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10-year prognosis in patients with microvascular angina

Session EAPC Essentials 4 You - ePosters

Speaker Associate Professor Irina Leonova

Event : EAPC Essentials 4 You 2020

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Coronary Artery Disease - Other
  • Session type : ePoster

Authors : I Leonova (Saint Petersburg,RU), S Boldueva (Saint Petersburg,RU), N Bodnar (Saint Petersburg,RU), A Shakhbazyan (Saint Petersburg,RU), O Zakharova (Saint Petersburg,RU)

Authors:
I Leonova1 , S Boldueva1 , N Bodnar1 , A Shakhbazyan1 , O Zakharova1 , 1North-Western State Medical University named after I.I. Mechnikov - Saint Petersburg - Russian Federation ,

Citation:

The prognosis in patients with microvascular angina  (MVA) has not been fully investigated. Some authors indicate that the frequency of major adverse cardiovascular events (MACE) in these patients is significantly lower than in patients with coronary artery atherosclerosis. Other authors note that in patients with MVS there is a 1.5-fold increase in mortality compared to patients without documented myocardial ischemia. But all researchers agree on the idea that the quality of life in such patients remains low. Therefore, a study was conducted of the incidence of MACE in patients with MVS and the quality of life was evaluated 10 years after the diagnosis was verified.

Materials and Methods: The study included 88 patients with MVA proved by symptoms, positive stress-test, normal coronary angiography (no evidence of coronary lesions), impaired reserve of endothelium - dependent vasodilation (cold pressor test) by positron - emission myocardial tomography, the presence of endothelium dysfunction ED be reactive hyperemia index< 1.67 according to peripheral arterial tonometry. All patients were included between Jan 2006 and Dec 2010. Full follow-up was obtained in 59 patients (84% female, 16% male, average age 68±5 years). Median follow-up was 10 years. 29 patients were lost from follow-up (changed phone number, etc). Assessment of the quality of life (QOL) and characteristics of pain was done using the Seattle Angina Questionnaire (SAQ).

Results: The sample taken into consideration includes 59 patients and among these no cardiovascular death occurred. 1 patient  (1,7%) reported MI and stenting of infarct-related artery, 1  (1,7%) patient underwent new coronarography without stenosis, 2  (3,4%) patient had anamnesis of non-fatal stroke, 1 (1,7%) patient had anamnesis of non-fatal oncology. Most patients noted a decrease in exposure to a provocative factor (chronic stress at work), in general, perception of the disease in most patients improved. On baseline 3 class of angina (Canadian Classification) described 60% of patients, class 2 - 40% of the patients, during the follow-up the functional class of angina decreased and angina of 3 class was described by less than 50% of patients. The characteristics of pain and quality of life (QOL) were assessed using the Seattle Angina Questionnaire (SAQ), consisting of 19 questions divided into five scales: physical limitation (PL), angina stability (AS), angina frequency (AF), treatment satisfaction (TS), and disease perception (DP). There was a significant (p<0.05) improvement in all indicators during a 10-year follow-up compared with baseline values.

Conclusion: the presented work demonstrated a rather good prognosis in patients with MVS, which differs from the data of some previous studies. The reason for this, in our opinion, is the use of more stringent criteria for the selection of patients (exclusion of patients with minimal atherosclerosis of the coronary arteries)

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