Objective: To determine whether women with anamnestic suspicion of angina pectoris more often than men with suspicion of angina pectoris have normal coronary arteries on coronary arteriograms. Second, to compare the prognosis of these patients with that of the mean population.
Design: Literature study.
Method: Articles were selected from Medline over the period 1966 to May 1998 with the use of search terms, and in De geïnformeerde huisarts (The informed GP) over 1992 to November 1998 following which the relevance of the articles was assessed on the basis of title and abstract. Data on the prognosis of the general population were obtained from a WHO project.
Results: Three articles were selected about sex differences in the presence of angiographically normal coronary arteries in patients with suspected angina pectoris. In 2 articles normal coronary arteries were found more often in women (40-41%) than in men (8-12%). In 1 article women were found to have less severe and extensive coronary artery disease then men. Eight articles were selected about the prognosis of patients with suspected angina pectoris and angiographically normal coronary arteries. Per 1000 patient years the total number of deaths ranged from 0 to 6.59 (weighted mean: 4.05), the number of deaths due to coronary disease from 0 to 0.92 (0.47) and the number of patients with non fatal myocardial infarctions from 0 to 1.83 (0.94). These figures were similar to those in an average population.
Conclusion: Women with anamnestic suspicion of angina pectoris have normal coronary angiograms more often than mean with anamnestic suspicion of angina pectoris. The prognosis of patients with suspected angina pectoris and normal coronary arteries in terms of mortality and number of non fatal myocardial infarctions is the same as in the general population.