Association between Angina Class at Presentation with Percutaneous Coronary Intervention

Background:
Percutaneous coronary intervention (PCI) with stent placement is an approved therapy for critical coronary artery stenosis, not eligible for coronary artery bypass graft (CABG). We looked at association of angina class at presentation with odds of receiving PCI.

Methods:
It is a single center retrospective study. We analysed data from January 2015 to March 2018 using our local angiogram registry. Anginal class was defined based on Canadian Cardiovascular Society Angina Class grading system. Patients who required surgical intervention after angiogram were excluded (56). Patients were divided into two groups based on whether they required PCI or not. Chi-square and Student's T-test were used for statistical analysis. Binary linear regression was run to compare clinical variables.

Results:
Final sample size was 7388 patients. Average age was 65.4±12.4 years with 62% males (4744). Of the 7388 patients, 2798 (37.9%) required PCI. PCI group had significantly higher proportion of males (70.6% vs 29.4%, OR: 1.42, CI: 1.26-1.60, p<0.001) and patients with history of dyslipidemia (OR:1.13, CI:1.00-1.26, p=0.035) and prior MI (OR:1.46, CI: 1.29-1.64, p<0.001). When compared for anginal class, we found that patients in higher anginal classes were more likely to receive PCI compared with lower anginal classes (p<0.001). In PCI group, 62.9% (1760) patients presented with anginal class 5 symptoms, 19.6% (548) with anginal class 4, 11.8% (329) with anginal class 3, 2.5% (69) with anginal class 2 and 3.3% (92) with anginal class 1.

Conclusions:
A higher anginal class at presentation is associated with greater odds of receiving PCI.