自述有胸痛症状（心绞痛或非特异性胸痛）但无阻塞性冠状动脉疾病诊断的女性的健康状况和不良结局 - DenHeart 研究的结果。

Self-reported health and adverse outcomes among women living with symptoms of angina or unspecific chest pain but no diagnosis of obstructive coronary artery disease-findings from the DenHeart study.

机构信息

Department of Cardiology, University Hospital of Southern Denmark, Kresten Philipsens Vej 15, 6200 Aabenraa, Denmark.

Department of Regional Health Research, University of Southern Denmark, J.B. Winsløws Vej 19,3, 5000 Odense, Denmark.

出版信息

Eur J Cardiovasc Nurs. 2023 Jul 19;22(5):506-515. doi: 10.1093/eurjcn/zvac085.

DOI:10.1093/eurjcn/zvac085

PMID:36124692

Abstract

AIMS

The objectives were to describe differences in self-reported health at discharge between women diagnosed with angina or unspecific chest pain and investigate the association between self-reported health and adverse outcomes within 3 years.

METHODS AND RESULTS

Data from a national cohort study were used, including data from the DenHeart survey combined with 3 years of register-based follow-up. The population included two groups of women with symptoms of angina but no diagnosis of obstructive coronary artery disease at discharge (women with angina and women with unspecific chest pain). Self-reported health measured with validated instruments was combined with register-based follow-up on adverse outcomes (a composite of unplanned cardiac readmissions, revascularization, or all-cause mortality). Associations between self-reported health and time to first adverse outcomes were investigated with Cox proportional hazard models, reported as hazards ratios with 95% confidence intervals. In total, 1770 women completed the questionnaire (49%). Women with angina (n = 931) reported significantly worse self-reported health on several outcomes compared to women with unspecific chest pain (n = 839). Within the 3 years follow-up, women with angina were more often readmitted (29 vs. 23%, P = 0.011) and more underwent revascularization (10 vs. 1%, P < 0.001), whereas mortality rates were similar (4 vs. 4%, P = 0.750). Self-reported health (physical and mental) was associated with adverse outcomes between both groups (on most instruments).

CONCLUSION

Women with angina reported significantly worse self-reported health on most instruments compared to women with unspecific chest pain. Adverse outcomes varied between groups, with women diagnosed with angina experiencing more events.

REGISTRATION

ClinicalTrials.gov (NCT01926145).

摘要

目的

本研究旨在描述诊断为心绞痛或非特异性胸痛的女性出院时自我报告健康状况的差异，并探讨出院后 3 年内自我报告健康状况与不良结局之间的关系。

方法和结果

本研究使用了一项全国性队列研究的数据，该研究的数据来自 DenHeart 调查与 3 年基于登记的随访相结合。研究人群包括两组有胸痛但无阻塞性冠状动脉疾病诊断的女性（心绞痛女性和非特异性胸痛女性）。使用经过验证的工具测量的自我报告健康状况与基于登记的不良结局（计划外心脏再入院、血运重建或全因死亡率的复合结局）随访相结合。使用 Cox 比例风险模型调查自我报告健康状况与首次不良结局时间之间的关系，报告为 95%置信区间的风险比。共有 1770 名女性完成了问卷（49%）。与非特异性胸痛女性（n=839）相比，心绞痛女性（n=931）在几个结局上报告的自我报告健康状况明显更差。在 3 年随访期间，心绞痛女性再入院的比例更高（29%比 23%，P=0.011），血运重建的比例也更高（10%比 1%，P<0.001），而死亡率相似（4%比 4%，P=0.750）。自我报告的健康状况（身体和心理）与两组之间的不良结局相关（在大多数仪器上）。