Myocardial infarction in young patients. Consequences of routine coronary angiography
Vik-Mo, H.; Melberg, T.; Barvik, S.
Tidsskrift for den Norske Laegeforening Tidsskrift for Praktisk Medicin Ny Raekke 117(16): 2299-2302
1997
ISSN/ISBN: 0029-2001 PMID: 9265269 Document Number: 478477
The value of coronary angiography in unselected patients after myocardial infarction is still controversial. Our study includes 131 consecutive young patients (< 50 years old) in whom coronary angiography was performed after their first myocardial infarction. Angina pectoris was present in 71 (54%), and silent ischemia in 11 (9%): 49 patients (37%) were asymptomatic and without myocardial ischemia. Significant coronary artery stenosis was present in 119 patients (91%). A larger share of the patients with angina or silent ischemia than of those without had multivessel disease and high angiographic risk, and more of them were referred for revascularization. However, many of the asymptomatic patients with a negative result on the exercise test also had serious, high risk coronary heart disease, and needed revascularization. Thus, although the presence of angina or myocardial ischemia can identify a group of patients with serious coronary heart disease, the diagnostic precision is low, and if coronary angiography is not performed, many young patients with high risk disease may be overlooked.