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    Elderly women diagnosed with nonspecific chest pain may be at increased cardiovascular risk

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    Authors
    Robinson, Jennifer G.
    Wallace, Robert B.
    Limacher, Marian C.
    Sato, Alicia
    Cochrane, Barbara B.
    Wassertheil-Smoller, Sylvia
    Ockene, Judith K.
    Blanchette, Patricia L.
    Ko, Marcia G.
    UMass Chan Affiliations
    Department of Medicine, Division of Preventive and Behavioral Medicine
    Document Type
    Journal Article
    Publication Date
    2006-12-15
    Keywords
    Aged
    Cardiovascular Diseases
    and control
    Chest Pain
    Cohort Studies
    Confidence Intervals
    Female
    Health Status
    Humans
    Middle Aged
    Odds Ratio
    Postmenopause
    Risk Assessment
    Risk Factors
    Severity of Illness Index
    Stroke
    United States
    *Women's Health
    Life Sciences
    Medicine and Health Sciences
    Women's Studies
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    Link to Full Text
    http://dx.doi.org/10.1089/jwh.2006.15.1151
    Abstract
    BACKGROUND: Women are more likely than men to have nonspecific chest pain (NSCP) symptoms. The long-term outcomes in women discharged with a diagnosis of NSCP are unknown. METHODS: The Women's Health Initiative Observational Study enrolled postmenopausal women aged 50-79 years. After excluding those with prior cardiovascular disease (CVD), 83,622 women were studied. NSCP cases were defined as having an initial primary hospital discharge diagnosis of NSCP (ICD-9 codes 786.50, 786.51, 786.59) without a prior diagnosis of coronary heart disease (CHD). Risks of subsequent CHD events were estimated from Cox proportional hazard ratio (HR) models stratified by clinic and adjusted for baseline age, cardiovascular risk factors, and hormone use. RESULTS: Over an average of 8 years of follow-up, 11% (230 of 2,092) of women with NSCP experienced a cardiovascular event compared with 9.5% (7,724 of 81,530) who did not. Compared with women without a hospitalization for NSCP during follow-up, those with NSCP had a greater than 2-fold higher risk of a subsequent hospitalization for clinically diagnosed angina (HR 2.18, 95% CI 1.66-2.86) and at least a 1.5-fold higher risk of nonfatal myocardial infarction (MI) (HR 1.59, 1.10-2.31), revascularization (HR 1.67, 1.28-2.20), and congestive heart failure (HR 1.75, 1.27-2.41). Women with NSCP who subsequently experienced a CHD event were more likely to be over age 65 or to have cardiovascular risk factors. CONCLUSIONS: Older women discharged with a diagnosis of NSCP may be at increased risk of CHD morbidity. Further research is needed to replicate these findings in other populations.
    Source
    J Womens Health (Larchmt). 2006 Dec;15(10):1151-60. Link to article on publisher's site
    DOI
    10.1089/jwh.2006.15.1151
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/50916
    PubMed ID
    17199456
    Related Resources
    Link to article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1089/jwh.2006.15.1151
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