High Sensitivity Troponin Out-Performs Conventional Assays in Predicting 2 Year Adverse Events

Abstract

Conclusion: Compared with a healthy population, patients with stable CAD and NoCAD have significantly poorer quality of life. Future management strategies need to address the health outcomes in these patients.Background: Approximately 20-30% of coronary angiograms for the investigation of chest pain show non-obstructive CAD (NoCAD). These patients receive little attention compared to those with obstructive CAD. We therefore assessed the health outcomes of patients with NoCAD as compared with CAD over 12 months.Method: Consecutive patients undergoing angiography for the investigation of chest pain were recruited prior to procedure. The following health outcomes were evaluated at baseline, 1, 6 and 12 months: (a) chest pain, (b) Seattle Angina Questionnaire (SAQ), and (c) Short-Form 36 (SF-36).Results: Of the 1148 patients with chest pain recruited, 28% had NoCAD. Compared with CAD, these patients were younger (62 ± 11 vs 57 ± 12 years, respectively; p < 0.001) and following age-adjusted analysis, were more likely to be female (29% vs 58%, respectively; p < 0.001). Baseline SF-36 and SAQ scores were similar for the two groups and over 12 months, both groups showed an improvement in scores. However, the change in SF-36 Physical Summary Score at 12 months compared to baseline was significantly lower in NoCAD patients. No longitudinal differences were seen in SAQ scores. Self reported chest pain was lower in the CAD patients compared with NoCAD at 1 (64% vs 68%, p > 0.05), 6 (46% vs 61%, p < 0.001) and 12 months (40% vs 48%, p > 0.05).Conclusion: NoCAD patients are younger and more likely to be female. After adjusting for age, they are more likely to have ongoing chest pain and impaired quality of life as assessed by the SF-36.