School of Population Health, Faculty of Health Sciences, University of Queensland, Herston, Brisbane, QLD 4006, Australia.
Circulation. 2009 Dec 8;120(23):2330-6. doi: 10.1161/CIRCULATIONAHA.109.887380. Epub 2009 Nov 23.
Angina symptoms have been reported to predict mortality in men. The aim of this study was to investigate the association between angina symptoms and mortality in women.
In 2004, 873 older participants in the Australian Longitudinal Study on Women's Health with self-reported ischemic heart disease participated in a nested substudy. Women were 77 to 83 years of age; 165 (19%) died during the 4.5-year follow-up. Angina symptoms were established with Seattle Angina Questionnaire (SAQ) scores for physical limitation, angina frequency, angina stability, and disease perception. Proportional hazards modeling was used to examine the relationship of SAQ score differences with mortality. Physical limitation scores were associated with mortality, with hazard ratios of 1.1, 1.9, and 3.4 for mild, moderate, and severe versus minimal limitations, respectively (P<0.001). Angina frequency scores were also associated with death, with hazard ratios of 1.2, 1.2, and 4.8 for mild, moderate, and severe versus minimal angina frequency, respectively (P<0.001). Age (hazard ratio 1.1, 95% confidence interval 1.0 to 1.2), pulmonary disease (hazard ratio 1.6, 95% confidence interval 1.2 to 2.3), and kidney disease (hazard ratio 1.7, 95% confidence interval 1.1 to 2.5) were statistically significantly associated with mortality in a multivariable model of clinical predictors. In a combined model with SAQ scores and clinical predictors, SAQ scores for physical limitation and angina stability remained statistically significantly associated with mortality.
In older women with ischemic heart disease, angina symptoms assessed by use of SAQ scores for physical limitations and angina frequency were associated with mortality; SAQ scores may therefore prove to be a useful tool for risk assessment in this patient group.
心绞痛症状已被报道可预测男性的死亡率。本研究旨在探讨女性心绞痛症状与死亡率之间的关系。
2004 年，澳大利亚女性健康纵向研究中 873 名有自述缺血性心脏病的老年参与者参加了一项嵌套子研究。女性年龄为 77 至 83 岁；在 4.5 年的随访期间，有 165 人（19%）死亡。心绞痛症状通过西雅图心绞痛问卷（SAQ）的身体限制、心绞痛发作频率、心绞痛稳定性和疾病感知评分来确定。比例风险模型用于检查 SAQ 评分差异与死亡率的关系。身体限制评分与死亡率相关，轻度、中度和重度相对于轻度限制的危险比分别为 1.1、1.9 和 3.4（P<0.001）。心绞痛发作频率评分也与死亡相关，轻度、中度和重度相对于轻度心绞痛发作频率的危险比分别为 1.2、1.2 和 4.8（P<0.001）。多变量临床预测模型中，年龄（危险比 1.1，95%置信区间 1.0 至 1.2）、肺部疾病（危险比 1.6，95%置信区间 1.2 至 2.3）和肾脏疾病（危险比 1.7，95%置信区间 1.1 至 2.5）与死亡率呈统计学显著相关。在包含 SAQ 评分和临床预测因素的综合模型中，身体限制和心绞痛稳定性的 SAQ 评分与死亡率仍呈统计学显著相关。
在患有缺血性心脏病的老年女性中，使用 SAQ 评分评估身体限制和心绞痛发作频率的心绞痛症状与死亡率相关；因此，SAQ 评分可能成为该患者群体风险评估的有用工具。
