{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T13:58:12Z","timestamp":1790949492404,"version":"4.1.0"},"reference-count":20,"publisher":"Texas Heart Institute Journal","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:p>In a time when cardiac troponin assays are widely used to detect myocardial injury, data remain scarce concerning the incidence and predictors of substantial obstructive coronary artery disease that causes unstable angina.<\/jats:p>\n        <jats:p>This retrospective single-center study included consecutive patients hospitalized for unstable angina from January 2015 through January 2016. Patients with troponin I levels above the upper reference limit and those who did not undergo angiography were excluded. Multivariate logistic regression analysis was used to identify predictors of obstructive coronary artery disease that warranted revascularization and of major adverse cardiac events up to 6 months after discharge from the hospital.<\/jats:p>\n        <jats:p>Of the 114 patients who met the inclusion criteria, 46 (40%) had obstructive coronary artery disease. In the univariate analysis, male sex, white race, history of coronary artery disease, prior revascularization, hyperlipidemia, chronic kidney disease, aspirin use, long-acting nitrate use, and Thrombolysis in Myocardial Infarction score \u22653 were associated with obstructive coronary artery disease. History of coronary artery disease, prior revascularization, hyperlipidemia, and long-acting nitrate use were associated with major adverse cardiac events. Male sex was an independent predictor of obstructive coronary artery disease (adjusted odds ratio=4.82; 95% CI, 1.79\u201313; <jats:italic>P<\/jats:italic>=0.002) in the multivariate analysis.<\/jats:p>\n        <jats:p>Our results showed that coronary artery disease warranting revascularization is present in a considerable proportion of patients who have unstable angina. The association that we found between male sex and obstructive coronary artery disease suggests that the risk stratification of patients presenting with unstable angina may need to be refined to improve outcomes.<\/jats:p>","DOI":"10.14503\/thij-17-6329","type":"journal-article","created":{"date-parts":[[2019,10,31]],"date-time":"2019-10-31T15:59:21Z","timestamp":1572537561000},"page":"161-166","source":"Crossref","is-referenced-by-count":5,"title":["Incidence and Predictors of Obstructive Coronary Artery Disease and the Role of Cardiac Troponin Assays in Patients with Unstable Angina"],"prefix":"10.14503","volume":"46","author":[{"given":"Sushan","family":"Yang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nirmanmoh","family":"Bhatia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John A.","family":"McPherson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"5628","reference":[{"issue":"24","key":"i1526-6702-46-3-161-b1","series-title":"Circulation","first-page":"2452","article-title":"Unstable angina: is it time for a requiem?","volume":"127","year":"2013","unstructured":"Braunwald\n              E\n            , MorrowDA.\n          Unstable angina: is it time for a requiem?\n          Circulation\n          2013;127(24):2452\u20137."},{"issue":"3","key":"i1526-6702-46-3-161-b2","series-title":"Circulation","first-page":"902","article-title":"Diagnostic efficiency of troponin T measurements in acute myocardial infarction","volume":"83","year":"1991","unstructured":"Katus\n              HA\n            , RemppisA, NeumannFJ, ScheffoldT, DiederichKW, VinarG, \n          et al. Diagnostic efficiency of troponin T measurements in acute myocardial infarction. Circulation1991;83(3):902\u201312."},{"issue":"24","key":"i1526-6702-46-3-161-b3","series-title":"J Am Coll Cardiol","first-page":"e139","article-title":"2014 AHA\/ACC Guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines [published erratum appears in J Am Coll Cardiol 2014;64(24):2713\u20134]","volume":"64","year":"2014","unstructured":"Amsterdam\n              EA\n            , WengerNK, BrindisRG, CaseyDEJr, GaniatsTG, HolmesDRJr, \n          et al. 2014 AHA\/ACC Guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines [published erratum appears in J Am Coll Cardiol 2014;64(24):2713\u20134]. J Am Coll Cardiol2014;64(24):e139\u2013e228."},{"issue":"1","key":"i1526-6702-46-3-161-b4","series-title":"JAMA","first-page":"71","article-title":"Early invasive vs conservative treatment strategies in women and men with unstable angina and non-ST-segment elevation myocardial infarction: a meta-analysis","volume":"300","year":"2008","unstructured":"O'Donoghue\n              M\n            , BodenWE, BraunwaldE, CannonCP, ClaytonTC, de WinterRJ, \n          et al. Early invasive vs conservative treatment strategies in women and men with unstable angina and non-ST-segment elevation myocardial infarction: a meta-analysis. JAMA2008;300(1):71\u201380."