| Risk score for predicting death, myocardial infarction, and stroke in patients with stable angina, based on a large randomised trial cohort of patients. | |
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MedLine Citation:
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PMID: 16210253 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To derive a risk score for the combination of death from all causes, myocardial infarction, and disabling stroke in patients with stable symptomatic angina who require treatment for angina and have preserved left ventricular function. DESIGN: Multivariate Cox regression analysis of data from a large multicentre trial. SETTING: Outpatient cardiology clinics in western Europe, Israel, Canada, Australia, and New Zealand. PARTICIPANTS: 7311 patients with all required data available. MAIN OUTCOME MEASURE: Death from any cause or myocardial infarction or disabling stroke during a mean follow-up of 4.9 years. RESULTS: 1063 patients either died from any cause or sustained myocardial infarction or disabling stroke. The five year risk of this composite ranged from 4% for patients in the lowest tenth of risk to 35% for patients in the highest tenth. The risk score combines 16 routinely available clinical variables (in order of decreasing contribution): age, left ventricular ejection fraction, smoking, white blood cell count, diabetes, casual blood glucose concentration, creatinine concentration, previous stroke, at least one angina attack a week, coronary angiographic findings (if available), lipid lowering treatment, QT interval, systolic blood pressure > or = 155 mm Hg, number of drugs used for angina, previous myocardial infarction, and sex. Fitting the same model separately to all cause death, myocardial infarction, and stroke gave similar results. The risk score did not seem to predict the nature of the event (death in 39%, myocardial infarction in 46%, and disabling stroke in 15%) or the incidence of angiography or revascularisation, which occurred in 29% of patients. CONCLUSION: This risk score is an objective aid in deciding on further management of patients with stable angina with the aim of reducing serious outcome events. The score can also be used in planning future trials. |
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Authors:
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Tim C Clayton; Jacobus Lubsen; Stuart J Pocock; Zoltán Vokó; Bridget-Anne Kirwan; Keith A A Fox; Philip A Poole-Wilson |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2005-10-06 |
Journal Detail:
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Title: BMJ (Clinical research ed.) Volume: 331 ISSN: 1756-1833 ISO Abbreviation: BMJ Publication Date: 2005 Oct |
Date Detail:
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Created Date: 2005-10-14 Completed Date: 2005-10-21 Revised Date: 2012-03-06 |
Medline Journal Info:
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Nlm Unique ID: 8900488 Medline TA: BMJ Country: England |
Other Details:
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Languages: eng Pagination: 869 Citation Subset: AIM; IM |
Affiliation:
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Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London WC1E 7HT. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Angina Pectoris / mortality* Calcium Channel Blockers / therapeutic use Cohort Studies Female Humans Male Middle Aged Myocardial Infarction / mortality* Nifedipine / therapeutic use Quality of Life Risk Assessment / methods Risk Factors Stroke / mortality* |
| Chemical | |
Reg. No./Substance:
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0/Calcium Channel Blockers; 21829-25-4/Nifedipine |
| Comments/Corrections | |
Comment In:
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BMJ. 2005 Oct 15;331(7521):872
[PMID:
16210254
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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