Predictors of physician under-recognition include heart failure and less-frequent angina
WEDNESDAY, Aug. 17, 2016 (HealthDay News) — Physicians frequently under-recognize angina in their patients with coronary artery disease, with under-recognition more likely for patients with heart failure and less-frequent angina, according to research published online Aug. 16 in Circulation: Cardiovascular Quality and Outcomes.
Suzanne V. Arnold, M.D., from the Saint Luke’s Mid America Heart Institute in Kansas City, Mo., and colleagues describe the characteristics associated with under-recognition of angina. Patients with coronary artery disease completed the Seattle Angina Questionnaire before their clinic visit to quantify the frequency of angina. Physicians independently quantified their patients’ angina immediately after the clinic visit.
The researchers found that 411 of 1,257 patients reported angina in the previous month; 42 percent of these were under-recognized by their physician, with the physician reporting a lower-frequency category of angina. The odds of under-recognition were increased with heart failure (odds ratio, 3.06) and less-frequent angina (odds ratio for monthly angina versus daily/weekly, 1.69). No other factors correlated with under-recognition. Across physicians there was significant variability (median odds ratio, 2.06).
“Standardized prospective use of a validated clinical tool, such as the Seattle Angina Questionnaire, should be tested as a means to improve recognition of angina and, potentially, improve appropriate treatment of angina,” the authors write.
Several authors disclosed financial ties to medical device and pharmaceutical companies, including Gilead Sciences, which provided funding for the study. One author holds a copyright for the Seattle Angina Questionnaire.
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