Athar A Badar1, Ana Cristina Perez-Moreno2, Pardeep S Jhund2, Chih M Wong2, Nathaniel M Hawkins3, John G F Cleland4, Dirk J van Veldhuisen5, John Wikstrand6, John Kjekshus7, Hans Wedel8, Stuart Watkins9, Roy S Gardner1, Mark C Petrie1, John J V McMurray10. 1. BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK Golden Jubilee National Hospital, Glasgow, UK. 2. BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK. 3. University of British Columbia, Vancouver, Canada. 4. National Heart & Lung Institute, Royal Brompton & Harefield Hospitals, Imperial College, London, UK. 5. University Hospital Groningen, Groningen, Netherlands. 6. Gothenburg University, Gothenburg, Sweden. 7. Oslo University Hospital, Rikshospitalet, University of Oslo, Oslo, Norway. 8. Nordic School of Public Health, Gothenburg, Sweden. 9. Golden Jubilee National Hospital, Glasgow, UK. 10. BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK john.mcmurray@glasgow.ac.uk.
Abstract
AIM: Angina pectoris is common in patients with heart failure and reduced ejection fraction (HF-REF) but its relationship with outcomes has not been well defined. This relationship was investigated further in a retrospective analysis of the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA). METHODS AND RESULTS: Four thousand, eight hundred and seventy-eight patients were divided into three categories: no history of angina and no chest pain at baseline (Group A; n = 1240), past history of angina but no chest pain at baseline (Group B; n = 1353) and both a history of angina and chest pain at baseline (Group C; n = 2285). Outcomes were examined using Kaplan-Meier and Cox regression survival analysis. Compared with Group A, Group C had a higher risk of non-fatal myocardial infarction or unstable angina (HR: 2.36, 1.54-3.61; P < 0.001), this composite plus coronary revascularization (HR: 2.54, 1.76-3.68; P < 0.001), as well as HF hospitalization (HR: 1.35, 1.13-1.63; P = 0.001), over a median follow-up period of 33 months. There was no difference in cardiovascular or all-cause mortality. Group B had a smaller increase in risk of coronary events but not of heart failure hospitalization. CONCLUSION: Patients with HF-REF and ongoing angina are at an increased risk of acute coronary syndrome and HF hospitalization. Whether these patients would benefit from more aggressive medical therapy or percutaneous revascularization is not known and merits further investigation. Published on behalf of the European Society of Cardiology. All rights reserved.
RCT Entities:
AIM: Angina pectoris is common in patients with heart failure and reduced ejection fraction (HF-REF) but its relationship with outcomes has not been well defined. This relationship was investigated further in a retrospective analysis of the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA). METHODS AND RESULTS: Four thousand, eight hundred and seventy-eight patients were divided into three categories: no history of angina and no chest pain at baseline (Group A; n = 1240), past history of angina but no chest pain at baseline (Group B; n = 1353) and both a history of angina and chest pain at baseline (Group C; n = 2285). Outcomes were examined using Kaplan-Meier and Cox regression survival analysis. Compared with Group A, Group C had a higher risk of non-fatal myocardial infarction or unstable angina (HR: 2.36, 1.54-3.61; P < 0.001), this composite plus coronary revascularization (HR: 2.54, 1.76-3.68; P < 0.001), as well as HF hospitalization (HR: 1.35, 1.13-1.63; P = 0.001), over a median follow-up period of 33 months. There was no difference in cardiovascular or all-cause mortality. Group B had a smaller increase in risk of coronary events but not of heart failure hospitalization. CONCLUSION:Patients with HF-REF and ongoing angina are at an increased risk of acute coronary syndrome and HF hospitalization. Whether these patients would benefit from more aggressive medical therapy or percutaneous revascularization is not known and merits further investigation. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: E Marc Jolicœur; Allison Dunning; Serenella Castelvecchio; Rafal Dabrowski; Myron A Waclawiw; Mark C Petrie; Ralph Stewart; Pardeep S Jhund; Patrice Desvigne-Nickens; Julio A Panza; Robert O Bonow; Benjamin Sun; Tan Ru San; Hussein R Al-Khalidi; Jean L Rouleau; Eric J Velazquez; John G F Cleland Journal: J Am Coll Cardiol Date: 2015-11-10 Impact factor: 24.094
Authors: Meaghan Lunney; Marinella Ruospo; Patrizia Natale; Robert R Quinn; Paul E Ronksley; Ioannis Konstantinidis; Suetonia C Palmer; Marcello Tonelli; Giovanni Fm Strippoli; Pietro Ravani Journal: Cochrane Database Syst Rev Date: 2020-02-27
Authors: Cassandra Freitas; Xuesong Wang; Yin Ge; Heather J Ross; Peter C Austin; Peter S Pang; Dennis T Ko; Michael E Farkouh; Therese A Stukel; John J V McMurray; Douglas S Lee Journal: CJC Open Date: 2020-02-24