Copyright © 2003 by the European Society of Cardiology.
Regular Articles
The value of routine non-invasive tests to predict clinical outcome in stable angina
a Kim Fox Research Department, Royal Brompton Hospital, Sydney St, London SW3 6NP, UK
b Robertson Centre for Biostatics, University of Glasgow, Glasgow G12 8QQ, UK
c Southern General Hospital, Govan Road, Glasgow, UK
d CRI in Heart Failure, Wolfson Building, University of Glasgow, Glasgow G12 8QQ, UK
* Corresponding author. Tel.: +44-207-351-8265; fax: +44-207-351-8643
E-mail address: c.daly{at}rbh.nthames.nhs.uk
E-mail address: j.norrie{at}stats.gla.ac.uk
E-mail address: ian{at}stats.gla.ac.uk
Received 20 November 2002; accepted 20 November 2002
Background Chronic stable angina is a common condition, but considerable differences exist in the likelihood of acute coronary events such as CHD death, non-fatal myocardial infarction (MI) and unstable angina between individual patients. Effective risk prediction is necessary for optimum management. The aim of this study was to identify clinical features and non-invasive test parameters associated with high risk of these coronary events in stable angina and compose a clinically useful model to predict adverse outcomes in this population.
Methods Six hundred and eighty-two patients with stable angina and a positive exercise test (1mm ST depression) from the Total Ischaemic Burden European Trial (TIBET) study, were studied. Resting ECG, exercise tolerance testing and echocardiography were performed at baseline, off anti-anginal therapy. The patients were then randomised to treatment with atenolol, nifedipine or a combination of both. Clinical follow up continued for an average of 2 years (range 1–3 years).
Results and conclusions Prior MI or prior CABG were the clinical parameters associated with adverse outcome in patients with stable angina and a positive exercise test. On the ECG, left ventricular hypertrophy was predictive, and on echocardiogram, increased left ventricular dimensions were predictive of adverse events. When combined with time to ischaemia on exercise testing in a simple clinically applicable table these factors could be used to predict of 2 year probability of events for an individual patient.
Key Words: Stable angina • Non-invasive testing • Echocardiography • Exercise testing • Prognosis
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  Authors/Task Force Members, K. Fox, M. A. A. Garcia, D. Ardissino, P. Buszman, P. G. Camici, F. Crea, C. Daly, G. De Backer, P. Hjemdahl, et al. Guidelines on the management of stable angina pectoris: executive summary: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology Eur. Heart J., June 1, 2006; 27(11): 1341 - 1381. [Full Text] [PDF]
|
|
|
|
 |
|
 T. C Clayton, J. Lubsen, S. J Pocock, Z. Voko, B.-A. Kirwan, K. A A Fox, P. A Poole-Wilson, and on behalf of the ACTION investigators Risk score for predicting death, myocardial infarction, and stroke in patients with stable angina, based on a large randomised trial cohort of patients BMJ, October 15, 2005; 331(7521): 869. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. A. Daly, F. Clemens, J. L. L. Sendon, L. Tavazzi, E. Boersma, N. Danchin, F. Delahaye, A. Gitt, D. Julian, D. Mulcahy, et al. The clinical characteristics and investigations planned in patients with stable angina presenting to cardiologists in Europe: from the Euro Heart Survey of Stable Angina Eur. Heart J., May 2, 2005; 26(10): 996 - 1010. [Abstract] [Full Text] [PDF]
|
|