Cardiovascular risk in women with non-specific chest pain (from the Women's Health Initiative Hormone Trials)

Jennifer G Robinson; Robert Wallace; Marian Limacher; Hong Ren; Barbara Cochrane; Sylvia Wassertheil-Smoller; Judith K Ockene; Patricia L Blanchette; Marcia G Ko

doi:10.1016/j.amjcard.2007.12.044

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Cardiovascular risk in women with non-specific chest pain (from the Women's Health Initiative Hormone Trials)

Journal article

Peer reviewed

Cardiovascular risk in women with non-specific chest pain (from the Women's Health Initiative Hormone Trials)

Jennifer G Robinson, Robert Wallace, Marian Limacher, Hong Ren, Barbara Cochrane, Sylvia Wassertheil-Smoller, Judith K Ockene, Patricia L Blanchette and Marcia G Ko

The American journal of cardiology, Vol.102(6), pp.693-699

09/15/2008

DOI: 10.1016/j.amjcard.2007.12.044

PMID: 18773990

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Abstract

Women discharged with diagnoses of nonspecific chest pain (NSCP) may be at increased risk for subsequent coronary artery disease (CAD) events. The influence of hormone therapy on NSCP is unknown. The Women's Health Initiative (WHI) enrolled postmenopausal women aged 50 to 79 years. The duration of follow-up was 7.1 years in the WHI Estrogen-Alone trial (E-Alone) and 5.6 years in the WHI Estrogen Plus Progestin trial (E+P). After excluding women with previous cardiovascular disease, 9,427 women in E-Alone and 15,105 women in E+P were included in this analysis. NSCP, defined as having a primary hospital discharge diagnosis of NSCP by International Classification of Diseases, Ninth Revision, code, was reported in 322 women in E-Alone and 249 in E+P. Risks for subsequent CAD events were estimated using intent-to-treat Cox proportional-hazards models stratified by clinic and adjusted for age and other risk factors. In the fully adjusted models of the combined trials, women with NSCP had a twofold greater risk for subsequent nonfatal CAD events, including nonfatal myocardial infarction (2.3% vs 1.7%, hazard ratio [HR] 2.10, 95% confidence interval [CI] 1.11 to 3.98), revascularization (3.5% vs 2.6%, HR 1.99, 95% CI 1.20 to 3.30), and hospitalized angina (3.7% vs 2.3%, HR 2.39, 95% CI 1.46 to 3.92). Hormone therapy did not appear to have a significant effect on either the incidence of NSCP hospitalizations (E-Alone: HR 1.04, 95% CI 0.81 to 1.32; E+P: HR 0.78, 95% CI 0.59 to 1.02) or the risk for a subsequent CAD event. In conclusion, a hospitalization for NSCP doubles the risk for a subsequent CAD event in postmenopausal women over the next 5 to 7 years and identifies them as candidates for aggressive risk factor treatment.

Estrogen Replacement Therapy

Prospective Studies

Estrogens, Conjugated (USP) - administration & dosage

Humans

Middle Aged

Contraceptive Agents, Female - administration & dosage

Proportional Hazards Models

Risk

Hospitalization

Myocardial Revascularization

Randomized Controlled Trials as Topic

Chest Pain - epidemiology

Diabetes Mellitus - epidemiology

Cardiovascular Diseases - epidemiology

Female

Aged

Medroxyprogesterone Acetate - administration & dosage

Hypertension - epidemiology

Estrogens - administration & dosage

Details

Title: Subtitle: Cardiovascular risk in women with non-specific chest pain (from the Women's Health Initiative Hormone Trials)
Creators: Jennifer G Robinson - Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA. jennifer-g-robinson@uiowa.edu
Robert Wallace
Marian Limacher
Hong Ren
Barbara Cochrane
Sylvia Wassertheil-Smoller
Judith K Ockene
Patricia L Blanchette
Marcia G Ko
Resource Type: Journal article
Publication Details: The American journal of cardiology, Vol.102(6), pp.693-699
DOI: 10.1016/j.amjcard.2007.12.044
PMID: 18773990
NLM abbreviation: Am J Cardiol
ISSN: 0002-9149
eISSN: 1879-1913
Publisher: United States
Language: English
Date published: 09/15/2008
Academic Unit: Epidemiology; Injury Prevention Research Center; Internal Medicine
Record Identifier: 9983996079502771

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