Long-term survival in patients with refractory angina

被引:122
|
作者
Henry, Timothy D. [1 ,2 ]
Satran, Daniel [1 ,2 ,3 ]
Hodges, James S. [1 ,2 ]
Johnson, Randall K. [1 ]
Poulose, Anil K. [1 ]
Campbell, Alex R. [1 ]
Garberich, Ross F. [1 ]
Bart, Bradley A. [2 ,4 ]
Olson, Rachel E. [1 ]
Boisjolie, Charlene R. [1 ]
Harvey, Karen L. [1 ]
Arndt, Theresa L. [1 ]
Traverse, Jay H. [1 ,2 ]
机构
[1] Abbott NW Hosp, Minneapolis Heart Inst Fdn, Minneapolis, MN 55407 USA
[2] Univ Minnesota, Minneapolis, MN USA
[3] Pk Nicollet Heart & Vasc Ctr, Minneapolis, MN USA
[4] Hennepin Cty Med Ctr, Minneapolis, MN 55415 USA
关键词
Refractory angina; Chronic coronary artery disease; CORONARY-ARTERY-DISEASE; ENHANCED EXTERNAL COUNTERPULSATION; TRANSMYOCARDIAL LASER REVASCULARIZATION; CHRONIC STABLE ANGINA; MYOCARDIAL REVASCULARIZATION; MEDICAL THERAPY; RESEARCH ISSUES; HEART-DISEASE; DOUBLE-BLIND; VITAL STATUS;
D O I
10.1093/eurheartj/eht165
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims An increasing number of patients with severe coronary artery disease (CAD) are not candidates for traditional revascularization and experience angina in spite of excellent medical therapy. Despite limited data regarding the natural history and predictors of adverse outcome, these patients have been considered at high risk for early mortality. Methods and results The OPtions In Myocardial Ischemic Syndrome Therapy (OPTIMIST) program at the Minneapolis Heart Institute offers traditional and investigational therapies for patients with refractory angina. A prospective clinical database includes detailed baseline and yearly follow-up information. Death status and cause were determined using the Social Security Death Index, clinical data, and death certificates. Time to death was analysed using survival analysis methods. For 1200 patients, the mean age was 63.5 years (77.5% male) with 72.4% having prior coronary artery bypass grafting, 74.4% prior percutaneous coronary intervention, 72.6% prior myocardial infarction, 78.3% 3-vessel CAD, 23.0% moderate-to-severe left-ventricular (LV) dysfunction, and 32.6% congestive heart failure (CHF). Overall, 241 patients died (20.1%: 71.8% cardiovascular) during a median follow-up 5.1 years (range 0-16, 14.7% over 9). By Kaplan-Meier analysis, mortality was 3.9% (95% CI 2.8-5.0) at 1 year and 28.4% (95% CI 24.9-32.0) at 9 years. Multivariate predictors of all-cause mortality were baseline age, diabetes, angina class, chronic kidney disease, LV dysfunction, and CHF. Conclusion Long-term mortality in patients with refractory angina is lower than previously reported. Therapeutic options for this distinct and growing group of patients should focus on angina relief and improved quality of life.
引用
收藏
页码:2683 / +
页数:8
相关论文
共 50 条
  • [21] Long-term survival of patients with relapsed/refractory acute lymphoblastic leukemia treated with blinatumomab
    Topp, Max S.
    Goekbuget, Nicola
    Zugmaier, Gerhard
    Stein, Anthony S.
    Dombret, Herve
    Chen, Yuqi
    Ribera, Josep-Maria
    Bargou, Ralf C.
    Horst, Heinz-August
    Kantarjian, Hagop M.
    CANCER, 2021, 127 (04) : 554 - 559
  • [22] Long-term administration of human albumin improves survival in patients with cirrhosis and refractory ascites
    Di Pascoli, Marco
    Fasolato, Silvano
    Piano, Salvatore
    Bolognesi, Massimo
    Angeli, Paolo
    LIVER INTERNATIONAL, 2019, 39 (01) : 98 - 105
  • [23] Early coronary angiography improves long-term survival in unstable angina
    Mathew, V
    Farkouh, ME
    Gersh, BJ
    Rihal, CS
    Reeder, GS
    Grill, DE
    Urban, LH
    Kopecky, SL
    Chesebro, JH
    Holmes, DR
    AMERICAN HEART JOURNAL, 2001, 142 (05) : 768 - 774
  • [24] LONG-TERM OUTCOME OF EXTRACORPOREAL SHOCKWAVE MYOCARDIAL REVASCULARIZATION THERAPY FOR REFRACTORY ANGINA
    Alunni, G.
    Condotto, F.
    Deberardinis, A.
    Campana, M.
    Picardi, E.
    Fanelli, A.
    Marra, S.
    CARDIOLOGY, 2013, 126 : 457 - 457
  • [25] Long-term benefits of stellate ganglion block in severe chronic refractory angina
    Chester, M
    Hammond, C
    Leach, A
    PAIN, 2000, 87 (01) : 103 - 105
  • [26] LONG-TERM OUTCOMES OF A RANOLAZINE REFRACTORY ANGINA REGISTRY: 3 YEARS RESULTS
    Garberich, Ross
    Traverse, Jay
    Arndt, Theresa
    Bennett, Noel
    Henry, Timothy
    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2018, 71 (11) : 1213 - 1213
  • [27] Coronary angioplasty for elderly patients with ''high risk'' unstable angina: Short-term outcomes and long-term survival
    Morrison, DA
    Bies, RD
    Sacks, J
    JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1997, 29 (02) : 339 - 344
  • [28] Predictors of long-term survival in elderly patients with chronic angina treated with optimized drug therapy or revascularization
    Pfisterer, M
    Kaiser, C
    Jeger, R
    Bonetti, PO
    Rickenbacher, P
    Osswald, S
    Buser, P
    EUROPEAN HEART JOURNAL, 2004, 25 : 440 - 440
  • [29] Long-term survival of elderly patients with chronic angina managed invasively versus with optimized Medical therapy
    Pfisterer, ME
    Jeger, R
    Grize, L
    Ankli, B
    Kaiser, C
    CIRCULATION, 2003, 108 (17) : 591 - 591
  • [30] Long-term follow up of patients with vasospastic angina pectoris
    Schannwell, C. M.
    Mohammadi, H.
    Kirmanoglou, K.
    Fleissner, T.
    Siekiera, M.
    Strauer, B. E.
    EUROPEAN HEART JOURNAL, 2006, 27 : 592 - 592