Evidence map›Paper›PMID 37415006›Full record

ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2023

Decline in typical angina among patients referred for cardiac stress testing.

Alan Rozanski, Donghee Han, Robert J H Miller, Heidi Gransar, Piotr J Slomka, Sean W Hayes, John D Friedman, Louise E J Thomson, Daniel S Berman

Abstract read
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In one paragraph

Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.8field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 8 citations in OpenAlex.

  1. Article
  2. Increasing frequency of dyspnea among patients referred for cardiac stress testing.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023
    Article
  3. Is dyspnea the new angina? The ever-changing profile of patients referred for CAD evaluation.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2023
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 2 countries.

Alan RozanskiDivision of Cardiology and Department of Medicine, Mount Sinai Morningside Hospital, Mount Sinai Heart, and the Icahn School of Medicine at Mount Sinai, 1111 Amsterdam Avenue, New York, NY, 10025, USA. alan.rozanski@mountsinai.org.
Donghee HanDepartments of Imaging and Medicine and Burns and Allen Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Robert J H MillerDepartment of Cardiac Sciences, University of Calgary, Calgary, AB, Canada.
Heidi GransarDepartments of Imaging and Medicine and Burns and Allen Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Piotr J SlomkaDepartments of Imaging and Medicine and Burns and Allen Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Sean W HayesDepartments of Imaging and Medicine and Burns and Allen Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
John D FriedmanDepartments of Imaging and Medicine and Burns and Allen Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Louise E J ThomsonDepartments of Imaging and Medicine and Burns and Allen Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Daniel S BermanDepartments of Imaging and Medicine and Burns and Allen Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Cedars-Sinai Medical Center · USMount Sinai Hospital · USUniversity of Calgary · CA

Funding

Quantitative Prediction of Disease and Outcomes from Next Generation SPECT and CTR01HL089765 · NHLBI · CEDARS-SINAI MEDICAL CENTER · PI SLOMKA, PIOTR J · 2007 to 2021
$6.1M
NHLBI NIH HHS R01 HL089765
6 · The paper itself

Abstract

objectiveTo evaluate temporal trends in the prevalence of typical angina and its clinical correlates among patients referred for stress/rest SPECT myocardial perfusion imaging (MPI). PATIENTS AND

methodsWe evaluated the prevalence of chest pain symptoms and their relationship to inducible myocardial ischemia among 61,717 patients undergoing stress/rest SPECT-MPI between January 2, 1991 and December 31, 2017. We also assessed the relationship between chest pain symptom and angiographic findings among 6,579 patients undergoing coronary CT angiography between 2011 and 2017.

resultsThe prevalence of typical angina among SPECT-MPI patients declined from 16.2% between 1991 and 1997 to 3.1% between 2011 and 2017, while the prevalence of dyspnea without any chest pain increased from 5.9 to 14.5% over the same period. The frequency of inducible myocardial ischemia declined over time within all symptom groups, but its frequency among current patients (2011-2017) with typical angina was approximately three-fold higher versus other symptom groups (28.4% versus 8.6%, p < 0.001). Overall, patients with typical angina had a higher prevalence of obstructive CAD on CCTA than those with other clinical symptoms, but 33.3% of typical angina patients had no coronary stenoses, 31.1% had 1-49% stenoses, and 35.4% had ≥ 50% stenoses.

conclusionsThe prevalence of typical angina has declined to a very low level among contemporary patients referred for noninvasive cardiac tests. The angiographic findings among current typical angina patients are now quite heterogeneous, with one-third of such patients having normal coronary angiograms. However, typical angina remains associated with a substantially higher frequency of inducible myocardial ischemia compared to patients with other cardiac symptoms.

Indexed as

Coronary Artery DiseaseCoronary StenosisMyocardial Perfusion ImagingAngina PectorisChest PainConstriction, PathologicCoronary AngiographyHumansTomography, Emission-Computed, Single-Photoncoronary artery diseasemyocardial ischemiamyocardial perfusion imagingTypical angina

Identifiers

PMID37415006
OpenAlexW4383314363

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.