Author + information
- Puja K. Mehta,
- Tara Sedlak,
- Tanya Kenkre,
- B. Delia Johnson,
- Chrisandra Shufelt,
- John Petersen,
- Babak Azarbal,
- Bruce Samuels,
- R. Anderson,
- Leslee Shaw,
- Saibal Kar,
- Eileen Handberg,
- Sheryl Kelsey,
- Carl Pepine and
- C. Noel Bairey Merz
In women signs and symptoms of ischemia with no obstructive coronary artery disease (CAD), persistent angina (defined as continuing chest pain at 1 year after angiography) predicts adverse outcomes. However, persistent angina and angina-related quality of life (QoL) in this population using a validated tool (Seattle Angina Questionnaire, SAQ) associated with anti-anginal therapy has not been evaluated.
229 women with signs and symptoms of ischemia but no obstructive CAD in WISE (2009-2012) had baseline and follow-up evaluation, including symptom history, QoL, and SAQ.
Mean age was 54 ± 11, BMI 31 ± 9 kg/m2, 35% had hypertension, 14% dyslipidemia, 11% diabetes, and 7% were current smokers. 94% had angina at baseline; 7% perceived that their health was excellent. Baseline and follow-up SAQ demonstrated mild to moderate angina and a compromised angina-related QoL (Table). At 1 year follow-up, usual care anti-anginal medication use was unchanged except for ranolazine which increased from 6% to 17% (p=0.0006). Although SAQ scores improved significantly (Table), 74% continued to have angina.
Persistent angina is highly prevalent in women with signs and symptoms of ischemia but no obstructive CAD. Usual care anti-anginal therapy may be associated with improved SAQ, although a majority continued to have angina. Randomized clinical trials aimed at testing therapeutic strategies are needed to advise guidelines for management in this population.
|SAQ subscales Range: (0 – 100); 0 = worst, 100 = best||At Baseline (n = 229)||At 1-year Follow-up (n = 147)||p-value|
|Physical Limitation||69 ± 24||71 ± 24||0.73|
|Angina Stability||49 ± 26||54 ± 22||0.14|
|Angina Frequency||64 ± 27||74 ± 24||<0.0001|
|Treatment Satisfaction||72 ± 25||80 ± 19||0.03|
|Quality of Life||52 ± 25||67 ± 22||<0.001|
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.-10:45 a.m.
Session Title: Coronary Risk Factors and Management
Abstract Category: 28. Quality of Care and Outcomes Assessment
Presentation Number: 1115-98
- 2013 American College of Cardiology Foundation