Indicação da Cineangiocoronariografia em isquêmicos ao Ecoestresse Físico: Heurística inadequada?

Abstract

Background: coronary angiography (CATE) has a fundamental importance for the diagnosis and management of patients with coronary artery disease (CAD). It is unknown to what degree the risk factors and other clinical characteristics influence cardiologists in their decision making. The objective of the study is to evaluate the variables used by cardiologists to indicate the CATE and the adequacy of heuristics used to stratify patients according to risk factors for CAD. Methods: This is an observational, cross-sectional analytical that were analyzed 2201 patients with myocardial ischemia to physical stress echocardiography (PSE) from March / 2001 to May / 2014 (mean age 59.8 ± 10 , 4 and 1265 (57.5%) were male). Results: The frequency of patients who underwent the CATE was 28.6% (CI 95% 26.4 to 30.5). Ten variables allowed to discriminate individuals of this population into five groups with different risk for CAD. The variable that allowed the best discrimination was age. The first two groups had the highest risk profile compared to the other three. Although the groups lodge profiles of different risk factors together, the frequency indication for the CATE was similar, with no significant difference between groups (p = 0.54). Conclusions: The variables used by cardiologists in their clinical practice for decision making to indicate the CATE allowed stratify individuals into groups with different risk for CAD. The frequency indication of the CATE was similar between groups suggesting an inadequacy of heuristics used in decision-making to indicate it.