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To what degree is amelioration of angina following coronary revascularization associated with improvement in myocardial perfusion?
Author(s) -
Johansen Allan,
HøilundCarlsen Poul F.,
Vach Werner,
Christensen Henrik W.,
Møldrup Mette,
Haghfelt Torben
Publication year - 2006
Publication title -
clinical physiology and functional imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.608
H-Index - 67
eISSN - 1475-097X
pISSN - 1475-0961
DOI - 10.1111/j.1475-097x.2006.00685.x
Subject(s) - medicine , perfusion , revascularization , angina , chest pain , cardiology , myocardial perfusion imaging , canadian cardiovascular society , perfusion scanning , prospective cohort study , radiology , myocardial infarction
Summary Objective: To examine the association between changes in chest pain and changes in perfusion following revascularization as assessed by clinical evaluation and myocardial perfusion imaging (MPI) in patients with stable angina. Design: In a prospective series of 380 patients (58·8 ± 8·8 years) referred to angiography because of known or suspected stable angina, changes in chest discomfort and changes in perfusion after 2 years were assessed in 144 patients, who underwent revascularization, and 236, who did not. The decision to treat invasively was made without knowledge of the result of MPI. Results: In revascularized patients, the presence of typical/atypical angina was reduced from 93% to 36% and the improvement was associated with improvement in perfusion. A small improvement in perfusion induced a high frequency of change from angina to no pain, whereas a further reduction caused little extra change. In non‐revascularized patients the change in chest discomfort was not related to changes in perfusion, which were rarely present. Conclusion: Alleviation of chest discomfort 2 years after revascularization is associated with improvements in perfusion. This association appeared to be an all‐or‐nothing phenomenon. Non‐revascularized patients also exhibited improvements in chest discomfort despite insignificant changes in perfusion.