title: Clinical Characteristics and Outcomes of Patients With Coronary Artery Disease and Angina: Analysis of the Irbesartan in Patients With Heart Failure and Preserved Systolic Function Trial.
abstract: BACKGROUND
  The aim of our study was to investigate the relationship between coronary artery disease (CAD), angina, and clinical outcomes in patients with heart failure and preserved ejection fraction enrolled in the irbesartan in patients with heart failure and preserved systolic function (I-Preserve) trial.
  
  
  RESULTS
  The mean follow-up period for the 4128 patients enrolled in I-Preserve was 49.5 months. Patients were divided into 4 mutually exclusive groups according to history of CAD and angina: patients with no history of CAD or angina (n=2008), patients with no history of CAD but a history of angina (n=649), patients with a history of CAD but no angina (n=468), and patients with a history of CAD and angina (n=1003); patients with no known CAD or angina were the reference group. After adjustment for other prognostic variables using Cox proportional-hazard models, patients with CAD but no angina were found to be at higher risk of all-cause mortality (hazard ratio [HR], 1.58 [1.22-2.04]; P<0.01) and sudden death (HR, 2.12 [1.33-3.39]; P<0.01), compared with patients with no CAD or angina. Patients with CAD and angina were also at higher risk of all-cause mortality (HR, 1.29 [1.05-1.59]; P=0.02) and sudden death (HR, 1.83 [1.24-2.69]; P<0.01) compared with the same reference group and had the highest risk of unstable angina or myocardial infarction (HR, 5.84 [3.43-9.95]; P<0.01).
  
  
  CONCLUSIONS
  Patients with heart failure and preserved ejection fraction and CAD are at higher risk of all-cause mortality and sudden death when compared with those without CAD.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov. Unique identifier: NCT00095238.
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (A.A.B., A.C.P.-M., P.S.J., A.P.T.B., R.S.G., M.C.P., J.J.V.M.); Scottish National Advanced Heart Failure Service, Golden Jubilee National Hospital, Glasgow, United Kingdom (A.A.B., R.S.G., M.C.P.); Division of Cardiology, University of British Columbia, Vancouver, Canada (N.M.H.); Veterans Affairs Medical Center and University of Minnesota, Minneapolis (I.S.A.); Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada (R.S.M.); Pitié-Salpêtrière Hospital, Paris, France (M.K.); Ralph H. Johnson Veterans Affairs Medical Center and Medical University of South Carolina, Charleston (M.R.Z.); and Georgetown University and Washington DC Veterans Affairs Medical Center (P.E.C.).
authors.forename: Athar A
authors.initials: AA
authors.lastname: Badar
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (A.A.B., A.C.P.-M., P.S.J., A.P.T.B., R.S.G., M.C.P., J.J.V.M.); Scottish National Advanced Heart Failure Service, Golden Jubilee National Hospital, Glasgow, United Kingdom (A.A.B., R.S.G., M.C.P.); Division of Cardiology, University of British Columbia, Vancouver, Canada (N.M.H.); Veterans Affairs Medical Center and University of Minnesota, Minneapolis (I.S.A.); Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada (R.S.M.); Pitié-Salpêtrière Hospital, Paris, France (M.K.); Ralph H. Johnson Veterans Affairs Medical Center and Medical University of South Carolina, Charleston (M.R.Z.); and Georgetown University and Washington DC Veterans Affairs Medical Center (P.E.C.).
authors.forename: Ana Cristina
authors.initials: AC
authors.lastname: Perez-Moreno
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (A.A.B., A.C.P.-M., P.S.J., A.P.T.B., R.S.G., M.C.P., J.J.V.M.); Scottish National Advanced Heart Failure Service, Golden Jubilee National Hospital, Glasgow, United Kingdom (A.A.B., R.S.G., M.C.P.); Division of Cardiology, University of British Columbia, Vancouver, Canada (N.M.H.); Veterans Affairs Medical Center and University of Minnesota, Minneapolis (I.S.A.); Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada (R.S.M.); Pitié-Salpêtrière Hospital, Paris, France (M.K.); Ralph H. Johnson Veterans Affairs Medical Center and Medical University of South Carolina, Charleston (M.R.Z.); and Georgetown University and Washington DC Veterans Affairs Medical Center (P.E.C.).
