Document Detail


Detection of ambulatory ischaemia is not of practical clinical value in the routine management of patients with stable angina. A long-term follow-up study.
MedLine Citation:
PMID:  7789373     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
It has been reported that medically treated patients with stable angina and positive exercise test for ischaemia have an adverse 1-2 year outlook if they are shown also to have transient, and predominantly silent, ischaemic episodes detected by ambulatory ST segment monitoring during their daily activities: it has been suggested that this investigation could be used to identify patients more likely to benefit from early investigation and treatment. We assessed the long-term (up to 65 months) prognostic significance of transient ischaemic episodes during daily activities in 172 patients routinely attending cardiac outpatients with medically treated stable angina who had undergone exercise testing and 48 h of ambulatory ST segment monitoring between February 1988 and August 1989 for this purpose. A positive exercise test for ischaemia was not a prerequisite for inclusion. One hundred and four patients (60.5%) had a positive exercise test for ischaemia and 72 (42%) had transient ischaemia during daily activities (63 had both tests positive). Over a median 50-month follow-up period 54 patients suffered at least one cardiac event (primary event: cardiac death n = 7; non-fatal myocardial infarction n = 11; unstable angina n = 18; elective CABG/PTCA n = 18). Two further patients suffered non-cardiac death. Cardiac events, either objective (cardiac death or non-fatal myocardial infarction) or subjective (unstable angina or revascularisation) were no more likely to occur in those with transient ischaemia during daily life when compared with those without, at follow-up times up to 65 months.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
D Mulcahy; C Knight; D Patel; N Curzen; D Cunningham; C Wright; D Clarke; H Purcell; G Sutton; K Fox
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European heart journal     Volume:  16     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1995 Mar 
Date Detail:
Created Date:  1995-07-27     Completed Date:  1995-07-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  317-24     Citation Subset:  IM    
Affiliation:
Royal Brompton National Heart and Lung Hospital, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Ambulatory Care
Angina Pectoris / diagnosis*,  mortality,  physiopathology
Angioplasty, Transluminal, Percutaneous Coronary
Coronary Artery Bypass
Coronary Disease / diagnosis*,  mortality,  physiopathology
Death, Sudden, Cardiac / etiology,  prevention & control
Electrocardiography
Electrocardiography, Ambulatory*
Exercise Test
Female
Follow-Up Studies
Heart Conduction System / physiopathology
Humans
Long-Term Care
Male
Middle Aged
Myocardial Infarction / diagnosis,  mortality,  physiopathology
Outcome and Process Assessment (Health Care)
Postoperative Complications / diagnosis,  mortality,  physiopathology
Recurrence
Risk Factors
Survival Analysis
Survival Rate
Comments/Corrections
Comment In:
Eur Heart J. 1995 Mar;16(3):297-8   [PMID:  7789369 ]

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