dc.contributor.author | Buckley, B | |
dc.contributor.author | Murphy, A W | |
dc.date.accessioned | 2018-09-20T16:01:51Z | |
dc.date.available | 2018-09-20T16:01:51Z | |
dc.date.issued | 2008-07-31 | |
dc.identifier.citation | Buckley, B; Murphy, A W (2008). Do patients with angina alone have a more benign prognosis than patients with a history of acute myocardial infarction, revascularisation or both? findings from a community cohort study. Heart 95 (6), 461-467 | |
dc.identifier.issn | 1355-6037 | |
dc.identifier.uri | http://hdl.handle.net/10379/10571 | |
dc.description.abstract | Aim: To compare prognosis for patients with a diagnosis of angina alone to patients postacute myocardial infarction (AMI) and/or revascularisation and/or angina.
Design: Community-based retrospective cohort study.
Setting: A random selection of 37 Irish general practices.
Participants: 1,609 adults with ischaemic heart disease (IHD) identified in 2000/1.
Intervention: Medical records searches and postal questionnaires in 2000/1 and 2005/6.
Outcome measures: Primary: all-cause and IHD-related mortality. Secondary: acute myocardial infarction (AMI), cardiac artery bypass grafting (CABG) and percutaneous transluminal coronary angioplasty (PTCA); physical and mental health status as measured by SF36 and SF12; process of care measurements and behavioural risk factor outcomes.
Results: Compared with patients with previous AMI and/or revascularisation, patients with angina alone had slightly lower risks of all-cause and IHD-related death: however, although hazard ratios of 0.73 (95% CI 0.55 to 0.98) and 0.65 (95% CI 0.44 to 0.98), respectively, were significant at the p < 0.05 level, they were not significant at the p < 0.01 level currently suggested as appropriate in observational research. Proportional hazards models identified no statistically significant differences in adjusted risks of subsequent AMI, CABG or PTCA between patients with angina-alone and those with other IHD. Over the 4.5-year follow-up, physical functioning was consistently lower among those with angina alone, and the extent to which physical functioning was increasingly impaired was slightly greater.
Conclusions: Prognosis to death or cardiac outcomes for patients with angina alone was similar to those with previous AMI and/or revascularisation, while health status was poorer. The clinical importance of angina should not be underestimated in primary care. Further descriptive research is needed among representative community cohorts of people with angina. | |
dc.publisher | BMJ | |
dc.relation.ispartof | Heart | |
dc.rights | Attribution-NonCommercial-NoDerivs 3.0 Ireland | |
dc.rights.uri | https://creativecommons.org/licenses/by-nc-nd/3.0/ie/ | |
dc.subject | coronary-heart-disease | |
dc.subject | general-practice | |
dc.subject | secondary prevention | |
dc.subject | clinical-practice | |
dc.subject | men | |
dc.subject | guidelines | |
dc.subject | validity | |
dc.subject | pectoris | |
dc.subject | records | |
dc.subject | death | |
dc.title | Do patients with angina alone have a more benign prognosis than patients with a history of acute myocardial infarction, revascularisation or both? findings from a community cohort study | |
dc.type | Article | |
dc.identifier.doi | 10.1136/hrt.2008.146944 | |
dc.local.publishedsource | http://heart.bmj.com/content/heartjnl/95/6/461.full.pdf | |
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