Unstable Angina Benefits From Angiography

HealthDay News — Use of routine invasive coronary angiography is beneficial for management of patients with unstable angina, according to a study published in the Annals of Internal Medicine.

Sara Vogrin, MBBS, from the University of Melbourne in Australia, and colleagues examined the effect of angiography on mortality in unstable angina in a longitudinal study. Data were included for 33,901 emergently-admitted patients with unstable angina who did or did not receive angiography during their first hospitalization. Participants were balanced on 44 propensity score covariates.

The researchers observed a significant decrease in 12-month mortality with routine angiography (hazard ratio, 0.48); no additional statistically significant mortality benefit was seen for revascularization compared with diagnostic angiography alone. The predicted cumulative probability of death at 12 months was 0.024 and 0.097 for patients receiving angiography within 2 months of their index unstable angina versus those not receiving it, respectively. An unmeasured confounder must independently decrease mortality by 90% and have a prevalence gap of 15% or more between the angiographic groups in order to negate the observed effect size.

“Patients with unstable angina benefit from an invasive management pathway initiated by invasive coronary angiography during their hospitalization and up to two months after discharge,” the researchers write.

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Vogrin S, Harper R, Paratz E, et al. Comparative effectiveness of routine invasive coronary angiography for managing unstable angina [published online May 2, 2017]. Ann Intern Med. doi: 10.7326/M16-2420