Circulation, Vol 64, 360-367, Copyright © 1981 by American Heart Association
BR Chaitman, MG Bourassa, K Davis, WJ Rogers, DH Tyras, R Berger, JW Kennedy, L Fisher, MP Judkins, MB Mock and T Killip
The prevalence of coronary artery stenoses greater than or equal to 70% or
left main stenosis greater than or equal to 50% was evaluated in 20,391
patients who underwent angiography in the Coronary Artery Surgery Study
from 1975-1979. After the patients with unstable angina or myocardial
infarction were excluded, the disease prevalence in the 8157 patients with
definite angina, probable angina, and nonspecific chest pain was 93%, 66%
and 14% in men and 72%, 36% and 6% in women (p less than 0.001). The age
and sex of the patients and character of chest pain were important
determinants of disease prevalence and severity. Left main or three-vessel
coronary disease occurred in more than 50% of middle-aged men and older
women with definite angina and in more than 50% of men who had probable
angina and were older than 60 years of age. In contrast, left main coronary
disease occurred in less than 2% of 1282 men and less than 1% of 1397 women
with nonspecific chest pain regardless of age. In this latter patient
subset, less than 5% of men and less than 1% of women in each decade under
60 years had left main or three-vessel coronary artery disease. Thus,
high-risk coronary disease is common in middle-aged patients with definite
angina and older patients with probable angina, but is rare in patients
with nonspecific chest pain. Indications and guidelines for diagnostic
noninvasive tests and coronary angiography could be based on these results.
ARTICLES
Angiographic prevalence of high-risk coronary artery disease in patient subsets (CASS)
This article has been cited by other articles:
![]() |
J. A. Ladapo, U. Hoffmann, F. Bamberg, J. T. Nagurney, D. M. Cutler, M. C. Weinstein, and G. S. Gazelle Cost-Effectiveness of Coronary MDCT in the Triage of Patients with Acute Chest Pain Am. J. Roentgenol., August 1, 2008; 191(2): 455 - 463. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. H. Jung, J. Rieber, S. Stork, C. Hoyer, I. Erhardt, A. Nowotny, W. Voelker, F. Weidemann, G. Ertl, V. Klauss, et al. Effect of contrast application on interpretability and diagnostic value of dobutamine stress echocardiography in patients with intermediate coronary lesions: comparison with myocardial fractional flow reserve Eur. Heart J., May 21, 2008; (2008) ehn204v1. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. S. Douglas, B. Khandheria, R. F. Stainback, N. J. Weissman, E. D. Peterson, R. C. Hendel, R. F. Stainback, M. Blaivas, R. D. Des Prez, L. D. Gillam, et al. ACCF/ASE/ACEP/AHA/ASNC/SCAI/SCCT/SCMR 2008 Appropriateness Criteria for Stress Echocardiography: A Report of the American College of Cardiology Foundation Appropriateness Criteria Task Force, American Society of Echocardiography, American College of Emergency Physicians, American Heart Association, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance Endorsed by the Heart Rhythm Society and the Society of Critical Care Medicine J. Am. Coll. Cardiol., March 18, 2008; 51(11): 1127 - 1147. [Full Text] [PDF] |
||||
![]() |
STRESS ECHOCARDIOGRAPHY WRITING GROUP, P. S. Douglas, B. Khandheria, R. F. Stainback, N. J. Weissman, TECHNICAL PANEL MEMBERS, E. D. Peterson, R. C. Hendel, R. F. Stainback, M. Blaivas, et al. ACCF/ASE/ACEP/AHA/ASNC/SCAI/SCCT/SCMR 2008 Appropriateness Criteria for Stress Echocardiography: A Report of the American College of Cardiology Foundation Appropriateness Criteria Task Force, American Society of Echocardiography, American College of Emergency Physicians, American Heart Association, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society for Cardiovascular Magnetic Resonance: Endorsed by the Heart Rhythm Society and the Society of Critical Care Medicine Circulation, March 18, 2008; 117(11): 1478 - 1497. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. M. Tsutsui, F. Xie, D. Cloutier, S. Kalvaitis, A. Elhendy, and T. R. Porter Real-time dobutamine stress myocardial perfusion echocardiography predicts outcome in the elderly Eur. Heart J., February 1, 2008; 29(3): 377 - 385. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. L. Anderson, C. D. Adams, E. M. Antman, C. R. Bridges, R. M. Califf, D. E. Casey Jr, W. E. Chavey II, F. M. Fesmire, J. S. Hochman, T. N. Levin, et al. ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction) Developed in Collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine J. Am. Coll. Cardiol., August 14, 2007; 50(7): e1 - e157. [Full Text] [PDF] |
