title: Non-coronary chest pain does not affect long-term mortality: a prospective, observational study using a matched population control.
abstract: Chest pain assumed to be of non-coronary origin (NCCP) may be linked to enhanced mortality due to coronary heart disease (CHD). The aim of this study was to follow NCCP patients, as defined in primary care, with respect to mortality and long-term morbidity of CHD. We further examined if NCCP associates with risk factors for CHD.
  
  
  
  Patients consulting general practitioners (GPs) in 1998-2000 in three primary care centers in the southeast Sweden for chest pain regarded as NCCP were compared with controls matched for age, gender and residential area. Causes of death were gathered from registry data and death certificates. In 2005 a postal questionnaire was distributed to the survivors to collect demographic and clinical data. If participants had CHD diagnosed by a physician prior to inclusion they were excluded.
  
  
  
  Patients with NCCP (n = 382) and population controls (n = 746) did not differ with respect to mortality and incidence of CHD. The NCCP group reported more ongoing chest pain (OR 3.34 95 % CI 2.41-4.62), they more often had elevated blood pressure (OR 1.86 95 % CI 1.32-2.60), consumed more β-blockers (p < 0.001), aspirin (p = 0.013), thiazides (p = 0.004) and long-acting nitrates (p = 0.002). They further had more remedies for acid-related disorders (p = 0.014) and obstructive pulmonary disease (p < 0.001).
  
  
  
  The study suggests that individuals with chest pain judged by GPs to be NCCP do not develop CHD more frequently than population controls. It is evident that NCCP often lasts for many years and that the condition associates with hypertension.
authors.affiliation: Primary Health Care and Department of Medicine and Health Sciences, Linköping University, Norrköping, Sweden. staffan.g.nilsson@liu.se.|Vikbolandet Health Care Centre, Bygdevägen 13, Vikbolandet, SE-610 24, Sweden. staffan.g.nilsson@liu.se.
authors.forename: Staffan
authors.initials: S
authors.lastname: Nilsson
authors.affiliation: Department of Internal Medicine, The Vrinnevi Hospital, Norrköping, Sweden.
authors.forename: Petter
authors.initials: P
authors.lastname: Järemo
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D001241:Aspirin / Q000627:therapeutic use; D016022:Case-Control Studies; D002423:Cause of Death; D002637:Chest Pain / Q000209:etiology / Q000401:mortality*; D003327:Coronary Disease / Q000453:epidemiology* / Q000401:mortality; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009566:Nitrates / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology; D049971:Thiazides / Q000627:therapeutic use
chemical_list: D000319:Adrenergic beta-Antagonists; D009566:Nitrates; D010975:Platelet Aggregation Inhibitors; D049971:Thiazides; D001241:Aspirin
keywords: Coronary heart disease; Hypertension; Mortality; Non-coronary chest pain; Primary health care