TY - JOUR
T1 - Angina and future cardiovascular events in stable patients with coronary artery disease
T2 - Insights from the Reduction of Atherothrombosis for Continued Health (REACH) registry
AU - on Behalf of the REACH Registry Investigators
AU - Eisen, Alon
AU - Bhatt, Deepak L.
AU - Steg, P. Gabriel
AU - Eagle, Kim A.
AU - Goto, Shinya
AU - Guo, Jianping
AU - Smith, Sidney C.
AU - Ohman, E. Magnus
AU - Scirica, Benjamin M.
AU - Andersen-Dalheim, Heidi
AU - Anderson, Paul
AU - Anell, Bill
AU - Arber, Sam
AU - Armstrong, Kathleen
AU - Arnot, Dean
AU - Baldam, Alan
AU - Barratt, Ian
AU - Barresi, Sebastian
AU - Beder, Jeff
AU - Benson, Michael
AU - Bergman, Frederick
AU - Best, James
AU - Bhasim, Rajesh
AU - Bovell, Geoff
AU - Bowman, Neil
AU - Brkic, Mal
AU - Bromberger, David
AU - Brown, David
AU - Brown, Jean
AU - Brownstein, Michael
AU - Bruce, Angela
AU - Buonopane, John
AU - Burns, Steven
AU - Butler, Alexis
AU - Byrne, Danny
AU - Carson, Judith
AU - Cassimatis, Peter
AU - Chaffey, Greig
AU - Chambers, Dianne
AU - Chan, Wing Jung
AU - Chan, Ben
AU - Cheatham, James
AU - Chen, Rachel
AU - Cheong, Brian
AU - Cheung, Christina
AU - Chin, John
AU - Chiu, Anthony
AU - Choo, Eric
AU - Chow, Andrew
AU - Goldstein, Robert
N1 - Publisher Copyright:
© 2016 The Authors.
PY - 2016
Y1 - 2016
N2 - 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%) 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% versus 16.3%, 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.
AB - 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%) 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% versus 16.3%, 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.
KW - Angina
KW - Cardiovascular events
KW - Coronary artery disease
UR - http://www.scopus.com/inward/record.url?scp=84994417481&partnerID=8YFLogxK
U2 - 10.1161/JAHA.116.004080
DO - 10.1161/JAHA.116.004080
M3 - Article
C2 - 27680665
AN - SCOPUS:84994417481
SN - 2047-9980
VL - 5
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 10
M1 - e004080
ER -