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  • Angina may trump ischaemia in predicting stable coronary artery disease outcomes, but most cardiovascular events occur in patients without angina or asymptomatic ischaemia

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Prognosis
Cohort study
Angina may trump ischaemia in predicting stable coronary artery disease outcomes, but most cardiovascular events occur in patients without angina or asymptomatic ischaemia
  1. Richard Kones,
  2. Umme Rumana
  1. Department of Cardiology, Cardiometabolic Research Institute, Houston, Texas, USA
  1. Correspondence to : Dr Richard Kones, Department of Cardiology, Cardiometabolic Research Institute, Houston, TX 77054, USA; cardiacresearchinstitute{at}gmail.com

https://doi.org/10.1136/ebmed-2014-110128

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    Commentary on: Steg PG, Greenlaw N, Tendera M, et al., Prospective Observational Longitudinal Registry of Patients With Stable Coronary Artery Disease (CLARIFY) Investigators. Prevalence of anginal symptoms and myocardial ischemia and their effect on clinical outcomes in outpatients with stable coronary artery disease: data from the International Observational CLARIFY Registry. JAMA Intern Med 2014;174:1651–9OpenUrlCrossRefPubMed.

    Context

    The presence of angina portends a poor prognosis. Greater attention has recently been directed to asymptomatic ischaemia, the severity of which plays a role in development of chest pain1 and is a robust and independent predictor of mortality in patients with stable angina.2 Ischaemia during normal activity markedly raises the relative risk of cardiac events and mortality in patients with or without heart disease.3

    Modern antianginal drugs, secondary prevention, diagnostic/invasive techniques and …

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    Footnotes

    • Contributors RK provided the framework of the commentary including analysis, interpretation of data, and reviewed its final form. UR contributed significantly to the intellectual content, conducted the literature search, and crafted the final copy. Both authors are responsible for the accuracy and integrity of the work.

    • Competing interests None.

    • Provenance and peer review Commissioned; internally peer reviewed.