Survival following first diagnosis of coronary heart disease

Zukel, William J.; Cohen, B. E.; Mattingly, Thomas W.; Hrubec, Zdenek

doi:10.1016/0002-8703(69)90004-0

Cited by 75 publications

(9 citation statements)

References 12 publications

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“…8 The mortality risk of angina pectoris varies from 25% in the first year and 9%/ year in the Framingham study to 3%/year in another survey. 9 The findings in this study are in line with an epidemiological survey in 1998, some 30 years later where in men with uncomplicated angina pectoris an adjusted relative risk of coronary heart disease related death was reported of 4% during the first four years and of some 3% during the last four-year period. 10 Nowadays, the influence of all sorts of interventions, from early prevention to multiple invasive procedures, …”

Section: N T E R U N I V E R S I T Y C a R D I O L O G Y I N S T I supporting

confidence: 91%

Chest pain and angina pectoris – or the ugly swan and the beautiful duckling

Tellingen¹

2010

Neth Heart J

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561chest pain and angina pectoris -or the ugly swan and the beautiful duckling M e d i c i n a A n t i q u aThe original description of Heberden's angina pectoris is put forward to stress the importance of proper history-taking in identifying patients. In a marketdriven approach to improve cost-effectiveness in healthcare, angina pectoris as an entity seems stripped to its bare minimum: chest and pain. The diagnostic yield of exercise testing, however, depends on the pretest likelihood of disease and therefore knowledge of its clinical utility and pitfalls is essential to refine an initial and subjective diagnosis based on anamnesis. Nowadays chest pain units attempt to improve diagnostic accuracy by submitting all sorts of patients to the (stress) test. In the end protocol-driven policies like these may very well prove to be contraproductive when fundamentals are ignored. (Neth Heart J 2010;18:561-4.)

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Section: N T E R U N I V E R S I T Y C a R D I O L O G Y I N S T I supporting

confidence: 91%

Chest pain and angina pectoris – or the ugly swan and the beautiful duckling

Tellingen¹

2010

Neth Heart J

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“…A favorable 1 year mortality in young patients with myocardial infarction has been reported by others,9' 24, 34, 5 although not all authors are in agreement.32 ' 36, 37 In a follow-up study of 440 patients discharged from the hospital, Vedin et al32 found no difference in 1 year mortality between patients less than and older than 55 years of age. Zukel et al 36 showed a higher first year mortality in patients with myocardial infarction who were below the age of 40, but those who survived had a more favorable long-term prognosis compared with older patients. Such disparate results may be due in part to selection bias and problems inherent in defining natural history retrospectively.…”

Section: Discussionmentioning

confidence: 99%

Myocardial infarction in young patients: an analysis by age subsets.

Hoit¹,

Gilpin²,

Henning³

et al. 1986

Circulation

198

104

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We examined, in age subsets, 2643 patients with acute myocardial infarction. Clinical features and 1 year morbidity and mortality were compared in 203 young patients (<45 years), 1671 patients 46 to 70 years old, and 769 elderly patients (>70 years). Ninety-two percent of young patients were men, and a family history of premature coronary artery disease was more common in young patients (41% compared with 28% of middle-aged and 12% of elderly patients). More young patients were currently smoking cigarettes (82% compared with 56% of middle-aged and 24% of elderly patients), and only 8% of young patients had never smoked. Previous myocardial infarction and history of angina pectoris or congestive heart failure were less common (p < .001) in the young patients than in middle-aged and elderly patients. In-hospital mortality was only 2.5% for young patients, compared with 9.0% in middle-aged and 21.4% in elderly patients (both p < .001). Postdischarge 1 year mortality was also strikingly low in young patients, at 2.6% compared with 10.3% in middle-aged and 24.4% in elderly patients. The incidence of reinfarction during the 1 year of follow-up was similar in all subsets. The statistical significance of 65 variables as predictors of 1 year mortality and reinfarction was tested and the following found to be significant (p < .05): hospital discharge on antiarrhythmic drugs, digoxin, or diuretics; history of previous myocardial infarction or congestive heart failure; chest x-ray findings of heart failure; low ejection fraction; and atrial fibrillation. Thus, young patients entering the hospital have an excellent 1 year prognosis, but those with prior infarction in whom there are selected abnormal findings at hospital discharge comprise a subgroup that may benefit from early aggressive management. Circulation 74, No. 4, 712-721, 1986. THERE IS A relative paucity of information concerning the clinical features, natural history, and prognosis in young patients with acute myocardial infarction. Despite the relatively low frequency of myocardial infarction in the young population,' the potential for death and long-term disability make this entity an important clinical problem. A number of studies have examined the epidemiologic features and the coronary arterial anatomy in young adults with evidence of coronary heart disease,'-" and angiographic studies have demonstrated less extensive coronary artery disease

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“…To determine the effect of age and sex on survival, we analyzed data from 5 studies 10,12,13,17,28 reporting death rates in 10-year age groups in men after hospital discharge after a first MI and from 7 studies 2,4,10,17,19,27,28 reporting data that allowed an age-adjusted comparison of rates in men and women. Some of these studies reported only all-cause mortality; we estimated death rates from ischemic heart disease and stroke (typically approximately 85% of all deaths) according to age by subtracting from the published all-cause death rates the average ageand sex-specific death rates from all causes other than heart disease and stroke recorded in the country in which the study was conducted in the years during which the follow-up took place.…”

Section: Methodsmentioning

confidence: 99%