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The development of heart failure in patients with stable angina pectoris
Author(s) -
Sutton George C.,
Otterstad Jan Erik,
Kirwan BridgetAnne,
Vokó Zoltán,
Brouwer Sophie,
Lubsen Jacobus,
PooleWilson Philip A.
Publication year - 2007
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2006.09.002
Subject(s) - medicine , heart failure , cardiology , angina , myocardial infarction , ejection fraction , nifedipine , diabetes mellitus , unstable angina , risk factor , blood pressure , creatinine , calcium , endocrinology
Background: To describe the clinical characteristics of patients with stable angina pectoris who develop heart failure and the events preceding its onset. Methods and results: Of 7665 patients with stable angina in the ACTION trial, which compared long‐acting nifedipine to placebo, 207 (2.7%) developed heart failure (HF) during a mean follow‐up of 4.9years. Those who developed HF were significantly ( P <0.05) older, more often had diabetes, had a more extensive history of cardiovascular disease, lower ejection fractions, a higher serum creatinine and glucose, a lower haemoglobin, and were more often on blood pressure lowering drugs. A cardiac event or an intervention ( n =155), a significant non‐cardiac infection ( n =19) or poor control of hypertension ( n =12) preceded the development of HF in 186/207 cases (90%). There was no obvious precipitating factor in the remaining 21 patients (10%). Myocardial infarction increased the risk of the development of new HF within one week more than 100‐fold. Nifedipine reduced the incidence of HF by 29% ( P =0.015). Conclusions: The development of heart failure is uncommon in patients with stable angina, and even less so in the absence of an obvious precipitating factor.