abstract

• Background-The extent to which angina is associated with future cardiovascular events in patients with coronary artery disease has long been debated. Methods and Results-Included were outpatients with established coronary artery disease who were enrolled in the REACH registry and were followed for 4 years. Angina at baseline was defined as necessitating episodic or permanent antianginal treatment. The primary end point was the composite of cardiovascular death, myocardial infarction, or stroke. Secondary end points included heart failure, cardiovascular hospitalizations, and coronary revascularization. The independent association between angina and first/total events was examined using Cox and logistic regression models. Out of 26 159 patients with established coronary artery disease, 13 619 (52%25) had angina at baseline. Compared with patients without angina, patients with angina were more likely to be older, female, and had more heart failure and polyvascular disease (P<0.001 for each). Compared with patients without angina, patients with angina had higher rates of first primary end-point event (14.2%25 versus 16.3%25, unadjusted hazard ratio 1.19, CI 1.11-1.27, P<0.001; adjusted hazard ratio 1.06, CI 0.99-1.14, P=0.11), and total primary end-point events (adjusted risk ratio 1.08, CI 1.01-1.16, P=0.03). Patients with angina were at increased risk for heart failure (adjusted odds ratio 1.17, CI 1.06-1.28, P=0.002), cardiovascular hospitalizations (adjusted odds ratio 1.29, CI 1.21-1.38, P<0.001), and coronary revascularization (adjusted odds ratio 1.23, CI 1.13-1.34, P<0.001). Conclusions-Patients with stable coronary artery disease and angina have higher rates of future cardiovascular events compared with patients without angina. After adjustment, angina was only weakly associated with cardiovascular death, myocardial infarction, or stroke, but significantly associated with heart failure, cardiovascular hospitalization, and coronary revascularization. © 2016 The Authors.

authors

• Rodríguez Leyva Ildefonso

publication date

• 2016-01-01

published in

• Journal of the American Heart Association  Journal

keywords

• Angina; Cardiovascular events; Coronary artery disease antiangina pectoris agent; age; aged; Article; cardiovascular mortality; cerebrovascular accident; controlled study; coronary artery disease; diabetes mellitus; disease association; female; follow up; heart failure; heart infarction; heart muscle revascularization; high risk patient; hospitalization; human; major clinical study; male; outcome assessment; polyvascular disease; priority journal; sex difference; smoking; stable angina pectoris; vascular disease; cardiovascular disease; case control study; cerebrovascular accident; coronary artery disease; heart failure; heart infarction; middle aged; mortality; odds ratio; prognosis; proportional hazards model; register; stable angina pectoris; statistics and numerical data; United States; utilization; Aged; Angina, Stable; Cardiovascular Diseases; Case-Control Studies; Coronary Artery Disease; Female; Heart Failure; Hospitalization; Humans; Male; Middle Aged; Myocardial Infarction; Myocardial Revascularization; Odds Ratio; Prognosis; Proportional Hazards Models; Registries; Stroke; United States

Digital Object Identifier (DOI)

• 10.1161/JAHA.116.004080

PubMed ID

• 27680665

start page

end page

volume

• 5

issue

• 10