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Angina Symptoms Persevere in Spite of Rigorous Treatment: Presented at ACC

By Jill Stein

NEW ORLEANS, LA -- March 9, 2004 -- Angina remains a significant clinical problem despite intensive use of medical therapy and revascularization procedures, investigators reported here on March 8^th at the American College of Cardiology 53^rd Annual Scientific Session.

To assess current chronic angina patient profiles, George Vetrovec, MD, Medical College of Virginia, Richmond, Virginia, and colleagues retrospectively surveyed 32 cardiology practices during a recent 6-month period.

"Angina is a significant clinical problem that affects 6.8 million Americans, and approximately 400,000 new cases are diagnosed each year in the US," Dr. Vetrovec pointed out, adding that patients with greater angina frequency have a worse quality of life.

To date, there has been scant information about contemporary patient demographics and treatment descriptions in the literature, he said.

Among the 1,957 patients with a mea age of 65.6 years of age studied, two thirds of patients had at least 1 serious comorbid condition, 32% had a prior myocardial infarction, 70% had hypertension, 32% had diabetes mellitus, 19% had congestive heart failure, 12% had chronic obstructive pulmonary disease and 17% had bradycardia.

Angina symptoms occurred in 92% of patients despite the use of drug treatment, including beta blockers, calcium channel blockers and long-acting nitrates in 88% of patients surveyed and of revascularization in 56% of patients.

Prior revascularization procedures included percutaneous coronary intervention (PCI) in 39% and coronary artery bypass grafting (CABG) in 28%; 11% of patients had both PCI and CABG, whereas 12% had more than 1 PCI procedure, and 4% had more than 1 CABG procedure.

Results also revealed a high frequency of angina symptoms, with one or more bouts of angina per week in 39% of all patients and in 53% of patients on triple therapy.

Monotherapy was used in 49% of patients, dual therapy in 33%, and triple therapy in 6%. Nitroglycerin was used as needed by 67% of patients, with 26% reporting its use at least once a week.

Angina attacks were positively correlated with use of nitroglycerin on an as-needed basis (R = 5.5, P < .001).

The frequency of angina episodes seen in this study suggests that patients may continue to have impaired quality of life despite drug treatment and revascularization procedures, Dr. Vetrovec said.


[Study title: Symptoms Persist in Patients With Chronic Angina Despite Frequent Anti-Anginal Use and Prior Revascularization. Abstract 1099-87]

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