Angiograms in Women - June 2009

Did you know...

Angiograms are not always accurate predictors of heart disease in women?

A recent study shows that women with symptoms of heart disease but normal results on their angiogram may still be at risk for developing heart disease within five years. The risk was greatest among those with 4 or more uncontrolled risk factors such as high blood pressure, diabetes, smoking and high cholesterol.

Researchers at Northwestern University and other medical centers in the US studied 540 women with potential heart disease symptoms referred for angiograms and followed them for about five years.  Rates of having some form of heart disease (stroke, heart attack, heart failure or cardiac death) were compared with women who had no symptoms of heart disease.  Surprisingly, women with symptoms of chest pain were three times more likely to have a heart attack than women without symptoms despite having normal heart arteries by angiogram.

What does CPC recommend?

This study shows that women with risk factors who also have symptoms of heart disease are at risk for heart disease and stroke even if their arteries appear normal on an angiogram. This suggests that these risk factors may be damaging the small blood vessels of the heart and that we cannot detect the damage on a routine angiogram. CPC recommends that both men and women with unexplained chest pain (or other signs shown in the figure) seek medical attention. They should visit their doctor regularly, and check blood pressure and cholesterol levels yearly if either one is elevated.  If an angiogram shows unclogged arteries, it is still prudent to aggressively treat risk factors with particular attention to not smoking, lowering blood pressure and controlling cholesterol.

The study cited above was published in the Archives of Internal Medicine 2009;169(9):843-850.