VARIATIONS IN THE USE OF CORONARY ANGIOGRAPHY IN 3 CITIES IN THE TRENT REGION - ABSTRACTS

Objective-To establish the characteristics of patients referred for co ronary angiography and the outcome of investigation. Design-Prospectiv e study. Setting-Three regional referral centres at Sheffield, Leicest er, and Nottingham. Patients-All patients referred for investigation f rom 1 July 1988 to 30 June 1989. Interventions-Coronary angiography fo r suspected ischaemic heart disease. Main outcome measures-Site and ex tent of coronary artery disease at coronary angiography and subsequent intervention. Results-There was a range of clinical activity with a t rend towards symptomatic control in Nottingham where patients tended t o have more severe angina of long duration and extensive drug treatmen t. Important coronary lesions were often found and most patients neede d coronary artery bypass surgery or angioplasty. In Leicester and Shef field, where angiography was used prognostically, patients tended to h ave mild angina of shorter duration and less extensive medical treatme nt; significant coronary disease was often found but fewer patients we re recommended for further intervention. Conclusions-Referral for coro nary angiography seems to reflect philosophical differences among the referring physicians. Referring patients late in the disease process e nsures that most have a subsequent intervention but the benefits of re vascularisation may be denied to those with mild symptoms but extensiv e coronary disease.