Clinical and detailed angiographic findings in patients with ambulatory electrocardiographic ischemia without critical coronary narrowing: results from the Asymptomatic Cardiac Ischemia Pilot (ACIP) Study
- PMID: 9491946
- PMCID: PMC6656285
- DOI: 10.1002/clc.4960210205
Clinical and detailed angiographic findings in patients with ambulatory electrocardiographic ischemia without critical coronary narrowing: results from the Asymptomatic Cardiac Ischemia Pilot (ACIP) Study
Abstract
Background: Patients with ambulatory electrocardiographic (AECG) ST-segment depression and critical coronary narrowing are known to be at increased risk for adverse outcome, but little is known about patients with AECG ST-segment depression without critical coronary narrowing.
Hypothesis: The objectives of this study were to characterize the coronary angiographic pathology in patients with AECG ST-segment depression but without critical (< 50% diameter stenosis) coronary narrowing and to compare demographic and clinical findings in these patients with those enrolled in the Asymptomatic Cardiac Ischemia Pilot Study with AECG ST-segment depression and critical (> or = 50% diameter stenosis) coronary narrowing.
Methods: Coronary angiograms from patients with AECG ST-segment depression were reviewed in a central laboratory and quantitative measurement of percent stenosis was performed. Clinical and angiographic comparisons were made between patients with and without critical coronary narrowing.
Results: Patients without critical coronary narrowing (n = 64) were younger (p = 0.02), less likely to be male (p < 0.001) or to have risk factors for coronary atherosclerosis or a history of myocardial infarction (p < 0.001), and had fewer ischemic episodes per 24 h on the screening AECG (p = 0.02) than patients with critical coronary narrowing (n = 441). Of patients without critical narrowing, one half had angiographic evidence for coronary artery disease (> or = 20% stenosis) and 60% had an ejection fraction > 70%.
Conclusions: Patients with AECG ST-segment depression without critical coronary narrowing are heterogeneous, with half having measurable coronary artery disease. Demographically and clinically, they appear to be different than patients with AECG ST-segment depression with critical coronary narrowing.
Similar articles
-
A detailed angiographic analysis of patients with ambulatory electrocardiographic ischemia: results from the Asymptomatic Cardiac Ischemia Pilot (ACIP) study angiographic core laboratory.J Am Coll Cardiol. 1997 Jan;29(1):78-84. doi: 10.1016/s0735-1097(96)00444-5. J Am Coll Cardiol. 1997. PMID: 8996298
-
Relation between ambulatory electrocardiographic monitoring and myocardial perfusion imaging to detect coronary artery disease and myocardial ischemia: an ACIP ancillary study. The Asymptomatic Cardiac Ischemia Pilot (ACIP) Investigators.J Am Coll Cardiol. 1997 Mar 15;29(4):764-9. doi: 10.1016/s0735-1097(96)00572-4. J Am Coll Cardiol. 1997. PMID: 9091522
-
Diabetics with coronary disease have a prevalence of asymptomatic ischemia during exercise treadmill testing and ambulatory ischemia monitoring similar to that of nondiabetic patients. An ACIP database study. ACIP Investigators. Asymptomatic Cardiac Ischemia Pilot Investigators.Circulation. 1996 Jun 15;93(12):2097-105. doi: 10.1161/01.cir.93.12.2097. Circulation. 1996. PMID: 8925577 Clinical Trial.
-
Asymptomatic Cardiac Ischemia Pilot (ACIP) Study. Relationship between exercise-induced and ambulatory ischemia in patients with stable coronary disease.Circulation. 1996 Oct 1;94(7):1537-44. doi: 10.1161/01.cir.94.7.1537. Circulation. 1996. PMID: 8840841 Clinical Trial.
-
ST-segment analysis in ambulatory ECG (AECG or Holter) monitoring in patients with coronary artery disease: clinical significance and analytic techniques.Ann Noninvasive Electrocardiol. 2005 Apr;10(2):263-78. doi: 10.1111/j.1542-474X.2005.10203.x. Ann Noninvasive Electrocardiol. 2005. PMID: 15842439 Free PMC article. Review. No abstract available.
References
-
- Gottlieb SO, Weisfeldt ML. Ouyang P, Mellits ED, Gerstenbilth G: Silent ischemia as u marker for early favorable outcomes in patients in unstable angina. N Engl J Med 1986; 314: 1214–1219 - PubMed
-
- Gottlieb SO, Weisfeldt ML, Ouyang P, Mellits ED, Gerstenbilth G: Silent ischemia predicts infarction and death in two years of follow‐up of unstable angina. J Am Coll Cardiol 1987; 10 (1): 756‐760 - PubMed
-
- Nademanee K, Intarachot V, Josephson MA, Rieders D, Mody FV, Singh BN: Prognostic significance of silent myocardial ischemia in patients with unstable angina. J Am Coll Cardiol 1987; 10 (1): 1–9 - PubMed
-
- von Arnim T, Gerbig HW, Krawietz W, Hofling B: Prognostic implications of transient predominantly silent ischemia in patients with unstable angina pectoris. Eur Heart J 1988; 9: 435–440 - PubMed
-
- Langer A, Freeman MR. Armstrong PW: ST‐segment shifts in unstable angina: Pathophysiology in association with coronary anatomy and hospital outcome. J Am Coll Cardiol 1989; 13: 1495–1502 - PubMed
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Medical