Analysis of the effectiveness of selection of women for coronarography in real clinical practice-Reference-Cited by-同舟云学术

Analysis of the effectiveness of selection of women for coronarography in real clinical practice

Published:2019-08-25 Issue:1-2 Volume:13 Page:34-40
ISSN:2412-8775
Container-title:The Clinician
language:
Short-container-title:Klinicist

Author:

Izmozherova N. V.¹^ORCID,Popov A. A.¹^ORCID,Sherstobitov V. E.²^ORCID

Affiliation:

1. Ural State Medical University, Ministry of Health of Russia

2. Sverdlovsk Regional Clinical Hospital No. 1

Abstract

Objective: evaluation of the effectiveness of selection for coronary angiography of women who have applied to a cardiologist for thoracalgia and dorsalgia and regarded primarily as having a clinic of stable angina.Materials and methods. 108 women (median age 59.5) applying to cardiologist due to chest pain were included in a cross-sectional study and underwent coronary angiography. Subjects with identified clinically significant atherosclerotic coronary lesions were compared to persons with intact coronary arteries.Results. One-, two- and three-vessel lesions were diagnosed in accordingly 16; 21 and 26 % of patients. Intact coronary arteries were detected in 37 % subjects. In 17 of 40 persons with intact structure of the coronary arteries spasm of the coronary arteries was diagnosed. Odds ratio for atherosclerotic coronary arteries lesions in type 2 diabetic persons were 7.91 (1.74–36.00), for hypertension odds ratio 4.79 (1.52–15.01). Severe angina (3 and 4 functional class) was significantly more often diagnosed in women with identified coronary atherosclerosis. Severe coronary atherosclerosis was associated with absence of negative or doubtful results, whereas intact coronary vessels, negative and questionable results revealed more than half of the women. The obtained data reflect the relevance of the development of more effective algorithms for diagnosis of coronary artery disease in women, since the gender peculiarities of the formation of coronary atherosclerosis have been clearly confirmed in a number of large studies.Conclusion. Medical history, physical load tests results, and subject’s emotional status should be evaluated to assess the feasibility of coronary angiography.

Publisher

Publishing House ABV Press

Reference25 articles.

1. Chazova I.E., Smetnik V.P., Balan V.E. Management of peri- and post-menopausal women with cardiovascular risk: consensus of Russian cardiologists and gynecologists. Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology 2008;4:61–78. (In Russ.) DOI: 10.15829/1560-4071-2008-4-61-78.

2. Factors of women’s health from the point of view of aging of the reproductive system and the risk of developing cardiovascular disease. Lopatina O.V., Balan V.E., Tkacheva O.N. et al. Almanakh Klinicheskoy Mediatsiny = Almanac of clinical medicine 2015;37:111–7. (In Russ.)

3. Eaker E.D., Chesebro J.H., Sacks F.M. et al. Cardiovascular disease in women. Circulation 1993;88(4 Pt 1):1999–2009. DOI: 10.1161/01.CIR.88.4.1999.

4. Maichuk E.Yu., Gumina O.L. Assessment of paon percepton and psychological status of patients with different lenght current CHD. Problemy zhenskogo zdorovia = Women’s Health Issues 2013;8(2):36–45. (In Russ.)

5. Karpov R.S., Mordovin V.F., Fedorov A.Yu. Diagnostic informativeness of changes in stress ECG in women with various forms of coronary heart disease. Kardiologia = Cardiology 1991;31(9):21–4. (In Russ.)