Symptoms of angina pectoris increase the probability of disability pension and premature exit from the workforce even in the absence of obstructive coronary artery disease

To evaluate probabilities of disability pension (DP) and premature exit from the workforce (PEW) in patients with stable angina symptoms and no obstructive coronary artery disease (CAD) at angiography compared with obstructive CAD and asymptomatic reference individuals. We followed 4303 patients wit...

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Bibliographic Details
Published in:European heart journal 2013-11, Vol.34 (42), p.3294-3303
Main Authors: Jespersen, Lasse, Abildstrøm, Steen Z, Hvelplund, Anders, Galatius, Søren, Madsen, Jan K, Pedersen, Frants, Højberg, Søren, Prescott, Eva
Format: Article
Language:English
Subjects:
Adult
Analysis of Variance
Angina, Stable - epidemiology
Coronary Stenosis - epidemiology
Denmark - epidemiology
Disabled Persons - statistics & numerical data
Epidemiologic Methods
Female
Humans
Male
Middle Aged
Pensions - statistics & numerical data
Retirement - statistics & numerical data
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Summary:To evaluate probabilities of disability pension (DP) and premature exit from the workforce (PEW) in patients with stable angina symptoms and no obstructive coronary artery disease (CAD) at angiography compared with obstructive CAD and asymptomatic reference individuals. We followed 4303 patients with no prior cardiovascular disease having a first-time coronary angiography (CAG) in 1998-2009 due to stable angina symptoms and 2772 reference individuals from the Copenhagen City Heart Study, all aged 0.2 for interaction). Thus, in pooled multivariable-adjusted analysis, patients referred to CAG for angina had a three-fold higher probability of DP and ~50% higher probability of PEW, with little difference between patients with angiographically normal coronary arteries, angiographically diffuse non-obstructive CAD, 1VD, 2VD, 3VD, the hazard ratios for DP being 2.7, 3.0, 3.3, 3.1, and 3.2 (all P < 0.001) and for PEW being 1.3, 1.4, 1.5, 1.6, and 1.6 (all P < 0.05). Patients with angina symptoms and angiographically normal coronary arteries, diffuse non-obstructive CAD, or obstructive CAD at angiography have a three-fold increased probability of DP regardless of angiographic findings.
ISSN:0195-668X
1522-9645
DOI:10.1093/eurheartj/eht395