THE PREVALENCE OF INTACT CORONARY ARTERIES IN RELATION WITH INDICATIONS FOR SCHEDULED CORONARY ARTERIOGRAPHY

Aim. To evaluate the prevalence and possible reasons for intact coronary arteries (CA) diagnostics in patients with different indications for scheduled coronary arteriography (CAG).

Material and methods. The selection studied, consisted of 711 case histories of patients, underwent scheduled CAG at SRI CICVP during 1 April — 31 may 2014. Taken the indications for CAG, 5 groups were selected: 1 — patients with coronary heart disease (CHD) suspicious (n=288), 2 — patients with myocardial infarction (MI) in anamnesis (n=277), 3 — atherosclerosis of peripheral arterial pools (PAP) (n=18), 4 — patients with acquired valve defects (AVD) (n=43), 5 — patients with cardiac rhythm disorders (CRD) (n=85).

Results. In intergroup comparison it is marked that men were predominant among patients with MI in anamnesis and having PAP atherosclerosis, but women predominated among AVD patients (p<0,01). The age of groups was comparable (p=0,266). Typical angina clinical picture was more common significantly in suspected CHD group and previous MI (p<0,001). Also, the atypical angina and cardialgia were less common in MI anamnesis group (p=0,003) and p<0,001). Cardialgia was more common in AVD (p<0,001). Mean value of pretest probability of CHD was higher in groups with MI anamnesis and PAP lesion, and lesser — in AVD (p=0,015). Rhythm disorders were more common in AVD patients and those who actually was being investigated for CRD (p<0,001). also, ischemic strokes dominated among PAP and AVD (p=0,019). Analysis of CAG data showed that the absence of coronary lesion with higher prevalence is in groups with AVD and CRD (p<0,001). No significant stenoses of CA were less common in MI anamnesis group and AVD (p=0,004). However, hemodynamically significant stenoses of CA were significantly more common in those after MI and in PAP lesion (p<0,001).

Conclusion. Among studied patients, in 32,9% there were no stenoses of CA in planned CAG. Highest number of intact CA was found in preoperation investigation of AVD patients (76,7%) and CRD (67,1%), least — in MI anamnesis (11,6%) and PAP lesion (16,7%). In investigation of suspected CHD, intact CA were found in 37,9% cases.

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