Clinical InvestigationAcute Ischemic Heart DiseaseAngina with “normal” coronary arteries: Sex differences in outcomes
Section snippets
Population
All patients presenting for cardiac catheterization in the province of British Columbia (BC), Canada, between July 1, 1999, and December 31, 2002, were eligible for the study. The study cohort was identified from the BC Cardiac Registry (BCCR), which prospectively captures information on all cardiac catheterization procedures performed in BC. All procedures are performed at one of 6 centers. Dedicated personnel enter detailed demographic, procedural, and clinical information on each patient
Results
We identified 32 856 patients who underwent an index, or first, coronary angiography for stable coronary disease or ACS. Among men, 7.1% had angiographically normal coronaries compared to 23.3% of women (P < .001). The final study cohort comprised 3647 patients (11.1% of total angiograms for these indications). Angiographically normal patients were more likely to present for catheterization with stable angina (56.7%) than patients with visible epicardial disease (38.7%) (P < .001). This pattern
Discussion
Just over 11% of patients presenting for their first cardiac catheterization, with ACS or stable angina, had angiographically normal coronaries in this population-based cohort. Women were 3 times more likely to be categorized as angiographically normal compared to men. Importantly, even after adjustment for differences in baseline characteristics, women were >4 times more likely than men to be readmitted to hospital for ACS or chest pain requiring cardiac catheterization within 180 days. We
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Dr Humphries is a Research Scholar funded by the Michael Smith Foundation and the Canadian Institutes of Health Research.
Dr Pilote is a Research Scholar funded by the Canadian Institutes of Health Research and the William Dawson Professor of Medicine at McGill University.