Systematic review: prognosis of angina in primary care.
BACKGROUND
Angina is a common chronic condition, largely managed in primary care in the UK. Mortality data are predominately from population or hospital studies with little known about the prognosis of angina in general practice settings.


OBJECTIVE
To describe the prognosis of angina in patients identified in primary care.


METHODS
Systematic review of cohort studies of angina in primary care. Data sources. Medline, PsycINFO, EMBASE, CINAHL, HMIC, WOS, IBSS, UK National Research Register, notification via JISC, CHAIN. REVIEW METHODS SELECTION CRITERIA: Cohort studies of patients with angina, with >12 months of follow-up, recruited within primary care. VALIDITY ASSESSMENT: Database searches and abstracts were reviewed independently by two authors. Papers were assessed according to criteria derived from the cohort methodological literature.


METHODS
Data were abstracted by two reviewers.


RESULTS
Narrative summary. A quantitative synthesis was planned.


METHODS
Total and cardiovascular death; non-fatal myocardial infarction (MI).


RESULTS
Six studies fulfilled our selection criteria. The annual total mortality rate is 2.8-6.6%, an annual cardiovascular death rate of 1.4-6.5% and an annual non-fatal MI rate of 0.3-5.5%. A quantitative synthesis was not possible, because the studies were clinically heterogeneous.


CONCLUSIONS
The primary studies have value in determining the prognosis of patients with angina recruited in general practice; however, the studies are old, have small numbers of events and are clinically heterogeneous. The contemporary prognosis of angina in primary care remains a key question, and further research is, therefore, required to estimate the prognosis of angina in this setting and its determinants.
Jones
Melvyn
M
Royal Free University College Medical School, Department of Primary Care and Population Sciences, London, UK. m.jones@pcps.ucl.ac.uk
Rait
Greta
G
Falconer
Jane
J
Feder
Gene
G
D000787:Angina Pectoris / Q000175:diagnosis* / Q000401:mortality*; D006801:Humans; D009203:Myocardial Infarction / Q000453:epidemiology / Q000401:mortality; D011320:Primary Health Care / Q000706:statistics & numerical data; D011379:Prognosis