Non-coronary chest pain does not affect long-term mortality: a prospective, observational study using a matched...

Area of Science:

• Cardiology
• Primary Care Medicine
• Epidemiology

Background:

• Non-coronary origin chest pain (NCCP) is a common presentation in primary care.
• Previous assumptions suggested a potential link between NCCP and increased coronary heart disease (CHD) mortality.
• This study investigates the long-term outcomes of NCCP patients regarding CHD mortality and morbidity.

Purpose of the Study:

• To determine if patients diagnosed with NCCP in primary care experience higher mortality and long-term morbidity from CHD.
• To assess the association between NCCP and established risk factors for CHD.

Main Methods:

• A cohort of 382 NCCP patients and 746 matched controls were identified from primary care centers (1998-2000).
• Mortality data were obtained from national registries and death certificates.
• A 2005 postal questionnaire collected data on survivors' demographics, clinical status, and CHD diagnoses prior to inclusion were exclusion criteria.

Main Results:

• No significant difference in mortality or CHD incidence was observed between NCCP patients and controls.
• NCCP patients reported significantly more ongoing chest pain (OR 3.34).
• The NCCP group exhibited higher rates of hypertension (OR 1.86), and increased use of beta-blockers, aspirin, thiazides, nitrates, and remedies for acid-related disorders and obstructive pulmonary disease.

Conclusions:

• Chest pain diagnosed as NCCP by general practitioners is not associated with increased CHD incidence or mortality compared to the general population.
• NCCP is a persistent condition, often lasting many years.
• Hypertension is a significant comorbidity associated with NCCP.