Association Between Angina Symptom Characteristics and Obstructive Coronary Artery Disease: A Comparative Cross-Sectional Study.
Ching-Ching Tsai, I-Chang Hsieh, Pao-Hsien Chu and 3 others
PMID 40748239WHAT IT FOUND
In 723 patients having coronary angiography, typical angina was linked to nearly twice the chance of obstructive coronary disease.
Severity and overall frequency were not; infrequent angina in older patients may still matter.
Key findings
01After adjustment, typical angina was associated with nearly twice the likelihood of obstructive coronary artery disease compared with atypical angina.
02Angina severity was not significantly associated with obstructive coronary artery disease in the overall analysis.
03In the older subgroup, having angina less than twice per week was associated with higher risk of obstructive coronary artery disease than having no angina episodes in the past month.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The cross-sectional design cannot show that angina symptoms caused or predicted disease. It was a single center in northern Taiwan with a high prevalence of coronary disease, so results may not apply elsewhere. Purposive sampling may have introduced selection bias. Symptom data were self-reported, with possible recall and reporting bias. Medication use for symptom relief was not considered. Subgroup analyses, especially by age and sex, used small samples, so they are not definitive.
Declared interests
Funding was from Chang Gung Memorial Hospital and National Science and Technology Council. The funder did not participate in the study or manuscript preparation.
The easy way to misread this
Do not use typical angina symptoms as a stand-alone test for obstructive coronary disease. In this study, almost half of patients without obstructive disease had typical symptoms, and one-third of patients with obstructive disease did not have typical symptoms. Symptom severity also did not track with obstructive disease, so mild or atypical symptoms do not rule it out.