Incidence, clinical characteristics, and short-term prognosis of angina pectoris.

Abstract

Conclusion-Incidence of new cases of angina pectoris in the United Kingdom is conservatively estimated from this study to be 22 600 patients per annum. Almost one third of these patients will have positive exercise tests at low workload, so the potential for coronary angiography and revascularisation is considerable. With one in 10 patients experiencing a nonfatal myocardial infarction or coronary death within a year of presentation the prognosis of angina is not benign. Further research is required to identify those patients in the general population who would benefit most from coronary revascularisation. (Br HeartJ' 1995;73:193-198)

Time changes in new cases of ischaemic heart disease in general practice

“…In 1995, the incidence of new cases of angina pectoris in the UK was estimated at 22 600 patients per annum, 7 with one in 10 of these developing further complications of non-fatal myocardial infarction or coronary death within 1 year of the initial diagnosis, but again this study relied upon patients from general practice being followed up in a hospital clinic.…”

International review of the utilisation and cost of percutaneous transluminal coronary angioplasty

“…A survey of GP records in Nottingham found that in patients presenting to their GP with angina as defined by the prescription of nitrates, fewer than 20% were referred to hospital and, of these, half were seen by a cardiologist and only 4% underwent angiographic investigation [38,39]. A questionnaire sent to GPs in Hampshire found that 80% of GPs reported referring 10% or fewer of their patients with angina to a cardiologist, and 72% reported referring 25% or fewer to a hospital physician [38,40]. A recent study by Hemingway et al [41] highlights that the underuse of coronary revascularisation in the UK is associated with adverse clinical outcomes.…”

Only modest resources are needed to improve treatment of hospitalised patients with chest pain or heart failure: rapid assessment is a safe and efficient strategy

“…Only 14% net improvement in the proportion of patients free of emergency department returns was achieved by routine angiography [7]. Chest pain units and clinics have been shown to improve diagnostic certainty, reduce length of stay, and contribute to modest savings [7,[9][10][11][12][13][14][15]. Hardly any knowledge of rapid assessment units that evaluate congestive heart failure patients systematically exists.…”