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Women who undergo catheterization for suspected cardiac ischemia often have normal or nonobstructed (<50% obstruction) coronary arteries and present a therapeutic dilemma. Several retrospective studies have shown that such women have worse outcomes than asymptomatic women.
Researchers compared outcomes in 540 symptomatic women who had normal coronary arteries or nonobstructive coronary artery disease (CAD) and in 1000 age-matched asymptomatic women who did not have histories of heart disease (mean age, 55; 18% nonwhite). Symptomatic women had been referred for coronary angiography for suspected ischemia as part of a study of diagnostic strategies for cardiovascular disease. Cardiologists who were blinded to historical data read the angiogram…