Seven year survival of patients with normal or near normal coronary arteriograms: a CASS registry study

The effect on 7 year survival of having a normal or near normal coronary arteriogram was examined using data from the CASS registry of 21,487 consecutive coronary arteriograms taken in 15 clinical sites. Of these, 4,051 arteriograms were normal or near normal, and the patients had normal left ventricular function as judged by absence of a history of congestive heart failure, no reported segmental wall motion abnormality and an ejection fraction of at least 50%; 3,136 arteriograms were entirely normal and the remaining 915 revealed mild disease with less than 50% stenosis in one or more segments. The 7 year survival rate was 96% for the patients with a normal arteriogram and 92% for those whose study revealed mild disease (p less than 0.0001). Nine risk variables recorded at entry were analyzed for predictive value for survival: age, sex, height, weight, history of smoking, presence of absence of mild disease, electrocardiographic response to exercise, family history of coronary heart disease and a history of hypertension. Of these, age, smoking history, presence or absence of disease and a history of hypertension had predictive value.

This article has been cited by other articles:

				P.-H. Huang, Y.-H. Chen, Y.-L. Chen, T.-C. Wu, J.-W. Chen, and S.-J. Lin Vascular endothelial function and circulating endothelial progenitor cells in patients with cardiac syndrome X Heart, September 1, 2007; 93(9): 1064 - 1070. [Abstract] [Full Text] [PDF]

				J. L. Anderson, C. D. Adams, E. M. Antman, C. R. Bridges, R. M. Califf, D. E. Casey Jr, W. E. Chavey II, F. M. Fesmire, J. S. Hochman, T. N. Levin, et al. ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction) Developed in Collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine J. Am. Coll. Cardiol., August 14, 2007; 50(7): e1 - e157. [Full Text] [PDF]

				S. J Russell, E. M Di Stefano, M. T Naffati, O. Brown, and S. Saltissi The effects of the angiotensin II receptor (type I) antagonist irbesartan in patients with cardiac syndrome X Heart, February 1, 2007; 93(2): 253 - 254. [Full Text] [PDF]

				R. Bugiardini, O. Manfrini, and G. M. De Ferrari Unanswered questions for management of acute coronary syndrome: risk stratification of patients with minimal disease or normal findings on coronary angiography. Arch Intern Med, July 10, 2006; 166(13): 1391 - 1395. [Abstract] [Full Text] [PDF]

				B. D. Johnson, L. J. Shaw, C. J. Pepine, S. E. Reis, S. F. Kelsey, G. Sopko, W. J. Rogers, S. Mankad, B. L. Sharaf, V. Bittner, et al. Persistent chest pain predicts cardiovascular events in women without obstructive coronary artery disease: results from the NIH-NHLBI-sponsored Women's Ischaemia Syndrome Evaluation (WISE) study Eur. Heart J., June 2, 2006; 27(12): 1408 - 1415. [Abstract] [Full Text] [PDF]

				E.B. Wu, F. Hodson, and J.B. Chambers A simple score for predicting coronary artery disease in patients with chest pain QJM, November 1, 2005; 98(11): 803 - 811. [Abstract] [Full Text] [PDF]

				J. Madaric, J. Bartunek, K. Verhamme, M. Penicka, E. Van Schuerbeeck, P. Nellens, G. R. Heyndrickx, W. Wijns, M. Vanderheyden, and B. De Bruyne Hyperdynamic Myocardial Response to Beta-Adrenergic Stimulation in Patients With Chest Pain and Normal Coronary Arteries J. Am. Coll. Cardiol., October 4, 2005; 46(7): 1270 - 1275. [Abstract] [Full Text] [PDF]

				R. Sicari, A. Palinkas, E. G. Pasanisi, L. Venneri, and E. Picano Long-term survival of patients with chest pain syndrome and angiographically normal or near-normal coronary arteries: the additional prognostic value of dipyridamole echocardiography test (DET) Eur. Heart J., October 2, 2005; 26(20): 2136 - 2141. [Abstract] [Full Text] [PDF]

				R. Bugiardini and C. N. Bairey Merz Angina With "Normal" Coronary Arteries: A Changing Philosophy JAMA, January 26, 2005; 293(4): 477 - 484. [Abstract] [Full Text] [PDF]

