Abstract 18962: Impact of Angina on Cardiovascular Outcomes in Patients With Stable Ischemic Heart Disease: A Post-Hoc Analysis From the COURAGE Trial
BACKGROUND: Previous data on the prognostic value of angina on clinical outcomes in patients with stable ischemic heart disease (SIHD) has been conflicting. We studied the impact of presence and severity of angina on clinical outcomes among participants in the COURAGE trial.
METHODS: Based on presence or absence of angina at baseline, 2,280 patients with SIHD were divided into 2 subgroups. Those with angina were further stratified based on angina severity determined by Canadian Cardiology Society (CCS) class. Hazard ratios for clinical outcomes were calculated using the group with silent ischemia (CCS = 0) as referent.
RESULTS: Table 1 shows cumulative event rates and hazard ratios among study participants after 4.6 years of follow-up. Although presence or absence of angina did not have any impact on clinical outcomes, patients with CCS III angina did have a significantly higher rate of death/MI/ACS, largely due to greater ACS (unstable angina) events.
CONCLUSIONS: Patients with SIHD on optimal medical therapy had similar rates of “hard” cardiovascular endpoints regardless of presence or severity of angina. Those with severe (CCS III) angina at baseline had higher incidence of unstable angina with negative biomarkers, a finding that merits further investigation in future clinical trials.
- © 2013 by American Heart Association, Inc.