Tags

Type your tag names separated by a space and hit enter

Anginal status and prediction of cardiac events in patients enrolled in the asymptomatic cardiac ischemia pilot (ACIP) study. ACIP investigators.
Am J Cardiol. 1997 Apr 01; 79(7):889-92.AJ

Abstract

We hypothesized that among the patients enrolled in the Asymptomatic Cardiac Ischemia Pilot (ACIP) trial, those who reported angina either within the previous 6 weeks or experienced angina during ambulatory electrocardiographic (ECG) monitoring during activities of daily life or during stress testing would be more likely to experience an adverse cardiac event within a year than those who did not experience angina. Of the 558 patients enrolled in ACIP, 325 (58.2%) reported angina in the previous 6 weeks, 300 (53.8%) had stress-induced angina, and 63 (11.3%) reported angina during activities of daily life associated with ST-segment changes on the 48-hour ambulatory electrocardiogram. Some patients had > 1 of these angina symptoms and thus 8 angina status categories were identified. Adverse cardiac events were defined as death, nonfatal myocardial infarction (MI), or hospitalization for ischemic events, which included revascularization not specified by the ACIP protocol. One hundred and sixty-seven patients (29.9%) were asymptomatic (i.e., they never had angina) by our defined criteria. Three hundred ninety-one patients (70.1%) were symptomatic. Symptomatic patients had a higher incidence of death, MI, or hospitalization for ischemic events (15.3% symptomatic vs 7.8% asymptomatic, p = 0.016). History of angina within 6 weeks before randomization was predictive of death, MI, or hospitalization for ischemic event (p = 0.007). This finding was due to a large difference in the need for hospitalizations which would be expected to be driven by the presence of angina. By contrast, angina during ambulatory electrocardiogram or stress test was not predictive of an adverse cardiac event. The asymptomatic status of coronary disease patients who have objective documentation of ischemia is not uniformly defined and many different categories can be identified. In this population of patients with proven coronary artery disease and myocardial ischemia, a history of angina in the previous 6 weeks was a good predictor of an adverse event occurring in the next year.

Authors+Show Affiliations

Division of Cardiology, University of Florida College of Medicine, Gainesville, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

9104900

Citation

Conti, C R., et al. "Anginal Status and Prediction of Cardiac Events in Patients Enrolled in the Asymptomatic Cardiac Ischemia Pilot (ACIP) Study. ACIP Investigators." The American Journal of Cardiology, vol. 79, no. 7, 1997, pp. 889-92.
Conti CR, Geller NL, Knatterud GL, et al. Anginal status and prediction of cardiac events in patients enrolled in the asymptomatic cardiac ischemia pilot (ACIP) study. ACIP investigators. Am J Cardiol. 1997;79(7):889-92.
Conti, C. R., Geller, N. L., Knatterud, G. L., Forman, S. A., Pratt, C. M., Pepine, C. J., & Sopko, G. (1997). Anginal status and prediction of cardiac events in patients enrolled in the asymptomatic cardiac ischemia pilot (ACIP) study. ACIP investigators. The American Journal of Cardiology, 79(7), 889-92.
Conti CR, et al. Anginal Status and Prediction of Cardiac Events in Patients Enrolled in the Asymptomatic Cardiac Ischemia Pilot (ACIP) Study. ACIP Investigators. Am J Cardiol. 1997 Apr 1;79(7):889-92. PubMed PMID: 9104900.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anginal status and prediction of cardiac events in patients enrolled in the asymptomatic cardiac ischemia pilot (ACIP) study. ACIP investigators. AU - Conti,C R, AU - Geller,N L, AU - Knatterud,G L, AU - Forman,S A, AU - Pratt,C M, AU - Pepine,C J, AU - Sopko,G, PY - 1997/4/1/pubmed PY - 1997/4/1/medline PY - 1997/4/1/entrez SP - 889 EP - 92 JF - The American journal of cardiology JO - Am. J. Cardiol. VL - 79 IS - 7 N2 - We hypothesized that among the patients enrolled in the Asymptomatic Cardiac Ischemia Pilot (ACIP) trial, those who reported angina either within the previous 6 weeks or experienced angina during ambulatory electrocardiographic (ECG) monitoring during activities of daily life or during stress testing would be more likely to experience an adverse cardiac event within a year than those who did not experience angina. Of the 558 patients enrolled in ACIP, 325 (58.2%) reported angina in the previous 6 weeks, 300 (53.8%) had stress-induced angina, and 63 (11.3%) reported angina during activities of daily life associated with ST-segment changes on the 48-hour ambulatory electrocardiogram. Some patients had > 1 of these angina symptoms and thus 8 angina status categories were identified. Adverse cardiac events were defined as death, nonfatal myocardial infarction (MI), or hospitalization for ischemic events, which included revascularization not specified by the ACIP protocol. One hundred and sixty-seven patients (29.9%) were asymptomatic (i.e., they never had angina) by our defined criteria. Three hundred ninety-one patients (70.1%) were symptomatic. Symptomatic patients had a higher incidence of death, MI, or hospitalization for ischemic events (15.3% symptomatic vs 7.8% asymptomatic, p = 0.016). History of angina within 6 weeks before randomization was predictive of death, MI, or hospitalization for ischemic event (p = 0.007). This finding was due to a large difference in the need for hospitalizations which would be expected to be driven by the presence of angina. By contrast, angina during ambulatory electrocardiogram or stress test was not predictive of an adverse cardiac event. The asymptomatic status of coronary disease patients who have objective documentation of ischemia is not uniformly defined and many different categories can be identified. In this population of patients with proven coronary artery disease and myocardial ischemia, a history of angina in the previous 6 weeks was a good predictor of an adverse event occurring in the next year. SN - 0002-9149 UR - https://www.unboundmedicine.com/medline/citation/9104900/Anginal_status_and_prediction_of_cardiac_events_in_patients_enrolled_in_the_asymptomatic_cardiac_ischemia_pilot__ACIP__study__ACIP_investigators_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S000291499700009X DB - PRIME DP - Unbound Medicine ER -