Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular events

Lasse Jespersen; Anders Hvelplund; Steen Z Abildstrøm; Frants Pedersen; Søren Galatius; Jan K Madsen; Erik Jørgensen; Henning Kelbæk; Eva Prescott

doi:10.1093/eurheartj/ehr331

Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular events

Lasse Jespersen, Anders Hvelplund, Steen Z Abildstrøm, Frants Pedersen, Søren Galatius, Jan K Madsen, Erik Jørgensen, Henning Kelbæk, Eva Prescott

412 Citations (Scopus)

Abstract

Aims Patients with chest pain and no obstructive coronary artery disease (CAD) are considered at low risk for cardiovascular events but evidence supporting this is scarce. We investigated the prognostic implications of stable angina pectoris in relation to the presence and degree of CAD with no obstructive CAD in focus.Methods and resultsWe identified 11 223 patients referred for coronary angiography (CAG) in 19982009 with stable angina pectoris as indication and 5705 participants from the Copenhagen City Heart Study for comparison. Main outcome measures were major adverse cardiovascular events (MACE), defined as cardiovascular death, myocardial infarction, stroke or heart failure, and all-cause mortality. Significantly more women (65) than men (32) had no obstructive CAD (P< 0.001). In Coxs models adjusted for age, body mass index, diabetes, smoking, and use of lipid-lowering or antihypertensive medication, hazard ratios (HRs) associated with no obstructive CAD were similar in men and women. In the pooled analysis, the risk of MACE increased with increasing degrees of CAD with multivariable-adjusted HRs of 1.52 (95 confidence interval, 1.271.83) for patients with normal coronary arteries and 1.85 (1.512.28) for patients with diffuse non-obstructive CAD compared with the reference population. For all-cause mortality, normal coronary arteries and diffuse non-obstructive CAD were associated with HRs of 1.29 (1.071.56) and 1.52 (1.241.88), respectively. Conclusion Patients with stable angina and normal coronary arteries or diffuse non-obstructive CAD have elevated risks of MACE and all-cause mortality compared with a reference population without ischaemic heart disease.

Original language	English
Journal	European Heart Journal (English Edition)
Volume	33
Issue number	6
Pages (from-to)	734-744
ISSN	0195-668X
DOIs	https://doi.org/10.1093/eurheartj/ehr331
Publication status	Published - Mar 2012

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1093/eurheartj/ehr331

ehr331.pdfFinal published version, 492 KB

Cite this

Jespersen, L., Hvelplund, A., Abildstrøm, S. Z., Pedersen, F., Galatius, S., Madsen, J. K., Jørgensen, E., Kelbæk, H., & Prescott, E. (2012). Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular events. European Heart Journal (English Edition), 33(6), 734-744. https://doi.org/10.1093/eurheartj/ehr331

Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular events. / Jespersen, Lasse; Hvelplund, Anders; Abildstrøm, Steen Z et al.

In: European Heart Journal (English Edition), Vol. 33, No. 6, 03.2012, p. 734-744.

Research output: Contribution to journal › Journal article › Research › peer-review

Jespersen, L, Hvelplund, A, Abildstrøm, SZ, Pedersen, F, Galatius, S, Madsen, JK, Jørgensen, E, Kelbæk, H & Prescott, E 2012, 'Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular events', European Heart Journal (English Edition), vol. 33, no. 6, pp. 734-744. https://doi.org/10.1093/eurheartj/ehr331

@article{ef0fd9457f53470ba1aa0fc171296beb,

title = "Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular events",

abstract = "Aims Patients with chest pain and no obstructive coronary artery disease (CAD) are considered at low risk for cardiovascular events but evidence supporting this is scarce. We investigated the prognostic implications of stable angina pectoris in relation to the presence and degree of CAD with no obstructive CAD in focus.Methods and resultsWe identified 11 223 patients referred for coronary angiography (CAG) in 19982009 with stable angina pectoris as indication and 5705 participants from the Copenhagen City Heart Study for comparison. Main outcome measures were major adverse cardiovascular events (MACE), defined as cardiovascular death, myocardial infarction, stroke or heart failure, and all-cause mortality. Significantly more women (65) than men (32) had no obstructive CAD (P< 0.001). In Coxs models adjusted for age, body mass index, diabetes, smoking, and use of lipid-lowering or antihypertensive medication, hazard ratios (HRs) associated with no obstructive CAD were similar in men and women. In the pooled analysis, the risk of MACE increased with increasing degrees of CAD with multivariable-adjusted HRs of 1.52 (95 confidence interval, 1.271.83) for patients with normal coronary arteries and 1.85 (1.512.28) for patients with diffuse non-obstructive CAD compared with the reference population. For all-cause mortality, normal coronary arteries and diffuse non-obstructive CAD were associated with HRs of 1.29 (1.071.56) and 1.52 (1.241.88), respectively. Conclusion Patients with stable angina and normal coronary arteries or diffuse non-obstructive CAD have elevated risks of MACE and all-cause mortality compared with a reference population without ischaemic heart disease.",

