exertion were compared; stabbing/sharp pain, CP related to cold or emotional stress and CP that radiates to back were significant factors against CAD; while absence of precipitating factors was related to CAD. Yet, none of the features of typical angina pectoris were significantly related to presence of CAD. Determinants of CAD were; prior revascularization (OR= 22.7, p=0.021), body mass index (OR=1.4, p=0.007), clopidogrel use(OR=55.5, p=0.018) and blood glucose (OR=1.02, p=0.046) in women; and age (OR=1.2, p=0.029) was the single predictor of CAD in men. This study demonstrated no association between classical features of typical CP and presence of CAD in patients with stable angina pectoris. Clinical factors that influenced presence of CAD in different genders were also different.
Açıklama
Anahtar Kelimeler
Biyoloji, Alerji, Anatomi ve Morfoloji, Androloji, Anestezi, Odyoloji ve Konuşma-Dil Patolojisi, Biyokimya ve Moleküler Biyoloji, Biyofizik, Biyoteknoloji ve Uygulamalı Mikrobiyoloji, Kalp ve Kalp Damar Sistemi, Hücre Biyolojisi, Klinik Nöroloji, Yoğun Bakım, Tıp, Dermatoloji, Acil Tıp, Endokrinoloji ve Metabolizma, Gastroenteroloji ve Hepatoloji, Geriatri ve Gerontoloji, Sağlık Bilimleri ve Hizmetleri, Hematoloji, İmmünoloji, Enfeksiyon Hastalıkları, Tamamlayıcı ve Entegre Tıp, Tıbbi Etik, Tıbbi İnformatik, Tıbbi Laboratuar Teknolojisi, Genel ve Dahili Tıp, Adli Tıp, Tıbbi Araştırmalar Deneysel, Mikrobiyoloji, Nörolojik Bilimler, Kadın Hastalıkları ve Doğum, Onkoloji, Göz Hastalıkları, Ortopedi, Kulak, Burun, Boğaz, Patoloji, Pediatri, Periferik Damar Hastalıkları, Fizyoloji, Temel Sağlık Hizmetleri, Psikiyatri, Halk ve Çevre Sağlığı, Radyoloji, Nükleer Tıp, Tıbbi Görüntüleme, Rehabilitasyon, Solunum Sistemi, Romatoloji, Spor Bilimleri, Cerrahi, Transplantasyon, Tropik Tıp, Üroloji ve Nefroloji
Kaynak
Medicine Science
WoS Q Değeri
Scopus Q Değeri
Cilt
8
Sayı
1
