Emergency department visits and hospitalizations after a diagnosis of angina with no obstructive coronary artery disease (ANOCA)
Authors' conclusion
ED visits for ANOCA have risen over time while hospitalizations remain stable, indicating a growing burden despite generally lower rates than SA with obstructive CAD. These findings underscore the need for more effective management strategies to address the significant morbidity and resource utilization in ANOCA.
Study context
- Population
- Individuals who had their first invasive cardiac catheterization for chest pain in Alberta from 2002 to 2017 (APPROACH database)ANOCA, 36%
- Participants
- 28,881 individuals
- Exposure
- Emergency department (ED) visits and hospitalizations following ANOCA and stable angina (SA) with obstructive coronary artery disease (CAD) diagnoses
- Outcome
- ED visits incidence rates (two-year postcatheterization), trend over time
- Follow-up
- Two-year postcatheterization
Main finding
As reported in the abstract
ANOCA
100.3-119.3
IR · per 1,000 person-years
SA with obstructive CAD
209.3-240.2
IR · per 1,000 person-years
- ANOCA trend, increased over time (b per biennium)
- b = 2.19 per biennium [95% CI 0.83-3.55]; P = .008
- SA with obstructive CAD trend, remained stable (b per biennium)
- b = −1.83 per biennium [95% CI −5.73 to 1.70]; P = .25
Observational data: associations, not effects.
Further findings
Factors associated with ED visits and hospitalizations for ANOCA: previous history of heart failure
| Comparison | HR (95% CI) | P value | |
|---|---|---|---|
| Previous history of heart failureED visits, ANOCA · Cox models · most associated factor | 1.74 (1.41–2.14) | P < 0.001 | |
| Previous history of heart failureHospitalizations, ANOCA · Cox models · most associated factor | 2.40 (1.82–3.18) | P < 0.001 | |
| 0.20.5125Hazard ratio (log scale) |
| Outcome | ANOCA | SA with obstructive CAD |
|---|---|---|
| Hospitalization incidence rates, trend over time | IR 12.4-25.8 per 1,000 person-years | IR 106.4-171.4 per 1,000 person-years |
- Hospitalization incidence rates, trend over time — ANOCA trend, stable (b per biennium)
- b = −0.93 per biennium [95% CI −2.49 to 0.64]; P = .20
- Hospitalization incidence rates, trend over time — SA with obstructive CAD trend, decreased over time (b per biennium)
- b = −9.02 per biennium [95% CI −13.27 to −4.77; P = .002
Original publication
Emergency department visits and hospitalizations after a diagnosis of angina with no obstructive coronary artery disease (ANOCA). Am Heart J. Published 1 March 2025. doi:10.
Summarised from the published abstract; every number is checked against it