DIFFERENTIATING ANGINAL PATIENTS WITH CORONARY-ARTERY DISEASE FROM THOSE WITH NORMAL CORONARY-ARTERIES USING PSYCHOLOGICAL MEASURES

Up to 30% of patients with chest pain who undergo coronary catheterization have angiographically normal coronary arteries.1 Several recent prospective studies have shown that patients who are found to have normal coronary arteries score consistently higher than patients with coronary artery disease (CAD) on measures of the personality dimension of neuroticism when measured at catheterization2-4 or 1 year after.5 These findings are based on a diverse set of psychological tests, including the Minnesota Multiphasic Personality Inventory, Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory, Eysenck Personality Questionnaire, Cornell Medical Index, and the Millon Behavioral Health Inventory, attesting to the reliability and validity of the association between normal coronary arteries and neuroticism. Anticipating these findings linking neuroticism and chest pain with minimal, if any, intimal irregularities of the coronary arteries, Costa6 raised the possibility that psychometric information might be helpful to physicians in evaluating candidates for angiography. If a sensitive and specific psychometric scale could be developed to determine that the patient is likely to have normal coronary arteries, then less invasive alternatives to catheterization might be recommended. As a first step, we initiated this prospective study to evaluate the usefulness of an inventory that was developed for use in medical settings to differentiate chest pain patients. © 1991.