Table 1.
Baseline patient characteristics stratified by appropriateness classification and initial treatment
| Characteristic | Appropriate | Uncertain | Inappropriate | ||||||
|---|---|---|---|---|---|---|---|---|---|
| PCI (n=654) |
OMT (n=680) |
P value | PCI (n=279) |
OMT (n=272) |
P value | PCI (n=53) |
OMT (n=49) |
P value | |
| Age, mean (SD) (years) | 62±10 | 63±10 | 0.33 | 61±10 | 60±10 | 0.71 | 61 ±11 | 60±10 | 0.32 |
| Men | 86% | 85% | 0.58 | 85% | 86% | 0.63 | 77% | 78% | 0.98 |
| White | 85% | 87% | 0.24 | 89% | 86% | 0.28 | 91% | 83% | 0.28 |
| Body mass index, mean (SD) (kg/m2) | 30±5 | 30±5 | 0.65 | 29±5 | 30±5 | 0.46 | 29±4 | 29±5 | 0.48 |
| Diabetes mellitus | 35% | 36% | 0.68 | 28% | 34% | 0.14 | 22% | 41% | 0.04 |
| Heart failure | 5% | 5% | 0.65 | 6% | 2% | 0.02 | 6% | 4% | 0.71 |
| Chronic lung disease | 10% | 13% | 0.12 | 7% | 12% | 0.04 | 6% | 10% | 0.48 |
| Current smoker (<30 days) | 27% | 26% | 0.51 | 31% | 32% | 0.84 | 34% | 43% | 0.42 |
| Cancer (other than skin) | 5% | 4% | 0.58 | 4% | 6% | 0.33 | 15% | 0% | <0.01 |
| Family history of CAD | 55% | 51% | 0.16 | 54% | 52% | 0.65 | 58% | 55% | 0.83 |
| Hypertension | 70% | 69% | 0.66 | 63% | 65% | 0.52 | 45% | 55% | 0.32 |
| Hypercholesterolemia | 47% | 52% | 0.08 | 53% | 52% | 0.74 | 49% | 59% | 0.31 |
| Prior myocardial infarction | 36% | 36% | 0.77 | 37% | 42% | 0.23 | 37% | 44% | 0.46 |
| Prior percutaneous coronary intervention | 16% | 15% | 0.64 | 13% | 14% | 0.71 | 8% | 12% | 0.51 |
| Prior coronary artery bypass grafting | 10% | 11% | 0.71 | 9% | 7% | 0.48 | 2% | 4% | 0.61 |
| Prior Stroke or TIA | 9% | 9% | 0.71 | 7% | 6% | 0.60 | 2% | 4% | 0.61 |
| Peripheral Vascular Disease | 8% | 9% | 0.49 | 4% | 7% | 0.16 | 11% | 10% | 0.86 |
| Systolic blood pressure, mean (SD) (mmHg) | 134±21 | 133±20 | 0.28 | 131±19 | 131±18 | 0.79 | 132±18 | 130±17 | 0.57 |
| Diastolic blood pressure, mean (SD) (mmHg) | 74±12 | 74±11 | 0.69 | 74±11 | 75±10 | 0.27 | 74±11 | 74±10 | 0.92 |
| Estimated GFR, mean (SD) (mL/min/1.73 m2) | 80±20 | 77±20 | <0.01 | 82±19 | 81 ±19 | 0.68 | 84±23 | 80±20 | 0.34 |
| Ejection fraction, mean (SD) (%) | 62±11 | 61±10 | 0.98 | 62±11 | 62±10 | 0.94 | 63±10 | 60±10 | 0.08 |
| No. of Coronary Arteries Narrowed | |||||||||
| 1 | 22% | 24% | 57% | 51% | 45% | 37% | |||
| 2 | 41% | 37% | 0.21 | 38% | 44% | 0.37 | 53% | 59% | 0.59 |
| 3 | 36% | 40% | 5% | 6% | 2% | 4% | |||
| Proximal Left Anterior Descending | 58% | 66% | 0.02 | 20% | 26% | 0.14 | 0% | 2% | 0.48 |
| Baseline medications | |||||||||
| β-blockers | 77% | 75% | 0.54 | 60% | 61% | 0.81 | 67% | 74% | 0.52 |
| Nitrates | 65% | 67% | 0.61 | 41% | 47% | 0.23 | 29% | 29% | 0.97 |
| ACE-I/ARBs | 52% | 52% | 0.84 | 53% | 51% | 0.61 | 43% | 66% | 0.05 |
| Statins | 68% | 68% | 0.92 | 63% | 66% | 0.44 | 53% | 58% | 0.67 |
| Calcium-channel blockers | 38% | 34% | 0.22 | 23% | 21.9% | 0.83 | 6.1% | 7.9% | 1.00 |
| ≥ 2 antianginal medications | 69% | 67% | 0.53 | 34% | 39.3% | 0.23 | 26.5% | 34.2% | 0.48 |
| Risk from stress test results | |||||||||
| Low | 2% | 1% | 4% | 4.0% | 36.6% | 51.3% | |||
| Intermediate | 54% | 50% | 0.35 | 86% | 88.6% | 0.64 | 63.4% | 48.7% | ND |
| High | 45% | 49% | 10% | 7.5% | 0% | 0% | |||
| Baseline health status | |||||||||
| CCS class | |||||||||
| None | 7% | 8% | 12% | 17% | 77% | 69% | |||
| I | 29% | 30% | 0.12 | 36% | 37% | 0.15 | 4% | 16% | ND |
| II | 35% | 39% | 41% | 39% | 19% | 14% | |||
| III | 29% | 24% | 11% | 7% | 0% | 0% | |||
| SAQ angina frequency score, mean ± SD (IQR) | 66±27 (40,90) |
66±26 (50,90) |
0.58 | 73±24 (60,100) |
76±24 (60,100) |
0.26 | 83±24 (75,100) |
85±23 (75,100) |
0.72 |
| SAQ physical limitation score, mean ± SD (IQR) | 64±25 (44,83) |
64±25 (44,83) |
0.88 | 70±24 (50,92) |
73±24 (53,94) |
0.29 | 78±20 (64,96) |
79±25 (69,100) |
0.88 |
| SAQ quality of life score, mean ± SD (IQR) | 50±25 (33,67) |
49 ±24 (33,67) |
0.36 | 52±26 (33,75) |
57±26 (42,83) |
0.05 | 64±25 (46,83) |
63±27 (42,83) |
0.86 |
Hypertension was defined by clinical history, systolic blood pressure >140 mm Hg, or diastolic blood pressure >90 mm Hg at the time of enrollment. Hyperlipidemia was defined by the patient’s clinical history at the time of enrollment.
ACE-I = angiotensin-converting enzyme inhibitor; ARB = angiotensin II receptor blocker; CCS = Canadian Cardiovascular Society; GFR = glomerular filtration rate; IQR = interquartile range; OMT = optimal medical therapy; PCI = percutaneous coronary intervention; SAQ = Seattle Angina Questionnaire; SD = standard deviation; TIA = transient ischemic attack.