				R. Bugiardini, O. Manfrini, C. Pizzi, F. Fontana, and G. Morgagni Endothelial Function Predicts Future Development of Coronary Artery Disease: A Study of Women With Chest Pain and Normal Coronary Angiograms Circulation, June 1, 2004; 109(21): 2518 - 2523. [Abstract] [Full Text] [PDF]

				R. F. Redberg, R. O. Cannon III, N. Bairey Merz, A. Lerman, S. E. Reis, D. S. Sheps, and Endorsed by the American College of Cardiology Fou Women's Ischemic Syndrome Evaluation: Current Status and Future Research Directions: Report of the National Heart, Lung and Blood Institute Workshop: October 2-4, 2002: Section 2: Stable Ischemia: Pathophysiology and Gender Differences Circulation, February 17, 2004; 109 (6): e47 - e49. [Full Text] [PDF]

				D. B. Mark and M. S. Lauer Exercise Capacity: The Prognostic Variable That Doesn't Get Enough Respect Circulation, September 30, 2003; 108(13): 1534 - 1536. [Full Text] [PDF]

				M.-H. Huang, G. A. Ewy, M. Bassan, A. Collins, D. J. Pennell, J. R. Panting, P. Collins, and J. A. Panza Cardiac Syndrome X N. Engl. J. Med., October 24, 2002; 347(17): 1377 - 1379. [Full Text] [PDF]

				J. R. Panting, P. D. Gatehouse, G.-Z. Yang, F. Grothues, D. N. Firmin, P. Collins, and D. J. Pennell Abnormal Subendocardial Perfusion in Cardiac Syndrome X Detected by Cardiovascular Magnetic Resonance Imaging N. Engl. J. Med., June 20, 2002; 346(25): 1948 - 1953. [Abstract] [Full Text] [PDF]

				A. Ling Electron Beam CT in Syndrome X Chest, November 1, 2001; 120(5): 1437 - 1439. [Full Text] [PDF]

				L. Schwartz and M. G. Bourassa Evaluation of Patients With Chest Pain and Normal Coronary Angiograms Arch Intern Med, August 13, 2001; 161(15): 1825 - 1833. [Full Text] [PDF]

				P. K. Goel, S. K. Gupta, A. Agarwal, and A. Kapoor Slow Coronary Flow: A Distinct Angiographic Subgroup in Syndrome X Angiology, August 1, 2001; 52(8): 507 - 514. [Abstract] [PDF]

				A.D. Hughes and S. Thom Wearing your heart in your sleeve? Eur. Heart J., July 1, 2001; 22(13): 1071 - 1073. [PDF]

				T.F.T Antonios, J.C Kaski, K.M Hasan, S.J Brown, and D.R.J Singer Rarefaction of skin capillaries in patients with anginal chest pain and normal coronary arteriograms Eur. Heart J., July 1, 2001; 22(13): 1144 - 1148. [Abstract] [PDF]

				T. M. Bashore, E. R. Bates, P. B. Berger, D. A. Clark, J. T. Cusma, G. J. Dehmer, M. J. Kern, W. K. Laskey, M. P. O'Laughlin, S. Oesterle, et al. American College of Cardiology/Society for Cardiac Angiography and Interventions Clinical Expert Consensus Document on Cardiac Catheterization Laboratory Standards: A report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents endorsed by the American Heart Association and the Diagnostic and Interventional Catheterization Committee of the Council on Clinical Cardiology of the AHA J. Am. Coll. Cardiol., June 15, 2001; 37(8): 2170 - 2214. [Full Text] [PDF]

				C Dodi, L Cortigiani, M Masini, I Olivotto, A Azzarelli, and E Nannini The incremental prognostic value of pharmacological stress echo over exercise electrocardiography in women with chest pain of unknown origin Eur. Heart J., January 2, 2001; 22(2): 145 - 152. [Abstract] [PDF]

				A. Buffon, S. Rigattieri, S. A. Santini, V. Ramazzotti, F. Crea, B. Giardina, and A. Maseri Myocardial ischemia-reperfusion damage after pacing-induced tachycardia in patients with cardiac syndrome X Am J Physiol Heart Circ Physiol, December 1, 2000; 279(6): H2627 - H2633. [Abstract] [Full Text] [PDF]

