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Comparison of Clinical Characteristics and Outcomes of Patients With Versus Without Diabetes Mellitus and With Versus Without Angina Pectoris (from the Duke Databank for Cardiovascular Disease).

Publication ,  Journal Article
Banks, A; Broderick, S; Chiswell, K; Shaw, L; Devore, A; Fiuzat, M; O'Connor, C; Felker, GM; Velazquez, E; Mentz, R
Published in: Am J Cardiol
June 1, 2017

Angina pectoris (AP) has different prognostic implications in various populations. Patients with diabetes mellitus (DM) may experience neuropathy such that AP may not be perceived in the setting of coronary artery disease (CAD). The prognostic utility of AP in DM patients with CAD is not well known. We analyzed patients with CAD who underwent coronary angiography at Duke University from 2002 to 2011 and compared patients with and without AP within the previous 6 weeks stratified by DM status. We used multivariable Cox regression to assess the association between AP and the outcomes of cardiovascular (CV) hospitalization/revascularization, all-cause mortality/myocardial infarction/revascularization, and all-cause mortality. Of 17,211 patients with CAD, 5,284 (31%) had DM and AP was present in 69% of DM and 67% of non-DM. After risk adjustment, the risk of CV hospitalization/revascularization and all-cause mortality/myocardial infarction/revascularization in patients with and without AP was similar regardless of DM status (all p ≥0.05). In patients with or without DM, AP was associated with lower all-cause mortality compared with no AP (adjusted hazard ratio 0.89, 95% confidence interval 0.82 to 0.97, p = 0.005 for DM patients). The relation between AP status and clinical outcomes was not dependent on DM status (all interaction p >0.10). In conclusion, in patients with CAD, AP was associated with similar risk for CV hospitalization and revascularization and lower all-cause mortality compared with patients without AP regardless of DM status. Future studies are needed to assess whether these findings are related to increased severity of disease in those without AP or whether AP leads to differential management that improves survival.

Duke Scholars

Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

June 1, 2017

Volume

119

Issue

11

Start / End Page

1703 / 1709

Location

United States

Related Subject Headings

  • Survival Rate
  • Risk Factors
  • Retrospective Studies
  • Registries
  • Prognosis
  • North Carolina
  • Middle Aged
  • Male
  • Incidence
  • Humans
 

Citation

APA
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MLA
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Banks, A., Broderick, S., Chiswell, K., Shaw, L., Devore, A., Fiuzat, M., … Mentz, R. (2017). Comparison of Clinical Characteristics and Outcomes of Patients With Versus Without Diabetes Mellitus and With Versus Without Angina Pectoris (from the Duke Databank for Cardiovascular Disease). Am J Cardiol, 119(11), 1703–1709. https://doi.org/10.1016/j.amjcard.2017.02.053
Banks, Adam, Samuel Broderick, Karen Chiswell, Linda Shaw, Adam Devore, Mona Fiuzat, Christopher O’Connor, Gary Michael Felker, Eric Velazquez, and Robert Mentz. “Comparison of Clinical Characteristics and Outcomes of Patients With Versus Without Diabetes Mellitus and With Versus Without Angina Pectoris (from the Duke Databank for Cardiovascular Disease).Am J Cardiol 119, no. 11 (June 1, 2017): 1703–9. https://doi.org/10.1016/j.amjcard.2017.02.053.
Banks A, Broderick S, Chiswell K, Shaw L, Devore A, Fiuzat M, O’Connor C, Felker GM, Velazquez E, Mentz R. Comparison of Clinical Characteristics and Outcomes of Patients With Versus Without Diabetes Mellitus and With Versus Without Angina Pectoris (from the Duke Databank for Cardiovascular Disease). Am J Cardiol. 2017 Jun 1;119(11):1703–1709.
Journal cover image

Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

June 1, 2017

Volume

119

Issue

11

Start / End Page

1703 / 1709

Location

United States

Related Subject Headings

  • Survival Rate
  • Risk Factors
  • Retrospective Studies
  • Registries
  • Prognosis
  • North Carolina
  • Middle Aged
  • Male
  • Incidence
  • Humans