Prognostic value of routinely available data in patients with stable coronary heart disease. A 10-year follow-up of patients sampled at random times during their disease course

ObjectiveTo characterise the long-term prognosis of patients with stable coronary artery heart disease by means of ‘standard predictors’ defined as demographic, clinical and biochemical quantities routinely available in general practices and ascertained at an interview not prompted by renewed cardia...

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Published in:Open heart 2018, Vol.5 (2), p.e000808-e000808
Main Authors: Winkel, Per, Jakobsen, Janus Christian, Hilden, Jørgen, Jensen, Gorm, Kjøller, Erik, Sajadieh, Ahmad, Kastrup, Jens, Kolmos, Hans Jørn, Larsson, Anders, Ärnlöv, Johan, Gluud, Christian
Format: Article
Language:English
Subjects:
Angina pectoris
Angioplasty
Cardiology
Cardiovascular disease
CLARICOR
Coronary Artery Disease
Coronary vessels
Diabetes
Health and Welfare
Health risk assessment
Heart attacks
Heart failure
Hypertension
Hälsa och välfärd
ischaemic heart disease
Medical prognosis
Medicin och hälsovetenskap
Mortality
Patients
predictors
Survival analysis
Task forces
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creator Winkel, Per
Jakobsen, Janus Christian
Hilden, Jørgen
Jensen, Gorm
Kjøller, Erik
Sajadieh, Ahmad
Kastrup, Jens
Kolmos, Hans Jørn
Larsson, Anders
Ärnlöv, Johan
Gluud, Christian
description ObjectiveTo characterise the long-term prognosis of patients with stable coronary artery heart disease by means of ‘standard predictors’ defined as demographic, clinical and biochemical quantities routinely available in general practices and ascertained at an interview not prompted by renewed cardiac complaints.MethodsThis is an observational study based on data from 2199 Copenhagen placebo patients from the ‘clarithromycin for patients with stable coronary heart disease’ trial of patients with stable coronary heart disease. In the trial, we compared the effects of 14 days of clarithromycin treatment versus placebo. The predictors were based on the interview forms and blood samples collected at entry, along with demographic information from hospital files.We studied ‘standard predictors’ of a composite outcome (myocardial infarction, unstable angina, cerebrovascular disease or all-cause death) and of all-cause death. Using Cox regression, we compared predictions of status at 3, 6 and 9 years without and with the use of ‘standard predictors’ and used receiver operating characteristic statistic.ResultsFew ‘standard predictors’ were associated (p
doi_str_mv 10.1136/openhrt-2018-000808
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A 10-year follow-up of patients sampled at random times during their disease course</title><source>Publicly Available Content Database</source><source>PubMed Central(OpenAccess)</source><source>BMJ Journals (Open Access)</source><creator>Winkel, Per ; Jakobsen, Janus Christian ; Hilden, Jørgen ; Jensen, Gorm ; Kjøller, Erik ; Sajadieh, Ahmad ; Kastrup, Jens ; Kolmos, Hans Jørn ; Larsson, Anders ; Ärnlöv, Johan ; Gluud, Christian</creator><creatorcontrib>Winkel, Per ; Jakobsen, Janus Christian ; Hilden, Jørgen ; Jensen, Gorm ; Kjøller, Erik ; Sajadieh, Ahmad ; Kastrup, Jens ; Kolmos, Hans Jørn ; Larsson, Anders ; Ärnlöv, Johan ; Gluud, Christian</creatorcontrib><description>ObjectiveTo characterise the long-term prognosis of patients with stable coronary artery heart disease by means of ‘standard predictors’ defined as demographic, clinical and biochemical quantities routinely available in general practices and ascertained at an interview not prompted by renewed cardiac complaints.MethodsThis is an observational study based on data from 2199 Copenhagen placebo patients from the ‘clarithromycin for patients with stable coronary heart disease’ trial of patients with stable coronary heart disease. In the trial, we compared the effects of 14 days of clarithromycin treatment versus placebo. The predictors were based on the interview forms and blood samples collected at entry, along with demographic information from hospital files.We studied ‘standard predictors’ of a composite outcome (myocardial infarction, unstable angina, cerebrovascular disease or all-cause death) and of all-cause death. Using Cox regression, we compared predictions of status at 3, 6 and 9 years without and