authors.forename: Nathaniel M
authors.initials: NM
authors.lastname: Hawkins
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (A.A.B., A.C.P.-M., P.S.J., A.P.T.B., R.S.G., M.C.P., J.J.V.M.); Scottish National Advanced Heart Failure Service, Golden Jubilee National Hospital, Glasgow, United Kingdom (A.A.B., R.S.G., M.C.P.); Division of Cardiology, University of British Columbia, Vancouver, Canada (N.M.H.); Veterans Affairs Medical Center and University of Minnesota, Minneapolis (I.S.A.); Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada (R.S.M.); Pitié-Salpêtrière Hospital, Paris, France (M.K.); Ralph H. Johnson Veterans Affairs Medical Center and Medical University of South Carolina, Charleston (M.R.Z.); and Georgetown University and Washington DC Veterans Affairs Medical Center (P.E.C.).
authors.forename: Pardeep S
authors.initials: PS
authors.lastname: Jhund
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (A.A.B., A.C.P.-M., P.S.J., A.P.T.B., R.S.G., M.C.P., J.J.V.M.); Scottish National Advanced Heart Failure Service, Golden Jubilee National Hospital, Glasgow, United Kingdom (A.A.B., R.S.G., M.C.P.); Division of Cardiology, University of British Columbia, Vancouver, Canada (N.M.H.); Veterans Affairs Medical Center and University of Minnesota, Minneapolis (I.S.A.); Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada (R.S.M.); Pitié-Salpêtrière Hospital, Paris, France (M.K.); Ralph H. Johnson Veterans Affairs Medical Center and Medical University of South Carolina, Charleston (M.R.Z.); and Georgetown University and Washington DC Veterans Affairs Medical Center (P.E.C.).
authors.forename: Alan P T
authors.initials: AP
authors.lastname: Brunton
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (A.A.B., A.C.P.-M., P.S.J., A.P.T.B., R.S.G., M.C.P., J.J.V.M.); Scottish National Advanced Heart Failure Service, Golden Jubilee National Hospital, Glasgow, United Kingdom (A.A.B., R.S.G., M.C.P.); Division of Cardiology, University of British Columbia, Vancouver, Canada (N.M.H.); Veterans Affairs Medical Center and University of Minnesota, Minneapolis (I.S.A.); Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada (R.S.M.); Pitié-Salpêtrière Hospital, Paris, France (M.K.); Ralph H. Johnson Veterans Affairs Medical Center and Medical University of South Carolina, Charleston (M.R.Z.); and Georgetown University and Washington DC Veterans Affairs Medical Center (P.E.C.).
authors.forename: Inder S
authors.initials: IS
authors.lastname: Anand
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (A.A.B., A.C.P.-M., P.S.J., A.P.T.B., R.S.G., M.C.P., J.J.V.M.); Scottish National Advanced Heart Failure Service, Golden Jubilee National Hospital, Glasgow, United Kingdom (A.A.B., R.S.G., M.C.P.); Division of Cardiology, University of British Columbia, Vancouver, Canada (N.M.H.); Veterans Affairs Medical Center and University of Minnesota, Minneapolis (I.S.A.); Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada (R.S.M.); Pitié-Salpêtrière Hospital, Paris, France (M.K.); Ralph H. Johnson Veterans Affairs Medical Center and Medical University of South Carolina, Charleston (M.R.Z.); and Georgetown University and Washington DC Veterans Affairs Medical Center (P.E.C.).
authors.forename: Robert S
authors.initials: RS
authors.lastname: McKelvie
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (A.A.B., A.C.P.-M., P.S.J., A.P.T.B., R.S.G., M.C.P., J.J.V.M.); Scottish National Advanced Heart Failure Service, Golden Jubilee National Hospital, Glasgow, United Kingdom (A.A.B., R.S.G., M.C.P.); Division of Cardiology, University of British Columbia, Vancouver, Canada (N.M.H.); Veterans Affairs Medical Center and University of Minnesota, Minneapolis (I.S.A.); Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada (R.S.M.); Pitié-Salpêtrière Hospital, Paris, France (M.K.); Ralph H. Johnson Veterans Affairs Medical Center and Medical University of South Carolina, Charleston (M.R.Z.); and Georgetown University and Washington DC Veterans Affairs Medical Center (P.E.C.).
authors.forename: Michel
authors.initials: M
authors.lastname: Komajda
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (A.A.B., A.C.P.-M., P.S.J., A.P.T.B., R.S.G., M.C.P., J.J.V.M.); Scottish National Advanced Heart Failure Service, Golden Jubilee National Hospital, Glasgow, United Kingdom (A.A.B., R.S.G., M.C.P.); Division of Cardiology, University of British Columbia, Vancouver, Canada (N.M.H.); Veterans Affairs Medical Center and University of Minnesota, Minneapolis (I.S.A.); Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada (R.S.M.); Pitié-Salpêtrière Hospital, Paris, France (M.K.); Ralph H. Johnson Veterans Affairs Medical Center and Medical University of South Carolina, Charleston (M.R.Z.); and Georgetown University and Washington DC Veterans Affairs Medical Center (P.E.C.).