||||
![]() |
P. A. Poole-Wilson, Z. Voko, B.-A. Kirwan, S. de Brouwer, P. H.J.M. Dunselman, J. Lubsen, and for the ACTION investigators Clinical course of isolated stable angina due to coronary heart disease Eur. Heart J., August 2, 2007; 28(16): 1928 - 1935. [Abstract] [Full Text] [PDF] |
||||
![]() |
W.-C. Wu, T. L. Schifftner, W. G. Henderson, C. B. Eaton, R. M. Poses, G. Uttley, S. C. Sharma, M. Vezeridis, S. F. Khuri, and P. D. Friedmann Preoperative Hematocrit Levels and Postoperative Outcomes in Older Patients Undergoing Noncardiac Surgery JAMA, June 13, 2007; 297(22): 2481 - 2488. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. Weidemann, P. Jung, C. Hoyer, J. Broscheit, W. Voelker, G. Ertl, S. Stork, C. E. Angermann, and J. M. Strotmann Assessment of the contractile reserve in patients with intermediate coronary lesions: a strain rate imaging study validated by invasive myocardial fractional flow reserve Eur. Heart J., June 2, 2007; 28(12): 1425 - 1432. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. A. Heidenreich, I. Schnittger, H. W. Strauss, R. H. Vagelos, B. K. Lee, C. S. Mariscal, D. J. Tate, S. J. Horning, R. T. Hoppe, and S. L. Hancock Screening for Coronary Artery Disease After Mediastinal Irradiation for Hodgkin's Disease J. Clin. Oncol., January 1, 2007; 25(1): 43 - 49. [Abstract] [Full Text] [PDF] |
||||
![]() |
Authors/Task Force Members, K. Fox, M. A. A. Garcia, D. Ardissino, P. Buszman, P. G. Camici, F. Crea, C. Daly, G. De Backer, P. Hjemdahl, et al. Guidelines on the management of stable angina pectoris: executive summary: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology Eur. Heart J., June 1, 2006; 27(11): 1341 - 1381. [Full Text] [PDF] |
||||
![]() |
J M Tsutsui, F C. Lario, D R Fernandes, I Kowatsch, J C Sbano, J A Franchini Ramires, and W Mathias Jr Safety and cardiac chronotropic responsiveness to the early injection of atropine during dobutamine stress echocardiography in the elderly Heart, December 1, 2005; 91(12): 1563 - 1567. [Abstract] [Full Text] [PDF] |
||||
![]() |
V. Bittner Perspectives on Dyslipidemia and Coronary Heart Disease in Women J. Am. Coll. Cardiol., November 1, 2005; 46(9): 1628 - 1635. [Abstract] [Full Text] [PDF] |
||||
![]() |
E. Biagini, A. Elhendy, A. F.L. Schinkel, J. J. Bax, R. Vittoria, R. T. van Domburg, C. Rapezzi, M. L. Simoons, and D. Poldermans Risk Stratification of Patients With Classic Angina Pectoris and No History of Coronary Artery Disease by Dobutamine Stress Echocardiography J. Am. Coll. Cardiol., August 16, 2005; 46(4): 730 - 732. [Full Text] [PDF] |
||||
![]() |
S. Natarajan, Y. Liao, G. Cao, S. R. Lipsitz, and D. L. McGee Sex Differences in Risk for Coronary Heart Disease Mortality Associated With Diabetes and Established Coronary Heart Disease Arch Intern Med, July 28, 2003; 163(14): 1735 - 1740. [Abstract] [Full Text] [PDF] |
||||
![]() |
S. V. Williams, S. D. Fihn, and R. J. Gibbons Guidelines for the Management of Patients with Chronic Stable Angina: Diagnosis and Risk Stratification Ann Intern Med, October 2, 2001; 135(7): 530 - 547. [Abstract] [Full Text] [PDF] |
||||
![]() |
J I Davar, E B Roberts, J G Coghlan, T R Evans, and D P Lipkin Prognostic value of stress echocardiography in women with high ({>=}80%) probability of coronary artery disease Postgrad. Med. J., September 1, 2001; 77(911): 573 - 577. [Abstract] [Full Text] [PDF] |
||||
![]() |
F. K. Welty Cardiovascular Disease and Dyslipidemia in Women Arch Intern Med, February 26, 2001; 161(4): 514 - 522. [Abstract] [Full Text] [PDF] |
||||
![]() |
