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Do patients with angina alone have a more benign prognosis than patients with a history of acute myocardial infarction, revascularisation or both? Findings from a community cohort study.
  1. Brian Buckley (bsbuckley{at}iol.ie)
  1. National University of Ireland, Republic of Ireland
    1. Andrew W Murphy (andrew.murphy{at}nuigalway.ie)
    1. National University of Ireland, Republic of Ireland

      Abstract

      Aim: To compare prognosis for patients with a diagnosis of angina alone to patients post acute myocardial infarction (AMI) and / or revascularisation and/or angina.

      Design: Community-based retrospective cohort study.

      Setting: A random selection of 37 Irish general practices.

      Participants: 1,609 adults with ischaemic heart disease (IHD) identified in 2000/1.

      Intervention: Medical records searches and postal questionnaires in 2000/1 and 2005/6.

      Outcome measures: Primary: all-cause and IHD-related mortality. Secondary: acute myocardial infarction (AMI), cardiac artery bypass grafting (CABG) and percutaneous transluminal coronary angioplasty (PTCA); physical and mental health status, process of care measurements and behavioural risk factor outcomes.

      Results: Compared with patients with previous AMI and / or revascularisation and / or angina, patients with angina alone had similar risks of all-cause and IHD-related death: hazard ratios of 0.73 (95% CI 0.55 – 0.98) and 0.65 (95% CI 0.44 - 0.98) respectively were not significant at the p=0.01 level. No statistically significant differences were identified in risks of subsequent AMI, CABG or PTCA, or other outcomes.

      Conclusions: Prognosis for patients with angina alone was similar to those with previous AMI and/ or revascularization and /or angina. The clinical importance of angina should not be underestimated in primary care. Further descriptive research is needed amongst representative community cohorts of people with angina.

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