with the use of ‘standard predictors’ and used receiver operating characteristic statistic.ResultsFew ‘standard predictors’ were associated (p&lt;0.01) with the composite outcome or with all-cause death. When no ‘standard predictors’ were included, 63.2% of the model-based predictions of the composite outcome and 79.9% of death predictions were correct. Including all ‘standard predictors’ in the model increased the figures to 68.4% and 83.4%, respectively. C indices were low, except when all-cause death was assessed as a single outcome where C was 0.79.Conclusion‘Standard predictors’ routinely available in general practices contribute only modestly to risk assessment in consecutively sampled patients with stable coronary heart disease as ascertained at a contact not prompted by renewed cardiac complaints. Novel biomarkers may improve the assessment.Trial registration number NCT00121550.</description><identifier>ISSN: 2053-3624</identifier><identifier>ISSN: 2398-595X</identifier><identifier>EISSN: 2053-3624</identifier><identifier>DOI: 10.1136/openhrt-2018-000808</identifier><identifier>PMID: 30228904</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Angina pectoris ; Angioplasty ; Cardiology ; Cardiovascular disease ; CLARICOR ; Coronary Artery Disease ; Coronary vessels ; Diabetes ; Health and Welfare ; Health risk assessment ; Heart attacks ; Heart failure ; Hypertension ; Hälsa och välfärd ; ischaemic heart disease ; Medical prognosis ; Medicin och hälsovetenskap ; Mortality ; Patients ; predictors ; Survival analysis ; Task forces</subject><ispartof>Open heart, 2018, Vol.5 (2), p.e000808-e000808</ispartof><rights>Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2018 Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0 Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b633t-c9c4678fd7590edc085c3102d15c8565473f3e7460c06807269207ec6a46854d3</citedby><cites>FETCH-LOGICAL-b633t-c9c4678fd7590edc085c3102d15c8565473f3e7460c06807269207ec6a46854d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2099781815/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2099781815?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,4024,25753,27549,27550,27923,27924,27925,37012,37013,44590,53791,53793,75126,77601,77632</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30228904$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:du-28518$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-363385$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:230228904$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Winkel, Per</creatorcontrib><creatorcontrib>Jakobsen, Janus Christian</creatorcontrib><creatorcontrib>Hilden, Jørgen</creatorcontrib><creatorcontrib>Jensen, Gorm</creatorcontrib><creatorcontrib>Kjøller, Erik</creatorcontrib><creatorcontrib>Sajadieh, Ahmad</creatorcontrib><creatorcontrib>Kastrup, Jens</creatorcontrib><creatorcontrib>Kolmos, Hans Jørn</creatorcontrib><creatorcontrib>Larsson, Anders</creatorcontrib><creatorcontrib>Ärnlöv, Johan</creatorcontrib><creatorcontrib>Gluud, Christian</creatorcontrib><title>Prognostic value of routinely available data in patients with stable coronary heart disease. A 10-year follow-up of patients sampled at random times during their disease course</title><title>Open heart</title><addtitle>Open Heart</addtitle><description>ObjectiveTo characterise the long-term prognosis of patients with stable coronary artery heart disease by means of ‘standard predictors’ defined as demographic, clinical and biochemical quantities routinely available in general practices and ascertained at an interview not prompted by renewed cardiac complaints.MethodsThis is an observational study based on data from 2199 Copenhagen placebo patients from the ‘clarithromycin for patients with stable coronary heart disease’ trial of patients with stable coronary heart disease. In the trial, we compared the effects of 14 days of clarithromycin treatment versus placebo. The predictors were based on the interview forms and blood samples collected at entry, along with demographic information from hospital files.We studied ‘standard predictors’ of a composite outcome (myocardial infarction, unstable angina, cerebrovascular disease or all-cause death) and of all-cause death. Using Cox regression, we compared predictions of status at 3, 6 and 9 years without and with the use of ‘standard predictors’ and