Long-term prognosis of patients with variant angina

A. Walling, D. D. Waters, D. D. Miller, D. Roy, G. B. Pelletier, P. Theroux

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115 Scopus citations

Abstract

The long-term prognosis of variant angina and the factors influencing it were assessed in 217 consecutive patients hospitalized in our coronary care unit and followed for a mean of 65 months (range 2 to 123). Cardiac death occurred in 30 patients and an additional 54 experienced a nonfatal myocardial infarction. Survival at 1 and 5 years was 95% and 89%, respectively; survival without infarction was 83% and 69%. Coronary disease and the degree of disease activity were strong predictors of survival by Cox analysis. Survival at 1 year was 99%, and that at 5 years was 95% and 94%, respectively, for patients with one-vessel disease (n = 81) and for those without stenoses of 70% or greater (n = 87). Survival at 1 and 5 years was only 87% and 77% for those with multivessel disease (n = 40). The Cox analysis selected left ventricular function, initial treatment, extent score, duration of angina at rest, and disease activity as multivariate predictors of survival without infarction. Coronary disease was a strong predictor (p < .0001) of survival without infarction by univariate analysis. Treatment with nifedipine, diltiazem, or verapamil improved survival without infarction compared with other medical treatment (p = .002). Myocardial infarction occurred most commonly soon after diagnosis in patients with a short history of angina at rest. Late coronary events were almost never preceded by resting angina.

Original languageEnglish (US)
Pages (from-to)990-997
Number of pages8
JournalCirculation
Volume76
Issue number5
DOIs
Publication statusPublished - Jan 1 1987
Externally publishedYes

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Walling, A., Waters, D. D., Miller, D. D., Roy, D., Pelletier, G. B., & Theroux, P. (1987). Long-term prognosis of patients with variant angina. Circulation, 76(5), 990-997. https://doi.org/10.1161/01.CIR.76.5.990