The prognostic significance of angina pectoris preceding the occurrence of a first acute myocardial infarction in 4166 consecutive hospitalized patients

Solomon Behar, Henrietta Reicher-Reiss, Edward Abinader, Jacob Agmon, Yaacov Friedman, Jacob Barzilai, Elieser Kaplinsky, Nissim Kauli, Yehezkiel Kishon, Abraham Palant, Benyamin Peled, Babeth Rabinovich, Leonardo Reisin, Zwi Schlesinger, Izhar Zahavi, Monty Zion, Uri Goldbourt

Research output: Contribution to journalArticlepeer-review

58 Scopus citations

Abstract

We examined the role of chronic (>1 month) angina pectoris (AP) before acute myocardial infarction (AMI) in predicting hospital and long-term mortality rates among 4166 patients with first AMIs. The prevalence of AP in these patients was 43%. Chronic AP was more common in women (49%), patients with hypertension (49%), and diabetic patients (49%) than in men and counterparts free of the former conditions (p < 0.005). In patients with AP the hospital course was more complicated and non-Q-wave AMI was more common than in counterparts without AP. In-hospital (16%), as well as 1 (8%)- and 5-year postdischarge (26%), mortality rates in hospital survivors were higher among patients with previous AP than in patients without previous AP (12%, 6%, and 19%, respectively) (p < 0.01). After adjustment for age and all other predictors of increased hospital mortality rates in this cohort of patients, AP preceding AMI emerged as an independent predictor of increased hospital mortality rates (odds ratio 1.30; 90% confidence interval 1.10 to 1.53). For postdischarge mortality rates (mean follow-up 5 1 2 years), the covariate-adjusted relative risk of death in patients with AP was similar at 1.29 (p < 0.0001; 90% confidence interval 1.16 to 1.44), according to estimation by Cox proportional hazards model. These data support the notion that preexisting AP identifies a group of patients at increased risk of death.

Original languageEnglish
Pages (from-to)1481-1486
Number of pages6
JournalAmerican Heart Journal
Volume123
Issue number6
DOIs
StatePublished - 1 Jan 1992
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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