Format

Send to

Choose Destination
Eur Heart J. 2014 Dec 21;35(48):3426-33. doi: 10.1093/eurheartj/ehu342. Epub 2014 Sep 28.

Relationship between angina pectoris and outcomes in patients with heart failure and reduced ejection fraction: an analysis of the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA).

Author information

1
BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK Golden Jubilee National Hospital, Glasgow, UK.
2
BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
3
University of British Columbia, Vancouver, Canada.
4
National Heart & Lung Institute, Royal Brompton & Harefield Hospitals, Imperial College, London, UK.
5
University Hospital Groningen, Groningen, Netherlands.
6
Gothenburg University, Gothenburg, Sweden.
7
Oslo University Hospital, Rikshospitalet, University of Oslo, Oslo, Norway.
8
Nordic School of Public Health, Gothenburg, Sweden.
9
Golden Jubilee National Hospital, Glasgow, UK.
10
BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK john.mcmurray@glasgow.ac.uk.

Abstract

AIM:

Angina pectoris is common in patients with heart failure and reduced ejection fraction (HF-REF) but its relationship with outcomes has not been well defined. This relationship was investigated further in a retrospective analysis of the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA).

METHODS AND RESULTS:

Four thousand, eight hundred and seventy-eight patients were divided into three categories: no history of angina and no chest pain at baseline (Group A; n = 1240), past history of angina but no chest pain at baseline (Group B; n = 1353) and both a history of angina and chest pain at baseline (Group C; n = 2285). Outcomes were examined using Kaplan-Meier and Cox regression survival analysis. Compared with Group A, Group C had a higher risk of non-fatal myocardial infarction or unstable angina (HR: 2.36, 1.54-3.61; P < 0.001), this composite plus coronary revascularization (HR: 2.54, 1.76-3.68; P < 0.001), as well as HF hospitalization (HR: 1.35, 1.13-1.63; P = 0.001), over a median follow-up period of 33 months. There was no difference in cardiovascular or all-cause mortality. Group B had a smaller increase in risk of coronary events but not of heart failure hospitalization.

CONCLUSION:

Patients with HF-REF and ongoing angina are at an increased risk of acute coronary syndrome and HF hospitalization. Whether these patients would benefit from more aggressive medical therapy or percutaneous revascularization is not known and merits further investigation.

KEYWORDS:

Angina pectoris; Heart failure; Reduced ejection fraction

PMID:
25265976
DOI:
10.1093/eurheartj/ehu342
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Silverchair Information Systems Icon for Norwegian BIBSYS system
Loading ...
Support Center