W B Kannel1, J C Evans, S Piper, J M Murabito. 1. National Heart, Lung and Blood Institute's Framingham Heart Study, Framingham, MA, USA. billkannel@yahoo.com
Abstract
OBJECTIVE: To compare implications of Angina Pectoris (AP) and Intermittent Claudication (IC) as indicators of clinical atherosclerosis in other vascular territories. STUDY DESIGN AND SETTING: Prospective cohort study of cardiovascular disease (CVD) in 5,209 men and women of Framingham, MA, aged 28-62 years at enrollment in 1948-1951, who received biennial examinations during the first 36 years of follow-up. Comparative 10-year incidence of subsequent atherosclerotic CVD in participants with IC and AP relative to a reference sample free of CVD was determined. RESULTS: On follow-up, 95 CVD events occurred in 186 participants with IC and 206 of 413 with AP. After age, sex, and risk-factor adjustment, the proportion acquiring other CVD was 34.0% for IC and 43.4% for AP. Relative to the reference sample, those with IC had a 2.73-fold higher age and sex-adjusted 10-year hazard of CVD (95% CI 2.21, 3.38) and for AP was 3.17 (95% CI 2.73, 3.69). CVD hazard ratios remained more elevated for AP and statistically significant after standard risk factor adjustment. Risk factors accounted for more of the excess CVD risk associated with IC (34.8%) than AP (9.5%). CONCLUSION: AP is as useful as IC as a hallmark of diffuse atherosclerotic CVD and an indication for comprehensive preventive measures.
OBJECTIVE: To compare implications of Angina Pectoris (AP) and Intermittent Claudication (IC) as indicators of clinical atherosclerosis in other vascular territories. STUDY DESIGN AND SETTING: Prospective cohort study of cardiovascular disease (CVD) in 5,209 men and women of Framingham, MA, aged 28-62 years at enrollment in 1948-1951, who received biennial examinations during the first 36 years of follow-up. Comparative 10-year incidence of subsequent atherosclerotic CVD in participants with IC and AP relative to a reference sample free of CVD was determined. RESULTS: On follow-up, 95 CVD events occurred in 186 participants with IC and 206 of 413 with AP. After age, sex, and risk-factor adjustment, the proportion acquiring other CVD was 34.0% for IC and 43.4% for AP. Relative to the reference sample, those with IC had a 2.73-fold higher age and sex-adjusted 10-year hazard of CVD (95% CI 2.21, 3.38) and for AP was 3.17 (95% CI 2.73, 3.69). CVD hazard ratios remained more elevated for AP and statistically significant after standard risk factor adjustment. Risk factors accounted for more of the excess CVD risk associated with IC (34.8%) than AP (9.5%). CONCLUSION: AP is as useful as IC as a hallmark of diffuse atherosclerotic CVD and an indication for comprehensive preventive measures.
Authors: A B Newman; L Shemanski; T A Manolio; M Cushman; M Mittelmark; J F Polak; N R Powe; D Siscovick Journal: Arterioscler Thromb Vasc Biol Date: 1999-03 Impact factor: 8.311
Authors: T R Pedersen; J Kjekshus; K Pyörälä; A G Olsson; T J Cook; T A Musliner; J A Tobert; T Haghfelt Journal: Am J Cardiol Date: 1998-02-01 Impact factor: 2.778
Authors: Arne Georg Kieback; Christine Espinola-Klein; Claudia Lamina; Susanne Moebus; Daniel Tiller; Roberto Lorbeer; Andreas Schulz; Christa Meisinger; Daniel Medenwald; Raimund Erbel; Alexander Kluttig; Philipp S Wild; Florian Kronenberg; Knut Kröger; Till Ittermann; Marcus Dörr Journal: PLoS One Date: 2019-11-04 Impact factor: 3.240