Family Practice Advance Access originally published online on July 27, 2006
Family Practice 2006 23(5):520-528; doi:10.1093/fampra/cml038
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Systematic review: prognosis of angina in primary care
a Royal Free University College Medical School, Department Of Primary Care and Population Sciences London, UK
b Royal Free and University College Medical School, Medical Library London, UK
c Barts and the London, Queen Mary, University of London Centre for Health Sciences, London, UK
Correspondence to Melvyn Jones, Royal Free and University College Medical School, Department of Primary Care and Population Sciences, Rowland Hill Street, London NW3 2PF, UK; Email: m.jones{at}pcps.ucl.ac.uk
Background. Angina is a common chronic condition, largely managed in primary care in the UK. Mortality data are predominately from population or hospital studies with little known about the prognosis of angina in general practice settings.
Objective. To describe the prognosis of angina in patients identified in primary care.
Methods
Design. Systematic review of cohort studies of angina in primary care.
Data sources. Medline, PsycINFO, EMBASE, CINAHL, HMIC, WOS, IBSS, UK National Research Register, notification via JISC, CHAIN.
Review methods
Selection criteria. Cohort studies of patients with angina, with >12 months of follow-up, recruited within primary care.
Validity assessment. Database searches and abstracts were reviewed independently by two authors. Papers were assessed according to criteria derived from the cohort methodological literature.
Data abstraction. Data were abstracted by two reviewers.
Data synthesis. Narrative summary. A quantitative synthesis was planned.
Main outcome measures. Total and cardiovascular death; non-fatal myocardial infarction (MI).
Results. Six studies fulfilled our selection criteria. The annual total mortality rate is 2.8–6.6%, an annual cardiovascular death rate of 1.4–6.5% and an annual non-fatal MI rate of 0.3–5.5%. A quantitative synthesis was not possible, because the studies were clinically heterogeneous.
Conclusions. The primary studies have value in determining the prognosis of patients with angina recruited in general practice; however, the studies are old, have small numbers of events and are clinically heterogeneous. The contemporary prognosis of angina in primary care remains a key question, and further research is, therefore, required to estimate the prognosis of angina in this setting and its determinants.
Keywords. Angina pectoris, primary health care, prognosis, systematic review.