[The Problem of Minimally Changed Coronary Arteries at Elective Coronary Angiography].

AIM: to study rates and possible causes of detecting "clean" coronary arteries at elective coronary angiography.

MATERIAL AND METHODS: Medical records of 711 patients who had undergone elective coronary angiography (ECAG) between 01/04 and 31/05 2014 were retrospectively reviewed. Four groups were distinguished: group 1 - patients with normal coronary arteries (n=234), group 2 - patients with coronary artery stenoses (CAS) <60% (n=94), group 3 - patients with 60-69% CAS (n=22), group 4 - patients with CAS more or equal 70% (n=361).

RESULTS: Most patients were men (p<0.001), except group 1, where women prevailed (p<0.05). Patients in groups 3 and 4 were older than in groups 1 and 2 (p=0.019). Symptoms of angina were less likely to be found in group 1 (p<0.001). History of myocardial infarction (MI) prevailed in group 4 (p<0.001). Arrhythmias were detected more frequently in group 1 (p<0.001); there were less diabetics in this group (p=0.010). Group 1 contained more patients examined before cardiac valve surgery (p<0.001). Typical angina was more often found in group 4, whereas atypical angina - in group 1 (p<0.001). Cardialgia prevailed in groups 1 and 2 (p<0.001). Holter ECG monitoring was used more frequently in group 1 (p<0.001). Symptoms of latent coronary insufficiency were mainly reported in group 1 (p=0.006). The pretest probability of ischemic heart disease (IHD) was higher in groups 2 and 4 compared to group 1 (p<0.001).

CONCLUSION: Among patients who had undergone ECAG 32.9% had no CAS. Younger females without history of MI and diabetes as well as patients with atypical angina or cardialgia prevailed in this group. This group of patients had the lowest pretest probability of IHD (58%). Patients without CAS were more often scheduled for EGAG before valvular heart surgery and because of cardiac arrhythmias.