title: Predictive factors of recurrent angina after acute coronary syndrome: the global registry acute coronary events from China (Sino-GRACE).
abstract: BACKGROUND
  Many patients with acute coronary syndrome (ACS) develop recurrent angina (RA) during hospitalization. The aim of this non-randomized, prospective study was to investigate the predictive factors of RA in unselected patients with ACS enrolled in the global registry acute coronary events (GRACE) during hospitalization in China.
  
  
  METHODS
  Between March 2001 and October 2004, enrolled were 1433 patients with ACS, including ST segment elevation myocardial infarction (662, 46.2%), non-ST segment elevation myocardial infarction (239, 16.7%) and unstable angina (532, 37.1%). The demographic distribution, medical history and clinical data were collected to investigate the predictive factors of RA by Logistic regression.
  
  
  RESULTS
  During hospitalization 275 (19.2%) patients were documented with RA including unstable angina (53.2%), non-ST segment elevation myocardial infarction (27.5%), ST segment elevation myocardial infarction (19.3%). A comorbidity of dyslipidemia, prior angina, percutaneous coronary intervention (PCI) within 6 months was more common in patients with RA, P < 0.05. In the patients with RA, a significantly higher proportion of patients with acute pulmonary edema was observed, 23 (8.4%) versus 43 (3.7%), P = 0.001. Acute renal failure was present in 8 (2.9%) of patients with RA versus 19 (1.6%) of patients without RA, P = 0.165. Hemorrhagic events were present in 6 (2.2%) of patients with RA versus 8 (0.7%) of patients without RA, ventricular tachycardia/ventricular fibrillation events in 12 patients (4.3%) versus 22 patients (1.9%), congestive heart failure in 69 patients (25.0%) versus 94 patients (8.1%), myocardial re-infarction in 28 patients (10.1%) versus 15 patients (1.3%), P < 0.05, respectively. A lower proportion of patients with RA underwent in-hospital PCI, 687 (59.3%) versus 114 (41.5%), P = 0.000. A higher proportion of patients with RA received heparin, 260 (94.5%) versus 1035 (89.4%), P = 0.006; and beta-blockers 176 (64.0%) versus 864 (74.5%), P = 0.000. Multivarible regression analysis showed that RA was associated with prior angina (OR 2.086, 95% CI 1.466 - 2.967), in-hospital PCI (OR 0.579, 95% CI 0.431 - 0.778), in-hospital congestive heart failure (OR 2.410, 95% CI 1.634 - 3.555), myocardial re-infarction (OR 7.695, 95% CI 3.701 - 15.999), beta-blocker (OR 0.626, 95% CI 0.458 - 0.855), and heparin (OR 3.411, 95% CI 1.604 - 7.382).
  
  
  CONCLUSIONS
  In-hospital congestive heart failure, myocardial re-infarction, prior angina history and use of heparin are stronger independent predictors of RA; beta-blockers and PCI are also important predictive factors for RA.
authors.affiliation: Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing 100029, China.
authors.forename: Fu-hai
authors.initials: FH
authors.lastname: Zhao
authors.forename: Yun-dai
authors.initials: YD
authors.lastname: Chen
authors.forename: Xian-tao
authors.initials: XT
authors.lastname: Song
authors.forename: Wei-qi
authors.initials: WQ
authors.lastname: Pan
authors.forename: Ze-ning
authors.initials: ZN
authors.lastname: Jin
authors.forename: Fei
authors.initials: F
authors.lastname: Yuan
authors.forename: Yong-bin
authors.initials: YB
authors.lastname: Li
authors.forename: Fang
authors.initials: F
authors.lastname: Ren
authors.forename: Shu-zheng
authors.initials: SZ
authors.lastname: Lü
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000209:etiology* / Q000628:therapy; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012042:Registries