Long-Term Clinical Outcomes in Patients with Angina and Insignificant Coronary Artery Stenosis

Background:This study was undertaken to evaluate the long-term clinical prognosis, the effects of anti-anginal medicines and the factors of recurrence in patients with angina and insignificant coronary artery stenosis (CAS. Methods:The study population was consisted of 372 patients with angina and normal or minimal (less than 50% stenosed CAS out of 2475 consecutive patients who underwent coronary angiogram over a 3.5 year period. We retrospectively reviewed the medical records of the study population. Results:Myocar- dial infarction was developed in 2 cases (0.5%, recurrence of angina in 59 cases (16%, and there was no death during mean 19-month follow-up period of the 372 patients. Patients with normal coronary artery (n= 266 were younger (mean 54 yrs vs 59 yrs, p<0.001, had a lower incidence of diabetes (5% vs 13%, p<0.01, hypertension (19% vs 29%, p<0.05, recurrent angina (15% vs 18%, not significant, and myocardial infarction (0.4% vs 0.9%, not significant than patients with minimal lesion (n=106. Anti-anginal medicine did not show benefits in relieving recurrent angina. Furthermore, in cases of patients with normal coronary artery taking, nitrates there was a more frequent recurrence of angina (23% vs 13%, p<0.01 than seen in similar patients not taking nitrates. There were no correlation between recurrent angina and age, sex, ischemic changes on electrocardiogram, smoking, hypertension, diabetes, or hyperlipidemia. Conclusion:The long- term clinical outcome in patients with insignificant CAS was good. Although there were no definitive factors associated with the recurrence of chest pain, the administration of nitrates may cause more frequent angina in patients with normal coronary angiography. (Korean Circulation J 2001;31(4 :392-397