Diagnostic utility of chest pain characteristics in discriminating obstructive coronary artery disease: A 'Historic' Dilemma

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dc.contributor.authorÖzkaramanlı Gür, Demet
dc.date.accessioned2022-05-11T14:40:05Z
dc.date.available2022-05-11T14:40:05Z
dc.date.issued2019
dc.departmentFakülteler, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Kardiyoloji Ana Bilim Dalı
dc.description.abstractChest 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.
dc.identifier.doi10.5455/medscience.2018.07.8882
dc.identifier.endpage92
dc.identifier.issn2147-0634
dc.identifier.issn2147-0634
dc.identifier.issue1en_US
dc.identifier.startpage88
dc.identifier.trdizinidTXpBNE16SXdNQT09
dc.identifier.urihttps://doi.org/10.5455/medscience.2018.07.8882
dc.identifier.urihttps://app.trdizin.gov.tr/makale/TXpBNE16SXdNQT09
dc.identifier.urihttps://hdl.handle.net/20.500.11776/8857
dc.identifier.volume8
dc.indekslendigikaynakTR-Dizin
dc.institutionauthorÖzkaramanlı Gür, Demet
dc.language.isoen
dc.relation.ispartofMedicine Science
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectBiyoloji
dc.subjectAlerji
dc.subjectAnatomi ve Morfoloji
dc.subjectAndroloji
dc.subjectAnestezi
dc.subjectOdyoloji ve Konuşma-Dil Patolojisi
dc.subjectBiyokimya ve Moleküler Biyoloji
dc.subjectBiyofizik
dc.subjectBiyoteknoloji ve Uygulamalı Mikrobiyoloji
dc.subjectKalp ve Kalp Damar Sistemi
dc.subjectHücre Biyolojisi
dc.subjectKlinik Nöroloji
dc.subjectYoğun Bakım
dc.subjectTıp
dc.subjectDermatoloji
dc.subjectAcil Tıp
dc.subjectEndokrinoloji ve Metabolizma
dc.subjectGastroenteroloji ve Hepatoloji
dc.subjectGeriatri ve Gerontoloji
dc.subjectSağlık Bilimleri ve Hizmetleri
dc.subjectHematoloji
dc.subjectİmmünoloji
dc.subjectEnfeksiyon Hastalıkları
dc.subjectTamamlayıcı ve Entegre Tıp
dc.subjectTıbbi Etik
dc.subjectTıbbi İnformatik
dc.subjectTıbbi Laboratuar Teknolojisi
dc.subjectGenel ve Dahili Tıp
dc.subjectAdli Tıp
dc.subjectTıbbi Araştırmalar Deneysel
dc.subjectMikrobiyoloji
dc.subjectNörolojik Bilimler
dc.subjectKadın Hastalıkları ve Doğum
dc.subjectOnkoloji
dc.subjectGöz Hastalıkları
dc.subjectOrtopedi
dc.subjectKulak
dc.subjectBurun
dc.subjectBoğaz
dc.subjectPatoloji
dc.subjectPediatri
dc.subjectPeriferik Damar Hastalıkları
dc.subjectFizyoloji
dc.subjectTemel Sağlık Hizmetleri
dc.subjectPsikiyatri
dc.subjectHalk ve Çevre Sağlığı
dc.subjectRadyoloji
dc.subjectNükleer Tıp
dc.subjectTıbbi Görüntüleme
dc.subjectRehabilitasyon
dc.subjectSolunum Sistemi
dc.subjectRomatoloji
dc.subjectSpor Bilimleri
dc.subjectCerrahi
dc.subjectTransplantasyon
dc.subjectTropik Tıp
dc.subjectÜroloji ve Nefroloji
dc.titleDiagnostic utility of chest pain characteristics in discriminating obstructive coronary artery disease: A 'Historic' Dilemma
dc.typeArticle

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