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This article has been peer reviewed. It is the authors' final version prior to publication in Coronary Artery Disease

Volume 21, Issue 5, August 2010, Pages 278-280.

The published version is available at DOI: 10.1097/MCA.0b013e32833bdf53. Copyright © Lippincott, Williams and Wilkins.


BACKGROUND: As the number of angina patients with severe coronary artery disease not amenable to revascularization increases, new therapies will be developed. How patients with depressed compared to normal left ventricular ejection fraction (LVEF) will respond to new therapies may differ.

HYPOTHESIS: We conducted a retrospective chart review to determine the distribution of LVEF in angina patients with severe coronary artery disease (three-vessel disease with >50% stenosis major epicardial vessels or >50% stenosis left main) not amenable to revascularization.

METHODS: Patients underwent cardiac catheterization between 2004 and 2009. LVEF, measured by echocardiography, nuclear-gated imaging or radioventriculography within 6 months of catheterization, was recorded. Demographics, symptoms, risk factors, past myocardial infarction, catheterization results, medications, and the Duke Coronary Artery Jeopardy Score were recorded.

RESULTS: Eight thousand six hundred and ninety-nine patient charts were reviewed; 124 met criteria. There was a continuous, and not bimodal, distribution of LVEF. Fifty-eight patients (47%) in the normal LVEF group were compared to 66 patients (53%) in the abnormal LVEF group (

CONCLUSION: There is a wide distribution of LVEF among angina patients not amenable to revascularization. A novel finding of this study showed that mortality was high regardless of LVEF. As new therapies for angina are developed, attention will need to be paid to how such therapies affect these two patient groups.

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