				G. Desideri, A. Gaspardone, M. Gentile, A. Santucci, P. A. Gioffre, and C. Ferri Endothelial Activation in Patients With Cardiac Syndrome X Circulation, November 7, 2000; 102(19): 2359 - 2364. [Abstract] [Full Text] [PDF]

				E. Braunwald, E. M. Antman, J. W. Beasley, R. M. Califf, M. D. Cheitlin, J. S. Hochman, R. H. Jones, D. Kereiakes, J. Kupersmith, T. N. Levin, et al. ACC/AHA guidelines for the management of patients with unstable angina and non-st-segment elevation myocardial infarction: A report of the american college of cardiology/ american heart association task force on practice guidelines (committee on the management of patients with unstable angina) J. Am. Coll. Cardiol., September 1, 2000; 36(3): 970 - 1062. [Full Text] [PDF]

				A. M. Borzecki, M. C. Pedrosa, and M. J. Prashker Should Noncardiac Chest Pain Be Treated Empirically?: A Cost-effectiveness Analysis Arch Intern Med, March 27, 2000; 160(6): 844 - 852. [Abstract] [Full Text] [PDF]

				J. Sztajzel, F. Mach, and A. Righetti Current concepts in medicine: Role of the vascular endothelium in patients with angina pectoris or acute myocardial infarction with normal coronary arteries Postgrad. Med. J., January 1, 2000; 76(891): 16 - 21. [Abstract] [Full Text]

				L. Cortigiani, C. Dodi, E. A. Paolini, D. Bernardi, G. Bruno, and E. Nannini Prognostic value of pharmacological stress echocardiography in women with chest pain and unknown coronary artery disease J. Am. Coll. Cardiol., December 1, 1998; 32(7): 1975 - 1981. [Abstract] [Full Text] [PDF]

				N. Ossei-Gerning, M. W. Mansfield, M. H. Stickland, I. J. Wilson, and P. J. Grant Plasminogen Activator Inhibitor-1 Promoter 4G/5G Genotype and Plasma Levels in Relation to a History of Myocardial Infarction in Patients Characterized by Coronary Angiography Arterioscler. Thromb. Vasc. Biol., January 1, 1997; 17(1): 33 - 37. [Abstract] [Full Text]

				Wen Lieng Lee, J.-W. Chen, Chi Woon Kong, Jiann Jong Wang, C.-T. Ting, Wan Leong Chan, S.-P. Wang, and M.-S. Chang Changes in Cardiac Autonomic Activities in Patients with Syndrome X: A Study of Spectral Analysis of Heart Rate Variability Angiology, October 1, 1996; 47(10): 929 - 939. [Abstract] [PDF]

				L. Palleschi, W. Gianni, G. De Vincentis, M. Banci, G. Sottosanti, M. Ierardi, F. Scopinaro, and V. Marigliano Dipyridamole Technetium-99M Sestamibi Imaging in the Diagnosis of Syndrome X Angiology, April 1, 1996; 47(4): 369 - 373. [Abstract] [PDF]

				B. Mukerji, V. Mukerji, M. A. Alpert, and R. Selukar The Prevalence of Rheumatologic Disorders in Patients with Chest Pain and Angiographically Normal Coronary Arteries Angiology, May 1, 1995; 46(5): 425 - 430. [Abstract] [PDF]

				R. O. Cannon, A. A. Quyyumi, R. Mincemoyer, A. M. Stine, R. H. Gracely, W. B. Smith, M. F. Geraci, B. C. Black, T. W. Uhde, M. A. Waclawiw, et al. Imipramine in Patients with Chest Pain Despite Normal Coronary Angiograms N. Engl. J. Med., May 19, 1994; 330(20): 1411 - 1417. [Abstract] [Full Text]

				R. O. Cannon Chest Pain with Normal Coronary Angiograms N. Engl. J. Med., June 10, 1993; 328(23): 1706 - 1708. [Full Text]

				P. M. Schofield Follow-up Study of Morbidity in Patients with Angina Pectoris and Normal Coronary Angiograms and the Value of Investigation for Esophageal Dysfunction Angiology, April 1, 1990; 41(4): 286 - 296. [Abstract] [PDF]