ArticleJournal of the American Heart Association2017
Variations in Use of Optimal Medical Therapy in Patients With Nonobstructive Coronary Artery Disease: A Population-Based Study.
Article in Journal of the American Heart Association, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed, 12 citations in OpenAlex.
- Risk Factors Predisposing to Angina in Patients with Non-Obstructive Coronary Arteries: A Retrospective Analysis.Journal of personalized medicine · 2022Article
- Article
- Stable ischemic heart disease: re-appraisal of coronary revascularization criteria in the light of contemporary evidence.Cardiovascular diagnosis and therapy · 2020Review
- Visit-to-visit variability in low-density lipoprotein cholesterol is associated with adverse events in non-obstructive coronary artery disease.Anatolian journal of cardiology · 2019Article
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Authors and funding
8 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is a paucity of data on the need for optimal medical therapy (OMT) in nonobstructive coronary artery disease . We sought to understand if there was variation in the use of OMT between hospitals for patients with nonobstructive coronary artery disease, the factors associated with such variation, and its clinical consequences. METHODS AND
resultsUsing a population-level clinical registry in Ontario, Canada, we identified all patients >66 years undergoing coronary angiography for the indication of stable angina, who had nonobstructive coronary artery disease between November 1, 2010, and October 31, 2013. Hierarchical multivariable logistic models were developed to identify the factors associated with OMT use, with median odds ratio used to quantify the degree of variation between hospitals not explained by the modeled risk factors. Clinical outcomes of interest were all-cause mortality and rehospitalization, with follow-up until March 31, 2015. Our cohort consisted of 5413 patients, of whom 2554 (47.2%) were receiving OMT within 1 year. There was a 2-fold variation in OMT across hospitals (30.4%-61.8%). The variation between hospitals was fully explained by preangiography medication use (median odds ratio of 1.21 in the null model and 1.03 in the full model). There was no difference in risk-adjusted mortality (hazard ratio, 0.94; 95% confidence interval, 0.76-1.16); however, patients receiving OMT had a lower risk of all-cause hospital readmission (hazard ratio, 0.89; 95% confidence interval, 0.84-0.95).
conclusionsThere is wide variation in the use of OMT in patients with nonobstructive coronary artery disease, the major driver of which is differences in baseline medication use.
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