},{"issue":"3","key":"i1526-6702-46-3-161-b5","series-title":"Cochrane Database Syst Rev","article-title":"Early invasive versus conservative strategies for unstable angina and non-ST elevation myocardial infarction in the stent era","year":"2010","unstructured":"Hoenig\n              MR\n            , AroneyCN, ScottIA.\n          Early invasive versus conservative strategies for unstable angina and non-ST elevation myocardial infarction in the stent era. Cochrane Database Syst Rev2010;(3):CD004815."},{"issue":"25","key":"i1526-6702-46-3-161-b6","series-title":"N Engl J Med","first-page":"1879","article-title":"Comparison of early invasive and conservative strategies in patients with unstable coronary syndromes treated with the glycoprotein IIb\/IIIa inhibitor tirofiban","volume":"344","year":"2001","unstructured":"Cannon\n              CP\n            , WeintraubWS, DemopoulosLA, VicariR, FreyMJ, LakkisN, \n          et al. Comparison of early invasive and conservative strategies in patients with unstable coronary syndromes treated with the glycoprotein IIb\/IIIa inhibitor tirofiban. N Engl J Med2001;344(25):1879\u201387."},{"issue":"4","key":"i1526-6702-46-3-161-b7","series-title":"N Engl J Med","first-page":"226","article-title":"Sex, clinical presentation, and outcome in patients with acute coronary syndromes. Global Use of Strategies to Open Occluded Coronary Arteries in Acute Coronary Syndromes IIb Investigators","volume":"341","year":"1999","unstructured":"Hochman\n              JS\n            , TamisJE, ThompsonTD, WeaverWD, WhiteHD, Van de WerfF, \n          et al. Sex, clinical presentation, and outcome in patients with acute coronary syndromes. Global Use of Strategies to Open Occluded Coronary Arteries in Acute Coronary Syndromes IIb Investigators. N Engl J Med1999;341(4):226\u201332."},{"issue":"16","key":"i1526-6702-46-3-161-b8","series-title":"Circulation","first-page":"1809","article-title":"Clinical features and outcomes of women with unstable ischemic heart disease: observations from metabolic efficiency with ranolazine for less ischemia in non-ST-elevation acute coronary syndromes-thrombolysis in myocardial infarction 36 (MERLIN-TIMI 36)","volume":"121","year":"2010","unstructured":"Mega\n              JL\n            , HochmanJS, SciricaBM, MurphySA, SloanS, McCabeCH, \n          et al. Clinical features and outcomes of women with unstable ischemic heart disease: observations from metabolic efficiency with ranolazine for less ischemia in non-ST-elevation acute coronary syndromes-thrombolysis in myocardial infarction 36 (MERLIN-TIMI 36). Circulation2010;121(16):1809\u201317."},{"issue":"10","key":"i1526-6702-46-3-161-b9","series-title":"Am J Cardiol","first-page":"1145","article-title":"Differences between men and women in the management of unstable angina pectoris (The GUARANTEE Registry). The GUARANTEE Investigators","volume":"84","year":"1999","unstructured":"Scirica\n              BM\n            , MoliternoDJ, EveryNR, AndersonHV, AguirreFV, GrangerCB, \n          et al. Differences between men and women in the management of unstable angina pectoris (The GUARANTEE Registry). The GUARANTEE Investigators. Am J Cardiol1999;84(10):1145\u201350."},{"issue":"3 Suppl","key":"i1526-6702-46-3-161-b10","series-title":"J Am Coll Cardiol","first-page":"S4","article-title":"Insights from the NHLBI-sponsored Women's Ischemia Syndrome Evaluation (WISE) study: part I: gender differences in traditional and novel risk factors, symptom evaluation, and gender-optimized diagnostic strategies","volume":"47","year":"2006","unstructured":"Shaw\n              LJ\n            , Bairey MerzCN, PepineCJ, ReisSE, BittnerV, KelseySF, \n          et al. Insights from the NHLBI-sponsored Women's Ischemia Syndrome Evaluation (WISE) study: part I: gender differences in traditional and novel risk factors, symptom evaluation, and gender-optimized diagnostic strategies. J Am Coll Cardiol2006;47(3 Suppl):S4\u2013S20."},{"issue":"2","key":"i1526-6702-46-3-161-b11","series-title":"Cardiol J","first-page":"160","article-title":"Prognostic utility of ischemic response in functional imaging tests (SPECT or stress echocardiography) in low-risk unstable angina patients","volume":"22","year":"2015","unstructured":"Trivi\n              M\n            , RonderosR, MerettaA, CondeD, AveglianoG.