Elhakeem Ramaze Farouke, Lutfi Mohamed Faisal, Ali Ahmed Babiker Mohamed, Sukkar Mohamed Yusif
College of Medicine, Qassim University, KSA, Buraydah, Qassim, Saudi Arabia.
Nile College of Medicine, Khartoum, Sudan.
Open Access Maced J Med Sci. 2019 Jul 25;7(14):2282-2286. doi: 10.3889/oamjms.2019.609. eCollection 2019 Jul 30.
This study aimed to assess if clinical remarks gained by analysis of the present and past medical history of patients undergoing elective coronary angiography (ECA) due to typical chest pain can help to predict the outcome of ECA.
One hundred and fifty-four ECA candidates with a history of typical chest were seen on the same day intended for ECA in the cardiac centre of AlShaab Teaching Hospital, Khartoum, Sudan. The details of the present complaints, characteristics of chest pain, past medical and socioeconomic history were recorded from each subject guided by a questionnaire. ECA confirmed CAD in 112 of the studied patients and were considered as the test group. The remaining patients (N = 42) were diagnosed as CSX after exclusion of significant narrowing of the coronary vessels and were considered as the control group.
Univariate analysis of pain characteristics among patients undergoing coronary angiography revealed that pain is less likely to radiate to the neck (OR = 0.44, 95% CI = 0.21 - 0.91, P = 0.027) and the back (OR = 0.48, 95% CI = 0.23 - 1.00, P = 0.049) in patients with CAD. Presence of shortness of breathing and/or dizziness significantly decrease the odds of having abnormal coronary angiography (OR = 0.30 and 0.48, 95% CI = 0.12 - 0.77 and 0.22 - 0.92, P = 0.013 and 0.030 respectively). Past history of diabetes mellitus significantly increases the odds of having abnormal coronary angiography (OR = 3.96, 95% CI = 1.68 - 9.30, P = 0.002). In contrast, past medical history of migraine decreases the odds of having positive finding in ECA (OR = 0.31, 95% CI = 0.13 - 0.72, P = 0.006).
Characteristics of chest pain are comparable in CAD and CSX. However, pain is less likely to radiate to the neck and/or the back in the first group. Presence of dyspnea and dizziness during angina attacks as well as the history of migraine significantly decreases the odds of having abnormal coronary angiography.
本研究旨在评估，通过分析因典型胸痛而接受选择性冠状动脉造影（ECA）患者的当前和既往病史所获得的临床信息，是否有助于预测ECA的结果。
在苏丹喀土穆的阿尔沙布教学医院心脏中心，同一天对154名有典型胸痛病史、拟接受ECA的患者进行了检查。在一份问卷的引导下，记录了每个受试者当前主诉的详细信息、胸痛特征、既往病史和社会经济史。ECA在112名研究患者中证实有冠心病，这些患者被视为试验组。其余患者（N = 42）在排除冠状动脉血管明显狭窄后被诊断为心脏X综合征（CSX），被视为对照组。
对接受冠状动脉造影的患者的疼痛特征进行单因素分析发现，CAD患者的疼痛向颈部放射的可能性较小（OR = 0.44，95% CI = 0.21 - 0.91，P = 0.027），向背部放射的可能性也较小（OR = 0.48，95% CI = 0.23 - 1.00，P = 0.049）。出现呼吸急促和/或头晕会显著降低冠状动脉造影异常的几率（OR = 0.30和0.48，95% CI = 0.12 - 0.77和0.22 - 0.92，P分别为0.013和0.030）。糖尿病既往史会显著增加冠状动脉造影异常的几率（OR = 3.96，95% CI = 1.68 - 9.30，P = 0.002）。相比之下，偏头痛既往史会降低ECA检查阳性结果的几率（OR = 0.31，95% CI = 0.13 - 0.72，P = 0.006）。
CAD和CSX患者的胸痛特征具有可比性。然而，第一组患者的疼痛向颈部和/或背部放射的可能性较小。心绞痛发作时出现呼吸困难和头晕以及偏头痛病史会显著降低冠状动脉造影异常的几率。
