title: Relationship between angina pectoris and outcomes in patients with heart failure and reduced ejection fraction: an analysis of the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA).
abstract: OBJECTIVE
  Angina pectoris is common in patients with heart failure and reduced ejection fraction (HF-REF) but its relationship with outcomes has not been well defined. This relationship was investigated further in a retrospective analysis of the Controlled Rosuvastatin Multinational Trial in Heart Failure (CORONA).
  
  
  RESULTS
  Four thousand, eight hundred and seventy-eight patients were divided into three categories: no history of angina and no chest pain at baseline (Group A; n = 1240), past history of angina but no chest pain at baseline (Group B; n = 1353) and both a history of angina and chest pain at baseline (Group C; n = 2285). Outcomes were examined using Kaplan-Meier and Cox regression survival analysis. Compared with Group A, Group C had a higher risk of non-fatal myocardial infarction or unstable angina (HR: 2.36, 1.54-3.61; P < 0.001), this composite plus coronary revascularization (HR: 2.54, 1.76-3.68; P < 0.001), as well as HF hospitalization (HR: 1.35, 1.13-1.63; P = 0.001), over a median follow-up period of 33 months. There was no difference in cardiovascular or all-cause mortality. Group B had a smaller increase in risk of coronary events but not of heart failure hospitalization.
  
  
  CONCLUSIONS
  Patients with HF-REF and ongoing angina are at an increased risk of acute coronary syndrome and HF hospitalization. Whether these patients would benefit from more aggressive medical therapy or percutaneous revascularization is not known and merits further investigation.
authors.affiliation: BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK Golden Jubilee National Hospital, Glasgow, UK.
authors.forename: Athar A
authors.initials: AA
authors.lastname: Badar
authors.affiliation: BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
authors.forename: Ana Cristina
authors.initials: AC
authors.lastname: Perez-Moreno
authors.affiliation: BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
authors.forename: Pardeep S
authors.initials: PS
authors.lastname: Jhund
authors.affiliation: BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
authors.forename: Chih M
authors.initials: CM
authors.lastname: Wong
authors.affiliation: University of British Columbia, Vancouver, Canada.
authors.forename: Nathaniel M
authors.initials: NM
authors.lastname: Hawkins
authors.affiliation: National Heart & Lung Institute, Royal Brompton & Harefield Hospitals, Imperial College, London, UK.
authors.forename: John G F
authors.initials: JG
authors.lastname: Cleland
authors.affiliation: University Hospital Groningen, Groningen, Netherlands.
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: van Veldhuisen
authors.affiliation: Gothenburg University, Gothenburg, Sweden.
authors.forename: John
authors.initials: J
authors.lastname: Wikstrand
authors.affiliation: Oslo University Hospital, Rikshospitalet, University of Oslo, Oslo, Norway.
authors.forename: John
authors.initials: J
authors.lastname: Kjekshus
authors.affiliation: Nordic School of Public Health, Gothenburg, Sweden.
authors.forename: Hans
authors.initials: H
authors.lastname: Wedel
authors.affiliation: Golden Jubilee National Hospital, Glasgow, UK.
authors.forename: Stuart
authors.initials: S
authors.lastname: Watkins
authors.affiliation: BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK Golden Jubilee National Hospital, Glasgow, UK.
authors.forename: Roy S
authors.initials: RS
authors.lastname: Gardner
authors.affiliation: BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK Golden Jubilee National Hospital, Glasgow, UK.
authors.forename: Mark C
authors.initials: MC
authors.lastname: Petrie
authors.affiliation: BHF Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK john.mcmurray@glasgow.ac.uk.
authors.forename: John J V
authors.initials: JJ
authors.lastname: McMurray
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000150:complications* / Q000401:mortality / Q000503:physiopathology; D005260:Female; D005464:Fluorobenzenes / Q000008:administration & dosage; D006333:Heart Failure / Q000150:complications* / Q000188:drug therapy / Q000401:mortality; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011743:Pyrimidines / Q000008:administration & dosage; D012189:Retrospective Studies; D000068718:Rosuvastatin Calcium; D013318:Stroke Volume / Q000502:physiology; D013449:Sulfonamides / Q000008:administration & dosage; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000150:complications / Q000401:mortality / Q000503:physiopathology
chemical_list: D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium
keywords: Angina pectoris; Heart failure; Reduced ejection fraction