Table 14.5Clinical and investigative parameters independently predictive of death or MI, determined by using stepwise selection procedures in general population with stable angina**

Clinical variables (n=2183)Hazard ratio (95% CI)P- value
Comorbidity2.41 (1.49 to 3.91)<0.001
Signs of heart failure1.62 (0.85 to 3.07)0.14
Previous myocardial infarction2.19 (1.08 to 4.42)0.03
Diabetes2.03 (1.25 to 3.31)0.004
Symptom duration >6 months0.54 (0.33 to 0.87)0.01
Symptom severity:
Class II versus class I1.95 (1.07 to 3.54)0.005
Class III versus class I2.65 (1.29 to 5.50)
Investigative variables (n=2963)
Stress testing:
Positive test1.43 (0.76 to 2.70)0.0001
No stress test done3.78 (2.04 to 7.00)
Echocardiography:
Abnormal left ventricular function2.57 (1.62 to 4.08)<0.0001
Electrocardiography:
ST or T wave changes1.63 (1.06 to 2.50)0.03
Combined clinical and investigative variables (n=2528)
Comorbidity2.25 (1.43 to 3.56)0.0008
Diabetes1.95 (1.22 to 3.11)0.007
Previous myocardial infarction
Symptoms >6 months0.48 (0.30 to 0.77)0.002
Symptom severity:
Class II versus class I1.76 (1.00 to 3.09)0.05
Class III versus class I2.18 (1.10 to 4.33)
ST or T wave changes1.56 (0.99 to 2.45)0.05
Stress test:
Positive stress test result1.29 (0.63 to 2.67)<0.0001
No stress test done3.48 (1.71 to 7.07)
Abnormal left ventricular function2.11 (1.29 to 3.46)0.004
**

As non performance of a test is not an objective measure of a patient but can be influenced by many physician related and non clinical factors. A further stepwise selection process was used to consider only the non invasive investigations that had been done. A positive versus negative or inconclusive non-invasive stress test result was not selected as a significant predictor of outcome when combined with information from echocardiography and resting echocardiography.

From: 14, Risk scores

Cover of Stable Angina
Stable Angina: Methods, Evidence & Guidance [Internet].
NICE Clinical Guidelines, No. 126.
National Clinical Guidelines Centre (UK).
Copyright © 2011, National Clinical Guidelines Centre.

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