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14-09-2009 | Cardiology | Article

Nearly one in three stable CAD patients suffer weekly angina


Free abstract

MedWire News: A study of stable coronary artery disease (CAD) patients attending primary care practices in Australia found that almost one in three had angina at least once a week, worsening their quality of life.

The problem, which was worse in women, patients with heart failure, and those with peripheral artery disease, was frequently underestimated by physicians.

“Clinicians should take heed and closely assess angina frequency and its impact on their patients,” say the authors, led by John Beltrame (University of Adelaide, South Australia).

The team studied angina frequency in the CAD in General Practice (CADENCE) Study, using the Seattle Angina Questionnaire (SAQ).

The study included 2031 consecutive patients, irrespective of the purpose of their visit, recruited by 207 participating primary care practitioners.

As reported in the Archives of Internal Medicine, 29% of patients reported having weekly angina, defined as one or more episodes per week over the preceding 4 weeks.

Patients with weekly angina had greater physical limitations and worse quality of life, at 24% and 27% lower scores on the SAQ, respectively, than those with minimal angina, defined as angina less than once a week over the preceding 4 weeks.

GPs’ assessments of angina control were discordant with those of their patients – GPs considered patients’ angina to be optimally controlled in 80% of cases overall, and in 48% and 37% of patients reporting weekly and daily angina, respectively.

Further analysis revealed marked variability in angina control across clinics, ranging from 0% to 100% of patients reporting weekly angina. Twenty-nine (14%) clinics had no patients with weekly angina, while at least half of patients reported weekly angina at 35 (18%) clinics, and all of the patients at eight (4%).

“The prevalence, consequences, and variability (with presumed opportunity for improvement), argue strongly that reproducible estimates of angina could be a valuable outcome measure of quality for outpatients with CAD,” Beltrame and co-workers comment.

MedWire ( is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

By Caroline Price

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