Favourable long term prognosis in stable angina pectoris: an extended follow up of the angina prognosis study in Stockholm (APSIS)
- 1 February 2006
- Vol. 92 (2), 177-182
- https://doi.org/10.1136/hrt.2004.057703
Abstract
Objective: To evaluate the long term prognosis of patients with stable angina pectoris. Design: Registry based follow up (median 9.1 years) of patients participating in the APSIS (angina prognosis study in Stockholm), which was a double blind, single centre trial of antianginal drug treatment. Patients: 809 patients (31% women) with stable angina pectoris < 70 (mean (SD) 59 (7) years at inclusion) and an age and sex matched reference population from the same catchment area. Interventions: Double blind treatment with metoprolol or verapamil during 3.4 years (median), followed by referral for usual care with open treatment. Main outcome measures: Cardiovascular (CV) death and non-fatal myocardial infarction (MI) in the APSIS cohort and total mortality in comparison with reference subjects. Results: 123 patients died (41 MI, 36 other CV causes) and 72 had non-fatal MI. Mortality (19% v 6%, pv 1.6%, p < 0.001) were increased among male compared with female patients. Diabetes, previous MI, hypertension, and male sex independently predicted CV mortality (p < 0.001). Diabetes greatly increased the risk in a small subgroup of female patients. Male patients had higher mortality than men in the reference population during the first three years (cumulative absolute difference 3.8%) but apparently not thereafter. Female patients had similar mortality to women in the reference population throughout the 9.1 years of observation. Conclusions: Female patients with stable angina had similar mortality to matched female reference subjects but male patients had an increased risk. Diabetes, previous MI, hypertension, and male sex were strong risk factors for CV death or MI.Keywords
This publication has 32 references indexed in Scilit:
- The impact of diabetes or elevated fasting blood glucose on cardiovascular prognosis in patients with stable angina pectorisDiabetic Medicine, 2005
- Long-term outcomes of optimized medical management of outpatients with stable coronary artery diseaseThe American Journal of Cardiology, 2004
- Regression models for relative survivalStatistics in Medicine, 2003
- Prognosis of angina with and without a diagnosis: 11 year follow up in the Whitehall II prospective cohort studyBMJ, 2003
- Inflammatory and hemostatic markers in relation to cardiovascular prognosis in patients with stable angina pectoris: Results from the APSIS studyAtherosclerosis, 2000
- Cardiovascular prognosis in relation to apolipoproteins and other lipid parameters in patients with stable angina pectoris treated with verapamil or metoprolol: Results from the Angina Prognosis Study in Stockholm (APSIS)Atherosclerosis, 1997
- Double-blind trial of aspirin in primary prevention of myocardial infarction in patients with stable chronic angina pectorisThe Lancet, 1992
- Significance of spasm in the pathogenesis of ischemic heart diseaseThe American Journal of Cardiology, 1979
- The role of the exercise test in the evaluation of patients for ischemic heart disease.Circulation, 1978
- Natural history of angina pectoris in the Framingham study: Prognosis and survivalThe American Journal of Cardiology, 1972