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Clinical Characteristics and Outcomes of Patients With Coronary Artery Disease and Angina: Analysis of the Irbesartan in Patients With Heart Failure and Preserved Systolic Function Trial.

AbstractBACKGROUND:
The aim of our study was to investigate the relationship between coronary artery disease (CAD), angina, and clinical outcomes in patients with heart failure and preserved ejection fraction enrolled in the irbesartan in patients with heart failure and preserved systolic function (I-Preserve) trial.
METHODS AND RESULTS:
The mean follow-up period for the 4128 patients enrolled in I-Preserve was 49.5 months. Patients were divided into 4 mutually exclusive groups according to history of CAD and angina: patients with no history of CAD or angina (n=2008), patients with no history of CAD but a history of angina (n=649), patients with a history of CAD but no angina (n=468), and patients with a history of CAD and angina (n=1003); patients with no known CAD or angina were the reference group. After adjustment for other prognostic variables using Cox proportional-hazard models, patients with CAD but no angina were found to be at higher risk of all-cause mortality (hazard ratio [HR], 1.58 [1.22-2.04]; P<0.01) and sudden death (HR, 2.12 [1.33-3.39]; P<0.01), compared with patients with no CAD or angina. Patients with CAD and angina were also at higher risk of all-cause mortality (HR, 1.29 [1.05-1.59]; P=0.02) and sudden death (HR, 1.83 [1.24-2.69]; P<0.01) compared with the same reference group and had the highest risk of unstable angina or myocardial infarction (HR, 5.84 [3.43-9.95]; P<0.01).
CONCLUSIONS:
Patients with heart failure and preserved ejection fraction and CAD are at higher risk of all-cause mortality and sudden death when compared with those without CAD.
CLINICAL TRIAL REGISTRATION:
URL: http://www.clinicaltrials.gov. Unique identifier: NCT00095238.
AuthorsAthar A Badar, Ana Cristina Perez-Moreno, Nathaniel M Hawkins, Pardeep S Jhund, Alan P T Brunton, Inder S Anand, Robert S McKelvie, Michel Komajda, Michael R Zile, Peter E Carson, Roy S Gardner, Mark C Petrie, John J V McMurray
JournalCirculation. Heart failure (Circ Heart Fail) Vol. 8 Issue 4 Pg. 717-24 (Jul 2015) ISSN: 1941-3297 [Electronic] United States
PMID26067854 (Publication Type: Comparative Study, Journal Article)
Copyright© 2015 American Heart Association, Inc.
Chemical References
  • Angiotensin II Type 1 Receptor Blockers
  • Biphenyl Compounds
  • Tetrazoles
  • irbesartan
Topics
  • Aged
  • Angina Pectoris (diagnosis, mortality, physiopathology)
  • Angiotensin II Type 1 Receptor Blockers (adverse effects, therapeutic use)
  • Biphenyl Compounds (adverse effects, therapeutic use)
  • Coronary Artery Disease (diagnosis, mortality, physiopathology)
  • Death, Sudden, Cardiac (epidemiology)
  • Female
  • Heart Failure (diagnosis, drug therapy, mortality, physiopathology)
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • Randomized Controlled Trials as Topic
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Stroke Volume
  • Systole
  • Tetrazoles (adverse effects, therapeutic use)
  • Time Factors
  • Treatment Outcome
  • Ventricular Function, Left

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