Indicators for Coronary Artery Disease and Criteria for Patient Selection for Invasive Coronary Angiography: Experience from Gaza Strip-Palestine -

Background: Identification of risk factors and defining significant obstruction in coronary artery disease (CAD) using only clinical and noninvasive methods are often difficult tasks for the physician. Currently, coronary angiography (ICA) is the gold standard procedure for diagnosis of CAD. Nevertheless, this test should be carefully requested, as it is an invasive procedure. Here, we assess the predictive risk factors of significant CAD and the criteria for patient selection for ICA. Methods: A cross-sectional study included 250 consecutive patients with suspected significant CAD referred to ICA to explore the extent of significant vessel disease. Patient characteristics, risk factors for CAD, and ICA test results were compared. Results: 141 (56.4%) of the study patients were considered to have a significant CAD, and 109 (43.6%) of them were considered to have non-significant CAD. The independent predictors for obstructive CAD were: diabetes (odds ratio [OR], 4.35; confidence interval [CI] 95% (1.13-16.76), family history of heart disease (OR, 3.12; CI 95%, 1.11-8.68), currently smoking (OR, 2.89; CI 95%, 1.51-5.52), hypertension (OR, 2.74; CI 95%, 1.22-6.18), obesity (OR, 2.39; CI 95%, 1.26-4.55), and sedentary lifestyle (OR, 2.14; CI 95%, 1.09-4.22). Conclusions: Strategies for risk stratification are needed to improve the appropriateness of patient selection for ICA.