used receiver operating characteristic statistic.ResultsFew ‘standard predictors’ were associated (p&lt;0.01) with the composite outcome or with all-cause death. When no ‘standard predictors’ were included, 63.2% of the model-based predictions of the composite outcome and 79.9% of death predictions were correct. Including all ‘standard predictors’ in the model increased the figures to 68.4% and 83.4%, respectively. C indices were low, except when all-cause death was assessed as a single outcome where C was 0.79.Conclusion‘Standard predictors’ routinely available in general practices contribute only modestly to risk assessment in consecutively sampled patients with stable coronary heart disease as ascertained at a contact not prompted by renewed cardiac complaints. Novel biomarkers may improve the assessment.Trial registration number NCT00121550.</description><subject>Angina pectoris</subject><subject>Angioplasty</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>CLARICOR</subject><subject>Coronary Artery Disease</subject><subject>Coronary vessels</subject><subject>Diabetes</subject><subject>Health and Welfare</subject><subject>Health risk assessment</subject><subject>Heart attacks</subject><subject>Heart failure</subject><subject>Hypertension</subject><subject>Hälsa och välfärd</subject><subject>ischaemic heart disease</subject><subject>Medical prognosis</subject><subject>Medicin och hälsovetenskap</subject><subject>Mortality</subject><subject>Patients</subject><subject>predictors</subject><subject>Survival analysis</subject><subject>Task forces</subject><issn>2053-3624</issn><issn>2398-595X</issn><issn>2053-3624</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>PIMPY</sourceid><recordid>eNqNktuKEzEcxgdR3GXdJxAk4I2wTs1hksncCGXVVVjQC_U2pJlMmzqTjDm09K18RNPtwa6waG4Skt_35X8qiucIThAi7I0btV34WGKIeAkh5JA_Ks4xpKQkDFePT85nxWUIy8wgTBls2NPijECMeQOr8-LXF-_m1oVoFFjJPmngOuBdisbqfgPkSppeznoNWhklMBaMMhptYwBrExcgxLtH5byz0m_AQksfQWuClkFPwBQgWG7yHehc37t1mcat_9EjyGHsdQtkBF7a1g0gmkEH0CZv7BzEhTb-4JY_ST7oZ8WTTvZBX-73i-Lbh_dfrz-Wt59vPl1Pb8sZIySWqlEVq3nX1rSBulWQU0UQxC2iilNGq5p0RNcVgwoyDmvMGgxrrZisGKdVSy6Kcucb1npMMzF6M-QMhZNG7K9-5JMWFacUNplvHuRH79o_ooMQH7qQta8f1L4z36fC-blISZCcGqcZv_o33iaBOUU80293dEaHXIlceC_7-_Hde7FmIeZuJRgitKLbzF7tDbz7mXSIYjBB6b6XVrsUBEZ50QqSOqMv_0KXuWk290lg2DQ1Rxxt4yc7SnkXgtfdMRgExXa6xX66xXa6xW66s-rFaR5HzUkVJztgNiz_y_E3rBkKtg</recordid><startdate>2018</startdate><enddate>2018</enddate><creator>Winkel, Per</creator><creator>Jakobsen, Janus Christian</creator><creator>Hilden, Jørgen</creator><creator>Jensen, Gorm</creator><creator>Kjøller, Erik</creator><creator>Sajadieh, Ahmad</creator><creator>Kastrup, Jens</creator><creator>Kolmos, Hans Jørn</creator><creator>Larsson, Anders</creator><creator>Ärnlöv, Johan</creator><creator>Gluud, Christian</creator><general>BMJ Publishing Group LTD</general><general>BMJ Publishing Group</general><scope>9YT</scope><scope>ACMMV</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D8T</scope><scope>ZZAVC</scope><scope>ACNBI</scope><scope>DF2</scope></search><sort><creationdate>2018</creationdate><title>Prognostic value of routinely available data in patients with stable coronary heart disease. A 10-year follow-up of patients sampled at random times during their disease course</title><author>Winkel, Per ; Jakobsen, Janus Christian ; Hilden, Jørgen ; Jensen, Gorm ; Kjøller, Erik ; Sajadieh, Ahmad ; Kastrup, Jens ; Kolmos, Hans Jørn ; Larsson, Anders ; Ärnlöv, Johan ; Gluud, Christian</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b633t-c9c4678fd7590edc085c3102d15c8565473f3e7460c06807269207ec6a46854d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Angina pectoris</topic><topic>Angioplasty</topic><topic>Cardiology</topic><topic>Cardiovascular disease</topic><topic>CLARICOR</topic><topic>Coronary Artery Disease</topic><topic>Coronary vessels</topic><topic>Diabetes</topic><topic>Health and Welfare</topic><topic>Health risk assessment</topic><topic>Heart attacks</topic><topic>Heart failure</topic><topic>Hypertension</topic><topic>Hälsa och välfärd</topic><topic>ischaemic heart disease</topic><topic>Medical prognosis</topic><topic>Medicin och hälsovetenskap</topic><topic>Mortality</topic><topic>Patients</topic><topic>predictors</topic><topic>Survival analysis</topic><topic>Task forces</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Winkel, Per</creatorcontrib><creatorcontrib>Jakobsen, Janus