author = "Lasse Jespersen and Anders Hvelplund and Abildstr{\o}m, {Steen Z} and Frants Pedersen and S{\o}ren Galatius and Madsen, {Jan K} and Erik J{\o}rgensen and Henning Kelb{\ae}k and Eva Prescott",

year = "2012",

month = mar,

doi = "10.1093/eurheartj/ehr331",

language = "English",

volume = "33",

pages = "734--744",

journal = "European Heart Journal",

issn = "0195-668X",

publisher = "Oxford University Press",

number = "6",

}

TY - JOUR

T1 - Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular events

AU - Jespersen, Lasse

AU - Hvelplund, Anders

AU - Abildstrøm, Steen Z

AU - Pedersen, Frants

AU - Galatius, Søren

AU - Madsen, Jan K

AU - Jørgensen, Erik

AU - Kelbæk, Henning

AU - Prescott, Eva

PY - 2012/3

Y1 - 2012/3

N2 - Aims Patients with chest pain and no obstructive coronary artery disease (CAD) are considered at low risk for cardiovascular events but evidence supporting this is scarce. We investigated the prognostic implications of stable angina pectoris in relation to the presence and degree of CAD with no obstructive CAD in focus.Methods and resultsWe identified 11 223 patients referred for coronary angiography (CAG) in 19982009 with stable angina pectoris as indication and 5705 participants from the Copenhagen City Heart Study for comparison. Main outcome measures were major adverse cardiovascular events (MACE), defined as cardiovascular death, myocardial infarction, stroke or heart failure, and all-cause mortality. Significantly more women (65) than men (32) had no obstructive CAD (P< 0.001). In Coxs models adjusted for age, body mass index, diabetes, smoking, and use of lipid-lowering or antihypertensive medication, hazard ratios (HRs) associated with no obstructive CAD were similar in men and women. In the pooled analysis, the risk of MACE increased with increasing degrees of CAD with multivariable-adjusted HRs of 1.52 (95 confidence interval, 1.271.83) for patients with normal coronary arteries and 1.85 (1.512.28) for patients with diffuse non-obstructive CAD compared with the reference population. For all-cause mortality, normal coronary arteries and diffuse non-obstructive CAD were associated with HRs of 1.29 (1.071.56) and 1.52 (1.241.88), respectively. Conclusion Patients with stable angina and normal coronary arteries or diffuse non-obstructive CAD have elevated risks of MACE and all-cause mortality compared with a reference population without ischaemic heart disease.

AB - Aims Patients with chest pain and no obstructive coronary artery disease (CAD) are considered at low risk for cardiovascular events but evidence supporting this is scarce. We investigated the prognostic implications of stable angina pectoris in relation to the presence and degree of CAD with no obstructive CAD in focus.Methods and resultsWe identified 11 223 patients referred for coronary angiography (CAG) in 19982009 with stable angina pectoris as indication and 5705 participants from the Copenhagen City Heart Study for comparison. Main outcome measures were major adverse cardiovascular events (MACE), defined as cardiovascular death, myocardial infarction, stroke or heart failure, and all-cause mortality. Significantly more women (65) than men (32) had no obstructive CAD (P< 0.001). In Coxs models adjusted for age, body mass index, diabetes, smoking, and use of lipid-lowering or antihypertensive medication, hazard ratios (HRs) associated with no obstructive CAD were similar in men and women. In the pooled analysis, the risk of MACE increased with increasing degrees of CAD with multivariable-adjusted HRs of 1.52 (95 confidence interval, 1.271.83) for patients with normal coronary arteries and 1.85 (1.512.28) for patients with diffuse non-obstructive CAD compared with the reference population. For all-cause mortality, normal coronary arteries and diffuse non-obstructive CAD were associated with HRs of 1.29 (1.071.56) and 1.52 (1.241.88), respectively. Conclusion Patients with stable angina and normal coronary arteries or diffuse non-obstructive CAD have elevated risks of MACE and all-cause mortality compared with a reference population without ischaemic heart disease.

U2 - 10.1093/eurheartj/ehr331

DO - 10.1093/eurheartj/ehr331

M3 - Journal article

C2 - 21911339

SN - 0195-668X

VL - 33

SP - 734

EP - 744

JO - European Heart Journal

JF - European Heart Journal

IS - 6

ER -

Stable angina pectoris with no obstructive coronary artery disease is associated with increased risks of major adverse cardiovascular events

Abstract

UN SDGs

Access to Document

Fingerprint

Cite this