authors.forename: Michael R
authors.initials: MR
authors.lastname: Zile
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (A.A.B., A.C.P.-M., P.S.J., A.P.T.B., R.S.G., M.C.P., J.J.V.M.); Scottish National Advanced Heart Failure Service, Golden Jubilee National Hospital, Glasgow, United Kingdom (A.A.B., R.S.G., M.C.P.); Division of Cardiology, University of British Columbia, Vancouver, Canada (N.M.H.); Veterans Affairs Medical Center and University of Minnesota, Minneapolis (I.S.A.); Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada (R.S.M.); Pitié-Salpêtrière Hospital, Paris, France (M.K.); Ralph H. Johnson Veterans Affairs Medical Center and Medical University of South Carolina, Charleston (M.R.Z.); and Georgetown University and Washington DC Veterans Affairs Medical Center (P.E.C.).
authors.forename: Peter E
authors.initials: PE
authors.lastname: Carson
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (A.A.B., A.C.P.-M., P.S.J., A.P.T.B., R.S.G., M.C.P., J.J.V.M.); Scottish National Advanced Heart Failure Service, Golden Jubilee National Hospital, Glasgow, United Kingdom (A.A.B., R.S.G., M.C.P.); Division of Cardiology, University of British Columbia, Vancouver, Canada (N.M.H.); Veterans Affairs Medical Center and University of Minnesota, Minneapolis (I.S.A.); Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada (R.S.M.); Pitié-Salpêtrière Hospital, Paris, France (M.K.); Ralph H. Johnson Veterans Affairs Medical Center and Medical University of South Carolina, Charleston (M.R.Z.); and Georgetown University and Washington DC Veterans Affairs Medical Center (P.E.C.).
authors.forename: Roy S
authors.initials: RS
authors.lastname: Gardner
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (A.A.B., A.C.P.-M., P.S.J., A.P.T.B., R.S.G., M.C.P., J.J.V.M.); Scottish National Advanced Heart Failure Service, Golden Jubilee National Hospital, Glasgow, United Kingdom (A.A.B., R.S.G., M.C.P.); Division of Cardiology, University of British Columbia, Vancouver, Canada (N.M.H.); Veterans Affairs Medical Center and University of Minnesota, Minneapolis (I.S.A.); Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada (R.S.M.); Pitié-Salpêtrière Hospital, Paris, France (M.K.); Ralph H. Johnson Veterans Affairs Medical Center and Medical University of South Carolina, Charleston (M.R.Z.); and Georgetown University and Washington DC Veterans Affairs Medical Center (P.E.C.).
authors.forename: Mark C
authors.initials: MC
authors.lastname: Petrie
authors.affiliation: From the BHF Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (A.A.B., A.C.P.-M., P.S.J., A.P.T.B., R.S.G., M.C.P., J.J.V.M.); Scottish National Advanced Heart Failure Service, Golden Jubilee National Hospital, Glasgow, United Kingdom (A.A.B., R.S.G., M.C.P.); Division of Cardiology, University of British Columbia, Vancouver, Canada (N.M.H.); Veterans Affairs Medical Center and University of Minnesota, Minneapolis (I.S.A.); Hamilton Health Sciences, McMaster University, Hamilton, Ontario, Canada (R.S.M.); Pitié-Salpêtrière Hospital, Paris, France (M.K.); Ralph H. Johnson Veterans Affairs Medical Center and Medical University of South Carolina, Charleston (M.R.Z.); and Georgetown University and Washington DC Veterans Affairs Medical Center (P.E.C.). john.mcmurray@glasgow.ac.uk.
authors.forename: John J V
authors.initials: JJ
authors.lastname: McMurray
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology; D047228:Angiotensin II Type 1 Receptor Blockers / Q000009:adverse effects / Q000627:therapeutic use*; D001713:Biphenyl Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D000077405:Irbesartan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D016032:Randomized Controlled Trials as Topic; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013318:Stroke Volume; D013599:Systole; D013777:Tetrazoles / Q000009:adverse effects / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D001713:Biphenyl Compounds; D013777:Tetrazoles; D000077405:Irbesartan
keywords: angina pectoris; coronary artery disease; heart failure; human; irbesartan