Spertus John A, Dawson Jill, Masoudi Frederick A, Krumholz Harlan M, Reid Kimberly J, Peterson Eric D, Rumsfeld John S
Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, Missouri, USA.
Am J Cardiol. 2006 Aug 1;98(3):282-8. doi: 10.1016/j.amjcard.2006.01.099. Epub 2006 Jun 6.
Angina pectoris (AP) is a treatable symptom that is associated with mortality and decreased quality of life. The prevalence and predictors of AP 1 month after a myocardial infarction (MI), a time when additional treatments might be offered, have not been described. We prospectively enrolled 2,094 patients with MI from 19 centers in the United States and evaluated angina symptoms 1 month after discharge with the Seattle Angina Questionnaire. Multivariable logistic regression analysis was performed to identify patient and treatment characteristics associated with 1-month AP. At 1 month, 571 patients (27.3%) had AP. Women (odds ratio [OR] 1.37, 95% confidence interval [CI] 1.09 to 1.74), younger patients (OR 1.33 per 10-year increment, 95% CI 1.20 to 1.47), those with previous coronary artery bypass (OR 1.47, 95% CI 1.05 to 2.05), smokers (OR 1.35, 95% CI 1.09 to 1.77), and those who developed postinfarct AP during the index hospitalization (OR 1.85, 95% CI 1.20 to 2.65) were more likely to have AP at follow-up. In contrast, patients who were treated with coronary artery bypass surgery during their index admission were less likely to have AP at 1 month (OR 0.5, 95% CI 0.33 to 0.77). The strongest correlate was the frequency of AP before patients' MI. Compared with those without AP before MI, those with AP < 1 time per week (OR 1.86, 95% CI 1.45 to 2.41), weekly (OR 4.24, 95% CI 3.09 to 5.82), and daily (OR 6.12, 95% CI 3.62 to 10.3) were more likely to have AP 1 month later. In conclusion, > 1 in 4 patients reported AP 1 month after an MI.
心绞痛(AP)是一种可治疗的症状,与死亡率和生活质量下降相关。心肌梗死(MI)后1个月时AP的患病率及预测因素尚未见描述,而此时可能会提供额外的治疗。我们前瞻性纳入了来自美国19个中心的2094例MI患者,并在出院1个月后使用西雅图心绞痛问卷评估心绞痛症状。进行多变量逻辑回归分析以确定与1个月时AP相关的患者及治疗特征。1个月时,571例患者(27.3%)发生AP。女性(比值比[OR]1.37,95%置信区间[CI]1.09至1.74)、年轻患者(每增加10岁OR为1.33,95%CI 1.20至1.47)、既往有冠状动脉搭桥术者(OR 1.47,95%CI 1.05至2.05)、吸烟者(OR 1.35,95%CI 1.09至1.77)以及在本次住院期间发生梗死后AP者(OR 1.85,95%CI 1.20至2.65)在随访时更易发生AP。相比之下,在本次住院期间接受冠状动脉搭桥手术治疗的患者在1个月时发生AP的可能性较小(OR 0.5,95%CI 0.33至0.77)。最强的关联因素是患者MI前AP的发作频率。与MI前无AP者相比,MI前AP发作频率<每周1次者(OR 1.86,95%CI 1.45至2.41)、每周发作1次者(OR 4.24,95%CI 3.09至5.82)以及每天发作1次者(OR 6.12,95%CI 3.62至10.3)在1个月后更易发生AP。总之,超过四分之一的患者在MI后1个月报告有AP。