\n          Prognostic utility of ischemic response in functional imaging tests (SPECT or stress echocardiography) in low-risk unstable angina patients. Cardiol J2015;22(2):160\u20134."},{"issue":"3","key":"i1526-6702-46-3-161-b12","series-title":"Exp Clin Cardiol","first-page":"133","article-title":"Appropriateness of diagnosis of unstable angina pectoris in patients referred for coronary arteriography","volume":"13","year":"2008","unstructured":"Goldberg\n              A\n            , YalonetskyS, KopeliovichM, AzzamZ, MarkiewiczW.\n          Appropriateness of diagnosis of unstable angina pectoris in patients referred for coronary arteriography. Exp Clin Cardiol2008;13(3):133\u20137."},{"issue":"6 Pt 1","key":"i1526-6702-46-3-161-b13","series-title":"Am Heart J","first-page":"1065","article-title":"Racial differences in the management of unstable angina: results from the multicenter GUARANTEE registry","volume":"138","year":"1999","unstructured":"Scirica\n              BM\n            , MoliternoDJ, EveryNR, AndersonHV, AguirreFV, GrangerCB, \n          et al. Racial differences in the management of unstable angina: results from the multicenter GUARANTEE registry. Am Heart J1999;138(6 Pt 1):1065\u201372."},{"issue":"14","key":"i1526-6702-46-3-161-b14","series-title":"JAMA","first-page":"1104","article-title":"Influence of race, sex, and age on management of unstable angina and non-Q-wave myocardial infarction: the TIMI III registry","volume":"275","year":"1996","unstructured":"Stone\n              PH\n            , ThompsonB, AndersonHV, KronenbergMW, GibsonRS, RogersWJ, \n          et al. Influence of race, sex, and age on management of unstable angina and non-Q-wave myocardial infarction: the TIMI III registry. JAMA1996;275(14):1104\u201312."},{"issue":"2","key":"i1526-6702-46-3-161-b15","series-title":"Circulation","first-page":"410","article-title":"Unstable angina. A classification","volume":"80","year":"1989","unstructured":"Braunwald\n              E.\n            \n          \n          Unstable angina. A classification. Circulation1989;80(2):410\u20134."},{"issue":"21","key":"i1526-6702-46-3-161-b16","series-title":"Circulation","first-page":"2219","article-title":"Unstable angina: an etiologic approach to management","volume":"98","year":"1998","unstructured":"Braunwald\n              E.\n            \n          \n          Unstable angina: an etiologic approach to management. Circulation1998;98(21):2219\u201322."},{"issue":"15","key":"i1526-6702-46-3-161-b17","series-title":"N Engl J Med","first-page":"913","article-title":"Coronary angioscopy in patients with unstable angina pectoris","volume":"315","year":"1986","unstructured":"Sherman\n              CT\n            , LitvackF, GrundfestW, LeeM, HickeyA, ChauxA, \n          et al. Coronary angioscopy in patients with unstable angina pectoris. N Engl J Med1986;315(15):913\u20139."},{"issue":"749","key":"i1526-6702-46-3-161-b18","series-title":"Postgrad Med J","first-page":"196","article-title":"Unstable angina","volume":"64","year":"1988","unstructured":"Patterson\n              DL.\n            \n          \n          Unstable angina. Postgrad Med J1988;64(749):196\u2013200."},{"issue":"18","key":"i1526-6702-46-3-161-b19","series-title":"N Engl J Med","first-page":"1342","article-title":"Cardiac-specific troponin I levels to predict the risk of mortality in patients with acute coronary syndromes","volume":"335","year":"1996","unstructured":"Antman\n              EM\n            , TanasijevicMJ, ThompsonB, SchactmanM, McCabeCH, CannonCP, \n          et al. Cardiac-specific troponin I levels to predict the risk of mortality in patients with acute coronary syndromes. N Engl J Med1996;335(18):1342\u20139."},{"issue":"3","key":"i1526-6702-46-3-161-b20","series-title":"JAMA","first-page":"347","article-title":"Association between minor elevations of creatine kinase-MB level and mortality in patients with acute coronary syndromes without ST-segment elevation. PURSUIT Steering Committee. Platelet Glycoprotein IIb\/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy","volume":"283","year":"2000","unstructured":"Alexander\n              JH\n            , SparapaniRA, MahaffeyKW, DeckersJW, NewbyLK, OhmanEM, \n          et al. Association between minor elevations of creatine kinase-MB level and mortality in patients with acute coronary syndromes without ST-segment elevation. PURSUIT Steering Committee. Platelet Glycoprotein IIb\/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy. 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