Document Detail

Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular events.
MedLine Citation:
PMID:  21911339     Owner:  NLM     Status:  MEDLINE    
AIMS: Patients with chest pain and no obstructive coronary artery disease (CAD) are considered at low risk for cardiovascular events but evidence supporting this is scarce. We investigated the prognostic implications of stable angina pectoris in relation to the presence and degree of CAD with no obstructive CAD in focus.
METHODS AND RESULTS: We identified 11 223 patients referred for coronary angiography (CAG) in 1998-2009 with stable angina pectoris as indication and 5705 participants from the Copenhagen City Heart Study for comparison. Main outcome measures were major adverse cardiovascular events (MACE), defined as cardiovascular death, myocardial infarction, stroke or heart failure, and all-cause mortality. Significantly more women (65%) than men (32%) had no obstructive CAD (P< 0.001). In Cox's models adjusted for age, body mass index, diabetes, smoking, and use of lipid-lowering or antihypertensive medication, hazard ratios (HRs) associated with no obstructive CAD were similar in men and women. In the pooled analysis, the risk of MACE increased with increasing degrees of CAD with multivariable-adjusted HRs of 1.52 (95% confidence interval, 1.27-1.83) for patients with normal coronary arteries and 1.85 (1.51-2.28) for patients with diffuse non-obstructive CAD compared with the reference population. For all-cause mortality, normal coronary arteries and diffuse non-obstructive CAD were associated with HRs of 1.29 (1.07-1.56) and 1.52 (1.24-1.88), respectively.
CONCLUSION: Patients with stable angina and normal coronary arteries or diffuse non-obstructive CAD have elevated risks of MACE and all-cause mortality compared with a reference population without ischaemic heart disease.
Lasse Jespersen; Anders Hvelplund; Steen Z Abildstrøm; Frants Pedersen; Søren Galatius; Jan K Madsen; Erik Jørgensen; Henning Kelbæk; Eva Prescott
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-09-11
Journal Detail:
Title:  European heart journal     Volume:  33     ISSN:  1522-9645     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-03-16     Completed Date:  2012-05-21     Revised Date:  2014-07-12    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  734-44     Citation Subset:  IM    
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MeSH Terms
Angina, Stable / mortality*,  radiography
Coronary Angiography / mortality
Coronary Artery Disease / mortality*,  radiography
Denmark / epidemiology
Epidemiologic Methods
Heart Failure / mortality
Middle Aged
Myocardial Ischemia / mortality
Stroke / mortality
Young Adult
Comment In:
Eur Heart J. 2014 Jun 1;35(21):1361-4   [PMID:  23045268 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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