Diagnostic utility of chest pain characteristics in discriminating obstructive coronary artery disease: A Historic Dilemma
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....
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| Format: | Article |
| Language: | English |
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Society of Turaz Bilim
2019-03-01
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| Series: | Medicine Science |
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| Online Access: | http://www.ejmanager.com/fulltextpdf.php?mno=2438 |
| _version_ | 1797327688855191552 |
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| author | Demet Ozkaramanli Gur |
| author_facet | Demet Ozkaramanli Gur |
| author_sort | Demet Ozkaramanli Gur |
| collection | DOAJ |
| description | 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. [Med-Science 2019; 8(1.000): 88-92] |
| first_indexed | 2024-03-08T06:42:06Z |
| format | Article |
| id | doaj.art-4bd7f0b839204790888f4f34f7de8692 |
| institution | Directory Open Access Journal |
| issn | 2147-0634 |
| language | English |
| last_indexed | 2024-03-08T06:42:06Z |
| publishDate | 2019-03-01 |
| publisher | Society of Turaz Bilim |
| record_format | Article |
| series | Medicine Science |
| spelling | doaj.art-4bd7f0b839204790888f4f34f7de86922024-02-03T08:36:58ZengSociety of Turaz BilimMedicine Science2147-06342019-03-0181889210.5455/medscience.2018.07.88822438Diagnostic utility of chest pain characteristics in discriminating obstructive coronary artery disease: A Historic DilemmaDemet Ozkaramanli Gur0Namik Kemal University Research and Education Hospital, Department of Cardiology, Tekirdag, TurkeyChest 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. [Med-Science 2019; 8(1.000): 88-92]http://www.ejmanager.com/fulltextpdf.php?mno=2438Chest paintypical angina pectoriscoronary artery disease |
| spellingShingle | Demet Ozkaramanli Gur Diagnostic utility of chest pain characteristics in discriminating obstructive coronary artery disease: A Historic Dilemma Medicine Science Chest pain typical angina pectoris coronary artery disease |
| title | Diagnostic utility of chest pain characteristics in discriminating obstructive coronary artery disease: A Historic Dilemma |
| title_full | Diagnostic utility of chest pain characteristics in discriminating obstructive coronary artery disease: A Historic Dilemma |
| title_fullStr | Diagnostic utility of chest pain characteristics in discriminating obstructive coronary artery disease: A Historic Dilemma |
| title_full_unstemmed | Diagnostic utility of chest pain characteristics in discriminating obstructive coronary artery disease: A Historic Dilemma |
| title_short | Diagnostic utility of chest pain characteristics in discriminating obstructive coronary artery disease: A Historic Dilemma |
| title_sort | diagnostic utility of chest pain characteristics in discriminating obstructive coronary artery disease a historic dilemma |
| topic | Chest pain typical angina pectoris coronary artery disease |
| url | http://www.ejmanager.com/fulltextpdf.php?mno=2438 |
| work_keys_str_mv | AT demetozkaramanligur diagnosticutilityofchestpaincharacteristicsindiscriminatingobstructivecoronaryarterydiseaseahistoricdilemma |