E. Braunwald, E. M. Antman, J. W. Beasley, R. M. Califf, M. D. Cheitlin, J. S. Hochman, R. H. Jones, D. Kereiakes, J. Kupersmith, T. N. Levin, et al. ACC/AHA guidelines for the management of patients with unstable angina and non-st-segment elevation myocardial infarction: A report of the american college of cardiology/ american heart association task force on practice guidelines (committee on the management of patients with unstable angina) J. Am. Coll. Cardiol., September 1, 2000; 36(3): 970 - 1062. [Full Text] [PDF] |
||||
![]() |
J.E Roeters van Lennep, A.H Zwinderman, H.W.O Roeters van Lennep, H.E Westerveld, H.W.M Plokker, A.A Voors, A.V.G Bruschke, and E.E van der Wall Gender differences in diagnosis and treatment of coronary artery disease from 1981 to 1997. No evidence for the Yentl syndrome Eur. Heart J., June 1, 2000; 21(11): 911 - 918. [Abstract] [PDF] |
||||
![]() |
A. Melidonis, V. Dimopoulos, E. Lempidakis, J. Hatzissavas, G. Kouvaras, A. Stefanidis, S. Foussas, and S. Foussas Angiographic Study of Coronary Artery Disease in Diabetic Patients in Comparison with Nondiabetic Patients Angiology, December 1, 1999; 50(12): 997 - 1006. [Abstract] [PDF] |
||||
![]() |
R. J. Gibbons, K. Chatterjee, J. Daley, J. S. Douglas, S. D. Fihn, J. M. Gardin, M. A. Grunwald, D. Levy, B. W. Lytle, R. A. O'Rourke, et al. ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Chronic Stable Angina) J. Am. Coll. Cardiol., June 1, 1999; 33(7): 2092 - 2197. [Full Text] [PDF] |
||||
![]() |
K. M. Kuntz, K. E. Fleischmann, M. G.M. Hunink, and P. S. Douglas Cost-Effectiveness of Diagnostic Strategies for Patients with Chest Pain Ann Intern Med, May 4, 1999; 130(9): 709 - 718. [Abstract] [Full Text] [PDF] |
||||
![]() |
A. M. Garber and N. A. Solomon Cost-Effectiveness of Alternative Test Strategies for the Diagnosis of Coronary Artery Disease Ann Intern Med, May 4, 1999; 130(9): 719 - 728. [Abstract] [Full Text] [PDF] |
||||
![]() |
P. J. Scanlon, D. P. Faxon, A.-M. Audet, B. Carabello, G. J. Dehmer, K. A. Eagle, R. D. Legako, D. F. Leon, J. A. Murray, S. E. Nissen, et al. ACC/AHA guidelines for coronary angiography: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Coronary Angiography) developed in collaboration with the Society for Cardiac Angiography and Interventions J. Am. Coll. Cardiol., May 1, 1999; 33(6): 1756 - 1824. [Full Text] [PDF] |
||||
![]() |
L. Cortigiani, C. Dodi, E. A. Paolini, D. Bernardi, G. Bruno, and E. Nannini Prognostic value of pharmacological stress echocardiography in women with chest pain and unknown coronary artery disease J. Am. Coll. Cardiol., December 1, 1998; 32(7): 1975 - 1981. [Abstract] [Full Text] [PDF] |
||||
![]() |
J. L. Thomas and P. A. Braus Coronary Artery Disease in Women: A Historical Perspective Arch Intern Med, February 23, 1998; 158(4): 333 - 337. [Abstract] [Full Text] [PDF] |
||||
![]() |
M. Enriquez-Sarano, E. Klodas, K. N. Garratt, K. R. Bailey, A. J. Tajik, and D. R. Holmes Secular Trends in Coronary Atherosclerosis -- Analysis in Patients with Valvular Regurgitation N. Engl. J. Med., August 1, 1996; 335(5): 316 - 322. [Abstract] [Full Text] [PDF] |
||||
![]() |
N. H.J. Pijls, B. Van Gelder, P. Van der Voort, K. Peels, F. A.L.E. Bracke, H. J.R.M. Bonnier, and M. I.H. El Gamal Fractional Flow Reserve : A Useful Index to Evaluate the Influence of an Epicardial Coronary Stenosis on Myocardial Blood Flow Circulation, December 1, 1995; 92(11): 3183 - 3193. [Abstract] [Full Text] |
||||
![]() |
A.M. Cicatiello, P. Landino, P. Simonelli, L. Del Mastro, P. Ferrara, A. Cioppa, and F. Ciaburri Safety of Echo-Dipyridamole Test in Elderly Patients with Coronary Artery Disease Angiology, April 1, 1995; 46(4): 321 - 326. [Abstract] [PDF] |
||||
![]() |
D. B. Mark, L. K. Shaw, E. R. DeLong, R. M. Califf, and D. B. Pryor Absence of Sex Bias in the Referral of Patients for Cardiac Catheterization N. Engl. J. Med., April 21, 1994; 330(16): 1101 - 1106. [Abstract] [Full Text] |
||||
|
Circulation Home | Subscriptions | Archives | Feedback | Authors | Help | AHA Journals Home | Search Copyright © 1981 American Heart Association, Inc. All rights reserved. Unauthorized use prohibited. |