Abstract 15786: Angina Frequency and Secondary Events in Patients with Stable Coronary Heart Disease: Data from the Heart and Soul Study

Abstract

Background: Angina is a common symptom in patients with coronary heart disease (CHD). We sought to describe the burden of angina and its association with secondary events in outpatients with stable CHD.

Methods: Between 9/00 and 12/02, we administered the Seattle Angina Questionnaire to 1023 outpatients with CHD. Hospitalizations for angina, revascularization, myocardial infarction, and heart failure were determined by blinded chart review during 8.9 years of follow-up. Death certificates were also obtained. We used Cox proportional hazards models to compare rates of secondary events in participants with daily or weekly angina to those without angina.

Results: Among 1023 participants, 633 (62%) reported no angina, 279 (27%) reported monthly angina, and 111 (11%) reported daily or weekly angina. During the follow-up period, 200 participants were hospitalized for angina, 187 for revascularization, 133 for myocardial infarction, and 179 for heart failure. A total of 392 participants died. Compared to participants without angina, participants with daily or weekly angina were more likely to be hospitalized for angina (HR 3.28, 95%CI 2.29, 4.70, p<.001), more likely to undergo revascularization (HR 2.10, 95%CI 1.41, 3.12; p<.001), more likely to be hospitalized for heart failure (HR 1.61, 95%CI 1.04, 2.49; p=0.03), and more likely to die (HR 1.47, 95%CI 1.09, 1.98; p=0.01), but not more likely to have a myocardial infarction (HR 1.43, 95%CI 0.83, 2.46; p=0.19) (Figure). After adjusting for age, sex, smoking, hypertension, history of heart failure, medication use, treadmill exercise capacity, and depressive symptoms, angina frequency remained associated with hospitalization for angina (HR 2.05, 95%CI 1.32, 3.19; p=0.001), but not with other events.

Conclusions: Higher angina frequency was associated with secondary events in outpatients with stable CHD. Those with daily or weekly angina had higher rates of angina, revascularization, heart failure, and death.