PT151 Ticagrelor versus Prasugrel in Patient with Acute Coronary Syndromes treated with Percutaneous Coronary Intervention

Introduction: Coronary angiography is the standard technique for assessment of coronary artery disease (CAD). In many patients investigated with angiography, no or minimal CAD (<50% stenosis) is detected. It is uncertain how this “negative” result influences subsequent management and outcomes. Objectives: We reviewed characteristics and outcomes in a contemporary cohort of patients with suspected angina pectoris and subsequently “negative” coronary angiography. Methods: Records for all patients undergoing coronary angiography at Auckland City Hospital during July 2010-October 2011 were reviewed (n1⁄42,983) and 15.6% (466) had “negative” results. Those referred on the basis of suspected angina pectoris (troponin negative) were studied (n1⁄4369) and followed-up for 2.3+/-0.6 years. Results: Mean age was 60.0+/-12.3 years and 56.1% (207) were female. The ECG was abnormal in 55.0% (203) and left ventricular systolic function impaired in 21.6% (47/218 performed). Stress testing was considered abnormal in 57.3% (86/150 performed). After angiography, 43.2% (158) had no changes to cardiac medications, while aspirin, statin, betablocker or ACE inhibitor was started in 14.2-22.1% of patients and only stopped in 4.1-8.2%. Nofinal diagnosiswas formulated in 53.4% (197),whilst a non-cardiac diagnosis suggested in 27.9% (103). Rates of major adverse cardiovascular events and re-admissions with chest pain were 0.3% (1) and 1.9% (7) respectively at 30 days, and 1.9% (7) and 6.0%(22) at 1 year. Conclusion: In this real-world cohort coronary angiography was “negative” in 15.6% of patients. Despite this finding, cardiac medications were more likely to be added than subtracted. Only a minority represented to hospital within the first year with further chest pain. Disclosure of Interest: None Declared