Chest pain

Study Questions Use of Coronary Angiography in Unstable Angina

Invasive coronary angiography was associated with a reduced mortality risk for patient with unstable angina, according to the results of a new study.

The longitudinal study included discharge data for 33,901 patients hospitalized with unstable angina in Victoria, Australia from 2001 to 2011, who were either did or did not receive invasive coronary angiography. Researchers conducted propensity and sensitivity analyses to determine whether angiography influenced 12-month all-cause mortality outcomes.

Overall, the researchers found that routine angiography was associated with a 52% decrease in 12-month mortality, but revascularization was not found to offer any additional benefit compared with diagnostic angiography alone.

At 12 months, the predicted cumulative probability of death was 0.024 for patients who received angiography within 2 months after the first record for unstable angina compared with 0.097 for patients who did not receive angiography.

“Patients with unstable angina benefit from an invasive management pathway initiated by invasive coronary angiography during their hospitalization and up to 2 months after discharge.”

—Melissa Weiss


Vogrin S, Harper R, Paratz E, et al. Comparative effectiveness of routine invasive coronary angiography for managing unstable angina [published online May 2, 2017]. Ann Intern Med. doi:10.7326/M16-2420.