The aim of the study was optimization of the evaluation of questioning data for detection of prognostically unfavorable coronary atherosclerosis (PUCA). The subjects were 124 patients (96 men; 28 women) with chest pain and coronary atherosclerosis risk factors. The patients were questioned in detail; the character of pain syndrome was analyzed; a priori probability (APP) of coronary heart disease was evaluated; a functional class according to Canadian Cardiovascular Society Functional Classification was established. All the patients underwent selective coronaroangiography (CAG). Coronary atherosclerosis was considered to be severe (PUCA) under the following conditions: 1) stenosis of the main trunk of the left coronary artery by at least 70% of the diameter; 2) stenosis of the anterior descending artery in the first segment by at least 95% of the diameter in the presence of stenosis of the other magistral coronary artery by at least 75% of the diameter; 3) stenosis of all the three magistral coronary arteries by at least 75% of the diameter. After the matching of the questioning data with CAG results, a chart of preliminary evaluation of APP of severe coronary atherosclerosis, approachable for general practitioners, was developed. The offered chart of evaluation of PUCA APP is characterized by high rate of reliable diagnostic conclusions (56.5 +/- 4.5%), and allows substantial decrease in the need for loading tests when selection for CAG is performed.
Adult Aged