title: Refractory angina pectoris carries a favourable prognosis: a three-year follow-up of 150 patients.
abstract: OBJECTIVE
  To investigate the three-year prognosis in refractory angina pectoris.
  
  
  METHODS
  Two hundred and forty three patients were screened at six European university hospitals for a gene therapy trial. In 150 patients refractory angina pectoris could be confirmed. Vital status was assessed after a mean of 33 months.
  
  
  RESULTS
  At baseline, mean age was 63+/-9 years and mean LVEF was 52+/-12%. In 61% there was a history of myocardial infarction and 83% had previously been revascularised. Mortality was 5.5% at one year and 13.5% at three years. New revascularisation options were found in 9.5% of the 243 screened patients at baseline coronary angiography. Additionally, in 6% of the trial patients the protocol-specified angiogram after three months revealed new significant stenosis, which was treated by percutaneous intervention.
  
  
  CONCLUSIONS
  Annual mortality in refractory angina pectoris seems higher than in stable angina pectoris in general, but substantially lower than after myocardial infarction. The "refractoriness" of these patients should be re-evaluated regularly, as new revascularisation options often occur.
authors.affiliation: Department of Cardiology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.
authors.forename: Andreas
authors.initials: A
authors.lastname: Rück
authors.forename: Christer
authors.initials: C
authors.lastname: Sylvén
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000401:mortality*; D017023:Coronary Angiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D011379:Prognosis; D012008:Recurrence