Prevalence of myocardial ischaemia among diabetics determined by validated Sinhala version of the WHO Rose angina questionnaire

Abstract

Objectives:Design Setting: Results:Interpretation:The aim of this study was to validate the original version of the Rose Angina Questionnaire (RAQ) and apply it to a group of long standing diabetics in a cross-sectional manner to assess it applicability in clinical settings.After a face validation and piloting the Part A of the Sinhala translated RAQ (SRAQ-Part A) was given to 47 adult patients who presented with chest pain where the possibility of stable angina was considered in the differential diagnosis. In these patients, the diagnosis of stable angina was confirmed by resting ECG. Patients who had a normal resting ECG or changes non-confirmatory of myocardial ischaemia underwent treadmill examination to detect exercise-induced myocardial ischaemia.Part B of the translated RAQ (SRAQ-Part B) was given to 68 patients who presented with acute chest pain of less than 24 hours where acute coronary syndrome was considered a possibility. These patients underwent serial ECGs and cardiac enzymes/troponin estimations.The validated SRAQ were administered to a group of diabetics (n = 311) attending medical clinics of Teaching hospital, Karapitiya in a cross-sectional manner to detect the prevalence of stable angina or history of acute coronary syndrome. Sensitivity, specificity, positive predictive value, and negative predictive values of SRAQ-Part A were 86.4%, 76%,76%, 86% and of part-B were 74.1, 70%, 93.5%, 31.8%, respectively.Of 311 diabetic patients the prevalence of stable angina in this group of patients would be 31% (95% CI = 26-37%). Part B of the questionnaire, 17 answered positively and rest negatively. Of these 17 positives, 16 were likely to have acute coronary disease.Our analysis shows that the Sinhala translation of the RAQ has an acceptable specificity and sensitivity in detecting either stable angina or acute coronary syndrome. The prevalence of stable angina was 31% among the diabetics selected for this analysis.

The use of Rose Angina Questionnaire and 12 lead Electrocardiogram (ECG) in the Identification of potential Ischemic Heart Changes among a group of Hypertensive Patients in Sri Lanka

“…Diabetes was noted among 10 (7%) individuals, while 25 (17%) had both diabetes and hypercholesterolemia, simultaneously. Though the statistical figure for diabetes (6%) is nearly consistent as compared with the study of Mendis S and Ekanayake E M in 1994 in Central Sri Lanka, [13] the prevalence of hypercholesterolemia among this hypertensive population was observed to be higher (12.6%) than previous findings.…”

“…In this study, the definitive evidence of IHDs (positive symptoms and ECG changes of ischemia) was 16/1000 (95% CL, 9-27) followed by the evidence on ECG changes of ischemia without symptoms was 32/1000 (95% CL, 21-46). [13] As hypertension has been recognized as a prominent but modifiable risk factor for IHDs nevertheless due to the lack of advanced diagnostic methods in the most of local health care settings, the hypertensive patients who are still asymptomatic but at risk of IHDs probably miss the opportunity to undergo early screening and detection of potentially preventable myocardial ischemic changes. Further, they lack the opportunity to undergo detailed early screening methods like RAQ due to the rush in overcrowded clinics conducted at the hospitals in Sri Lanka.…”

The association between psychological distress and angina pectoris: A population-based study

“…The original version of the questionnaire was developed in 1962 to assess triggering and mitigating factors as well as the location, frequency, nature, severity, and duration of chest pain [24]. Compared to clinical diagnoses, exercise echocardiograms (ECGs), and myocardial perfusion scans, the questionnaire had a sensitivity of 53–86% and specificity of 70–89% [25,26].…”

Prevalence and factors associated with undiagnosed and uncontrolled heart disease: A study based on self-reported chronic heart disease and symptom-based angina pectoris among middle-aged and older Indian adults

“…In large-scale epidemiological surveys, the RAQ, which has a moderate sensitivity but high specificity to detect CHD, can be used to evaluate individual at risk [19]. The questionnaire showed a sensitivity of 53-86% and a specificity of 70-89% in comparison to clinical diagnoses, exercise echocardiograms (ECGs), and myocardial perfusion scans [19,20]. In addition to this, another study also reported varying sensitivity and specificity of the RAQ depending on the gold standard employed, but generally, there has been high specificity (80-95%) but variable sensitivity (19-83%) [21].…”