Peter R Croft1, Elaine Thomas. 1. Primary Care Musculoskeletal Research Centre, Keele University, Keele.
Abstract
BACKGROUND: Chest pain may not be reported to general practice but could be an important first sign of coronary heart disease (CHD). AIMS: To determine whether self-reported chest pain predicts future consultation for CHD in those with no history of consultation for CHD. DESIGN OF STUDY: Population-based study, with 7 year's follow up by GP record linkage. SETTING: General practice in North Staffordshire. METHOD: A survey, including the Rose angina questionnaire, was mailed to 4002 adults. Linked GP records used to identify responders with no record of CHD (G3 Read code or British National Formulary code for nitrate use) in the 32 months before the survey to form the sample for a 7-year prospective study. 'Survival' was compared in those with and without self-reported chest pain up to the earliest date of GP diagnosis of CHD, death, or end of the study period. RESULTS: The survey response was 65% and 2348 participants gave permission to access their GP records. Of these, 2229 had no prior consultation for CHD. From the questionnaire, 558 reported chest pain of which 186 reported exertional pain and 103 met the criteria for angina. When followed prospectively, incidence of CHD consultations was higher in those with any chest pain definition, compared with no pain, and continued to be so for 7 years subsequently. Although these associations were strongly age related, self-reported symptoms were found to be an independent risk factor for future consultation for CHD. CONCLUSION: This study highlighted that self-reported chest pain is a marker of future CHD. The usefulness of early identification of people with this symptom remains to be established.
BACKGROUND:Chest pain may not be reported to general practice but could be an important first sign of coronary heart disease (CHD). AIMS: To determine whether self-reported chest pain predicts future consultation for CHD in those with no history of consultation for CHD. DESIGN OF STUDY: Population-based study, with 7 year's follow up by GP record linkage. SETTING: General practice in North Staffordshire. METHOD: A survey, including the Rose angina questionnaire, was mailed to 4002 adults. Linked GP records used to identify responders with no record of CHD (G3 Read code or British National Formulary code for nitrate use) in the 32 months before the survey to form the sample for a 7-year prospective study. 'Survival' was compared in those with and without self-reported chest pain up to the earliest date of GP diagnosis of CHD, death, or end of the study period. RESULTS: The survey response was 65% and 2348 participants gave permission to access their GP records. Of these, 2229 had no prior consultation for CHD. From the questionnaire, 558 reported chest pain of which 186 reported exertional pain and 103 met the criteria for angina. When followed prospectively, incidence of CHD consultations was higher in those with any chest pain definition, compared with no pain, and continued to be so for 7 years subsequently. Although these associations were strongly age related, self-reported symptoms were found to be an independent risk factor for future consultation for CHD. CONCLUSION: This study highlighted that self-reported chest pain is a marker of future CHD. The usefulness of early identification of people with this symptom remains to be established.
Authors: Mark Porcheret; Rhian Hughes; Dai Evans; Kelvin Jordan; Tracy Whitehurst; Helen Ogden; Peter Croft Journal: J Am Med Inform Assoc Date: 2003-10-05 Impact factor: 4.497
Authors: Kelvin P Jordan; Trishna Rathod-Mistry; James Bailey; Ying Chen; Lorna Clarson; Spiros Denaxas; Richard A Hayward; Harry Hemingway; Danielle A van der Windt; Mamas A Mamas Journal: J Am Heart Assoc Date: 2022-03-18 Impact factor: 6.106
Authors: Kelvin P Jordan; Adam Timmis; Peter Croft; Danielle A van der Windt; Spiros Denaxas; Arturo González-Izquierdo; Richard A Hayward; Pablo Perel; Harry Hemingway Journal: BMJ Date: 2017-04-03