Related Experiment Videos

Five year prognosis in patients with angina identified in primary care: incident cohort study

Brian S Buckley1, Colin R Simpson, David J McLernon

  • 1Department of General Practice, National University of Ireland, Galway, Ireland. bsbuckley@iol.ie

BMJ (Clinical Research Ed.)
|August 8, 2009
PubMed

Insights

Patients newly diagnosed with angina face significant risks of heart attack and death, with factors like male sex, increasing age, smoking, and obesity worsening outcomes. Optimal preventive treatments are crucial for managing angina patients and minimizing adverse events.

Area of Science:

  • Cardiovascular Medicine
  • Epidemiology
  • Public Health

Background:

  • Angina pectoris is a significant manifestation of ischaemic heart disease.
  • Understanding long-term risks following a new angina diagnosis is crucial for patient management.
  • Primary care data provides a valuable resource for studying incident cardiovascular conditions.

Purpose of the Study:

  • To assess the five-year risk of acute myocardial infarction, invasive cardiac procedures, and mortality in patients with newly diagnosed angina.
  • To identify demographic, lifestyle, and comorbidity factors associated with adverse outcomes.
  • To evaluate the impact of invasive cardiac procedures on subsequent mortality.

Main Methods:

  • An incident cohort study utilizing linked primary care, secondary care, and mortality data from 40 Scottish practices.
  • 1785 patients diagnosed with angina as their first manifestation of ischaemic heart disease were followed for five years.
  • Adjusted hazard ratios were calculated for key cardiovascular events and mortality, controlling for baseline characteristics.

Main Results:

  • Male sex, increasing age, smoking, and obesity were significantly associated with increased risks of acute myocardial infarction, ischaemic heart disease death, and all-cause mortality.
  • Chronic kidney disease showed a very high risk for death from ischaemic heart disease.
  • Acute myocardial infarction following angina diagnosis strongly predicted subsequent mortality; invasive procedures showed no significant mortality benefit.

Conclusions:

  • Significant sex differences exist in survival post-angina diagnosis, alongside age and sex disparities in revascularisation rates.
  • Acute myocardial infarction is a potent predictor of mortality in patients with incident angina.
  • Emphasizing optimal preventive strategies in primary care is essential for improving outcomes in angina patients.
Abstract

Related Concept Videos

Angina V: Nursing Management01:20

Angina V: Nursing Management

Angina, a symptom of myocardial ischemia, requires a structured nursing management approach to ensure effective care and prevent complications like myocardial infarction. Comprehensive nursing care involves assessing, diagnosing, planning, implementing interventions, and evaluating outcomes, all tailored to the individual patient's needs.Patient AssessmentNursing assessment begins with a detailed subjective evaluation of symptoms, which typically include chest pain or pressure radiating to the...
Angina III: Clinical Manifestations and Assessment01:29

Angina III: Clinical Manifestations and Assessment

Angina manifests as chest pain, tightness, or squeezing discomfort typically located behind the breastbone. It can radiate to the neck, jaw, shoulders, and inner aspects of the upper arms, most commonly the left arm. Patients may experience shortness of breath, fatigue, profuse sweating, dizziness, indigestion, heartburn, palpitations, anxiety, and vomiting as accompanying symptoms. This pain often lasts a few minutes and is triggered by physical exertion, emotional stress, heavy meals, or cold...
Angina IV: Management01:26

Angina IV: Management

IntroductionThe management of angina requires a comprehensive approach that includes pharmacological therapies, medical procedures, and lifestyle modifications.Pharmacological TherapiesAntiplatelet agents, such as aspirin, clopidogrel, prasugrel, and ticagrelor, play a pivotal role in preventing thrombus formation in patients with angina. These medications inhibit platelet aggregation and reduce the likelihood of myocardial infarction and other cardiovascular events.Anticoagulants, including...
Angina II: Classification01:27

Angina II: Classification

Angina, also known as angina pectoris, is a chest pain resulting from diminished blood flow to the heart muscle and is often a symptom of coronary artery disease. Angina presents several variants with distinctive attributes, etiologies, and therapeutic approaches. The main types of angina include stable, unstable, variant (Prinzmetal's), microvascular, intractable, and silent ischemia.Stable angina is caused by atherosclerosis, which leads to the formation of plaques that narrow the coronary...
Angina I: Introduction01:30

Angina I: Introduction

Definition and Symptoms: Angina (angina pectoris) is chest pain or discomfort caused by myocardial ischemia, which occurs when the heart muscle receives insufficient oxygen-rich blood. It typically manifests as pressing, squeezing, or crushing sensations in the chest and may radiate to the shoulders, arms, neck, jaw, or back.Primary Cause: In a healthy state, the coronary arteries can dilate (widen) to increase blood flow and meet the increased oxygen demand during physical activity or...
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...