학술논문
Angina and Non-Obstructive Coronary Artery (ANOCA) Patients with Coronary Vasomotor Disorders.
Document Type
Academic Journal
Author
La S; School of Medicine, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA 5000, Australia.; Central Adelaide Local Health Network, Adelaide, SA 5000, Australia.; Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Adelaide, SA 5011, Australia.; Tavella R; School of Medicine, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA 5000, Australia.; Central Adelaide Local Health Network, Adelaide, SA 5000, Australia.; Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Adelaide, SA 5011, Australia.; Wu J; School of Medicine, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA 5000, Australia.; Pasupathy S; School of Medicine, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA 5000, Australia.; Central Adelaide Local Health Network, Adelaide, SA 5000, Australia.; Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Adelaide, SA 5011, Australia.; Zeitz C; School of Medicine, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA 5000, Australia.; Central Adelaide Local Health Network, Adelaide, SA 5000, Australia.; Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Adelaide, SA 5011, Australia.; Worthley M; School of Medicine, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA 5000, Australia.; Central Adelaide Local Health Network, Adelaide, SA 5000, Australia.; Sinhal A; Southern Adelaide Local Health Network, Adelaide, SA 5042, Australia.; School of Medicine, Faculty of Health Sciences, Flinders University, Adelaide, SA 5042, Australia.; Arstall M; School of Medicine, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA 5000, Australia.; Northern Adelaide Local Health Network, Adelaide, SA 5112, Australia.; Spertus JA; School of Medicine, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA 5000, Australia.; Saint Luke's Mid America Heart Institute, Kansas City, MO 64111, USA.; School of Medicine, Healthcare Institute for Innovations in Quality, The University of Missouri-Kansas City, Kansas City, MO 64110, USA.; Beltrame JF; School of Medicine, Faculty of Health Sciences, The University of Adelaide, Adelaide, SA 5000, Australia.; Central Adelaide Local Health Network, Adelaide, SA 5000, Australia.; Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital, Adelaide, SA 5011, Australia.
Source
Publisher: MDPI AG Country of Publication: Switzerland NLM ID: 101580444 Publication Model: Electronic Cited Medium: Print ISSN: 2075-1729 (Print) Linking ISSN: 20751729 NLM ISO Abbreviation: Life (Basel) Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2075-1729
Abstract
Angina and Non-Obstructive Coronary Artery (ANOCA) patients often lack a clear explanation for their symptoms, and are frequently discharged with the label of "unspecified chest pain", despite the availability of functional coronary angiography (provocative spasm and microvascular function testing) to identify potential underlying coronary vasomotor disorders. This study compared the outcomes of ANOCA patients with a coronary vasomotor disorder diagnosis post elective coronary angiography to patients discharged with unspecified chest pain. Using the CADOSA (Coronary Angiogram Database of South Australia) registry, consecutive symptomatic patients ( n = 7555) from 2012 to 2018 underwent elective angiography; 30% had ANOCA (stenosis <50%). Of this cohort, 9% had documented coronary vasomotor disorders diagnosed, and 91% had unspecified chest pain. Patients with coronary vasomotor disorders were younger and had a similar female prevalence compared with those with unspecified chest pain. New prescriptions of calcium channel blockers and long-acting nitrates were more common for the coronary vasomotor cohort at discharge. In the 3 years following angiography, both groups had similar all-cause mortality rates. However, those with coronary vasomotor disorders had higher rates of emergency department visits for chest pain (39% vs. 15%, p < 0.001) and readmissions for chest pain (30% vs. 10%, p < 0.001) compared with those with unspecified chest pain. This real-world study emphasizes the importance of identifying high-risk ANOCA patients for personalized management to effectively address their symptoms.