What question did this study set out to answer?

To determine the long-term prognostic significance of transient ambulatory ischaemic episodes during daily life in outpatients receiving medical therapy for stable angina.

March 1, 1995European Heart Journal

Detection of ambulatory ischaemia is not of practical clinical value in the routine management of patients with stable angina: A long-term follow-up study

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Medically treated stable angina (n=172). Intervention: Transient ischaemia during daily activities vs. No transient ischaemia during daily activities. Primary outcome: Cardiac events (cardiac death, non-fatal myocardial infarction, unstable angina, elective CABG/PTCA).

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Key result

Transient ischaemia during daily life was not associated with an increased risk of cardiac events (which occurred in 54 of 172 patients overall) over a median 50-month follow-up.

Why the study?

Does the detection of transient ischaemia during daily activities predict cardiac events in patients with medically treated stable angina?

Population

172 patients routinely attending cardiac outpatients with medically treated stable angina who had undergone…

Comparison

Presence of transient ischaemia during daily… vs Absence of transient ischaemia during daily…

Design

Cohort

Follow-up

median 50 months

Authors

HMHugh MulcahyUniversity College Dublin CKC KnightUniversity of London DPDeesha PatelCenters for Disease Control and Prevention

Discussion

Member takes

Implication

Does not support ambulatory ST monitoring for prognostication in stable angina; leaves open relevance with contemporary therapies.

Key Points

To determine the long-term prognostic significance of transient ambulatory ischaemic episodes during daily life in outpatients receiving medical therapy for stable angina.
Followed 172 outpatients with medically treated stable angina who underwent exercise stress testing and 48-hour ambulatory ST segment monitoring between February 1988 and August 1989.
Tracked patients over a median follow-up of 50 months (up to 65 months) for adverse primary cardiac outcomes.
Exercise testing was positive for ischaemia in 104 patients (60.5%), and 72 patients (42%) displayed transient ischaemia during daily activities (63 had both tests positive).
Over follow-up, 54 patients experienced cardiac events, including 7 cardiac deaths, 11 non-fatal myocardial infarctions, 18 unstable angina presentations, and 18 revascularisation procedures (elective CABG or PTCA).
Both objective cardiac events (cardiac death or non-fatal myocardial infarction) and subjective events (unstable angina or revascularisation) occurred at similar frequencies between patients with and without transient ambulatory ischaemia.

Study Design

Type

Cohort (n=172)

Structured PICO

Does the detection of transient ischaemia during daily activities predict cardiac events in patients with medically treated stable angina?

Population

172 patients with medically treated stable angina who underwent exercise testing and 48-hour ambulatory ST segment monitoring, followed for a median of 50 months.

Exposure

Presence of transient ischaemia during daily activities detected by 48 h of ambulatory ST segment monitoring

Comparator

Absence of transient ischaemia during daily activities

Outcome

Composite of at least one cardiac event (cardiac death, non-fatal myocardial infarction, unstable angina, or elective CABG/PTCA) over a median 50-month follow-upcomposite

Detection of ambulatory ischaemia by ST segment monitoring does not provide long-term prognostic value for predicting cardiac events in patients with medically treated stable angina.

Cite This Study

Mulcahy et al. (1995) conducted a cohort in Medically treated stable angina (n=172). Transient ischaemia during daily activities vs. No transient ischaemia during daily activities was evaluated on Cardiac events (cardiac death, non-fatal myocardial infarction, unstable angina, elective CABG/PTCA). Transient ischaemia during daily life was not associated with an increased risk of cardiac events (which occurred in 54 of 172 patients overall) over a median 50-month follow-up.

synapsesocial.com/papers/6aa0abaf052b4a3e4c1a03fa https://doi.org/10.1093/oxfordjournals.eurheartj.a060913

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Detection of ambulatory ischaemia is not of practical clinical value in the routine management of patients with stable angina: A long-term follow-up study

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Detection of ambulatory ischaemia is not of practical clinical value in the routine management of patients with stable angina: A long-term follow-up study

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Also Consider

Also Consider