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Role of coronary angiography in severe left ventricular systolic dysfunction and dyspnoea. Do we really follow the guidelines?

Jeremias Bayon, Melisa Santas-Alvarez, Raymundo Ocaranza-Sanchez and Carlos Gonzalez-Juanatey

Introduction: Role of coronary angiography is not well established in left ventricular dysfunction patients coming with dyspnoea. The aim of our study is to evaluate in a 8 year retrospective sample of patients with severe systolic dysfunction and suspicion of underlying coronary artery disease, the diagnostic value of coronary angiography in relation to the patient's clinical and traditional cardiovascular risk factors. Methods: We analyse 1022 patients observing coronary disease in 288 (28.2%) and risk factors show that diabetes, smoking, male gender and age above 65 years are the most powerful predictors of coronary disease. Results: Regarding the extent of CAD, classic cardiovascular risk factors contributes significantly in those patients with a single coronary vessel disease, probable incidental finding without being responsible for systolic dysfunction. Only diabetes and gender male reach statistical significance as independent predictors in the three-vessel disease, where the CAD actually plays a role in the pathogenesis of systolic left ventricular dysfunction. Conclusions: The results of our work invited to question the need for coronary angiography only in certain groups of patients, based on their cardiovascular risk profile as part of the study of severe left ventricular systolic dysfunction.