Christian</creatorcontrib><creatorcontrib>Hilden, Jørgen</creatorcontrib><creatorcontrib>Jensen, Gorm</creatorcontrib><creatorcontrib>Kjøller, Erik</creatorcontrib><creatorcontrib>Sajadieh, Ahmad</creatorcontrib><creatorcontrib>Kastrup, Jens</creatorcontrib><creatorcontrib>Kolmos, Hans Jørn</creatorcontrib><creatorcontrib>Larsson, Anders</creatorcontrib><creatorcontrib>Ärnlöv, Johan</creatorcontrib><creatorcontrib>Gluud, Christian</creatorcontrib><collection>BMJ Journals (Open Access)</collection><collection>BMJ Journals:Open Access</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>PHMC-Proquest健康医学期刊库</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Articles full text</collection><collection>SWEPUB Uppsala universitet full text</collection><collection>SWEPUB Uppsala universitet</collection><jtitle>Open heart</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Winkel, Per</au><au>Jakobsen, Janus Christian</au><au>Hilden, Jørgen</au><au>Jensen, Gorm</au><au>Kjøller, Erik</au><au>Sajadieh, Ahmad</au><au>Kastrup, Jens</au><au>Kolmos, Hans Jørn</au><au>Larsson, Anders</au><au>Ärnlöv, Johan</au><au>Gluud, Christian</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic value of routinely available data in patients with stable coronary heart disease. A 10-year follow-up of patients sampled at random times during their disease course</atitle><jtitle>Open heart</jtitle><addtitle>Open Heart</addtitle><date>2018</date><risdate>2018</risdate><volume>5</volume><issue>2</issue><spage>e000808</spage><epage>e000808</epage><pages>e000808-e000808</pages><issn>2053-3624</issn><issn>2398-595X</issn><eissn>2053-3624</eissn><abstract>ObjectiveTo characterise the long-term prognosis of patients with stable coronary artery heart disease by means of ‘standard predictors’ defined as demographic, clinical and biochemical quantities routinely available in general practices and ascertained at an interview not prompted by renewed cardiac complaints.MethodsThis is an observational study based on data from 2199 Copenhagen placebo patients from the ‘clarithromycin for patients with stable coronary heart disease’ trial of patients with stable coronary heart disease. In the trial, we compared the effects of 14 days of clarithromycin treatment versus placebo. The predictors were based on the interview forms and blood samples collected at entry, along with demographic information from hospital files.We studied ‘standard predictors’ of a composite outcome (myocardial infarction, unstable angina, cerebrovascular disease or all-cause death) and of all-cause death. Using Cox regression, we compared predictions of status at 3, 6 and 9 years without and with the use of ‘standard predictors’ and used receiver operating characteristic statistic.ResultsFew ‘standard predictors’ were associated (p&lt;0.01) with the composite outcome or with all-cause death. When no ‘standard predictors’ were included, 63.2% of the model-based predictions of the composite outcome and 79.9% of death predictions were correct. Including all ‘standard predictors’ in the model increased the figures to 68.4% and 83.4%, respectively. C indices were low, except when all-cause death was assessed as a single outcome where C was 0.79.Conclusion‘Standard predictors’ routinely available in general practices contribute only modestly to risk assessment in consecutively sampled patients with stable coronary heart disease as ascertained at a contact not prompted by renewed cardiac complaints. Novel biomarkers may improve the assessment.Trial registration number NCT00121550.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>30228904</pmid><doi>10.1136/openhrt-2018-000808</doi><oa>free_for_read</oa></addata></record>
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subjects Angina pectoris
Angioplasty
Cardiology
Cardiovascular disease
CLARICOR
Coronary Artery Disease
Coronary vessels
Diabetes
Health and Welfare
Health risk assessment
Heart attacks
Heart failure
Hypertension
Hälsa och välfärd
ischaemic heart disease
Medical prognosis
Medicin och hälsovetenskap
Mortality
Patients
predictors
Survival analysis
Task forces
title Prognostic value of routinely available data in patients with stable coronary heart disease. A 10-year follow-up of patients sampled at random times during their disease course
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