Self-reported health and adverse outcomes among women living with symptoms of angina or unspecific chest pain but no diagnosis of obstructive coronary artery disease: findings from the DenHeart study

Jane Lange Dalsgaard; Michael Skov Hansen; Lars Thrysoee; Ola Ekholm; Charlotte Brun Thorup; Rikke Mols; Trine Bernholdt Rasmussen; Anne Vinggaard Christensen; Selina Kikkenborg Berg; Andreas Kristian Pedersen; Lisette Okkels Jensen; Christian Backer Mogensen; Britt Borregaard

doi:10.1093/eurjcn/zvac085

Self-reported health and adverse outcomes among women living with symptoms of angina or unspecific chest pain but no diagnosis of obstructive coronary artery disease: findings from the DenHeart study

Jane Lange Dalsgaard^*, Michael Skov Hansen, Lars Thrysoee, Ola Ekholm, Charlotte Brun Thorup, Rikke Mols, Trine Bernholdt Rasmussen, Anne Vinggaard Christensen, Selina Kikkenborg Berg, Andreas Kristian Pedersen, Lisette Okkels Jensen, Christian Backer Mogensen, Britt Borregaard

^*Corresponding author for this work

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Abstract

AIMS: The objectives were to describe differences in self-reported health at discharge between women diagnosed with angina or unspecific chest pain and investigate the association between self-reported health and adverse outcomes within three years.

METHODS AND RESULTS: Data from a national cohort study were used, including data from the DenHeart survey combined with three years of register-based follow-up. The population included two groups of women with symptoms of angina but no diagnosis of obstructive coronary artery disease at discharge (women with angina and women with unspecific chest pain). Self-reported health measured with validated instruments was combined with register-based follow-up on adverse outcomes (a composite of unplanned cardiac readmissions, revascularisation, or all-cause mortality). Associations between self-reported health and time to first adverse outcomes were investigated with Cox Proportional Hazard Models; reported as hazards ratios (HR) with 95% confidence intervals (CI).In total, 1770 women completed the questionnaire (49%). Women with angina (n = 931) reported significantly worse self-reported health on several outcomes than women with unspecific chest pain (n = 839). Within the three years follow-up, women with angina were more often readmitted (29% vs 23%, p = 0.011) and more underwent revascularisation (10% vs 1%, p < 0.001), whereas mortality rates were similar (4% vs 4%, p = 0.750). Self-reported health (physical and mental) was associated with adverse outcomes between both groups (on most instruments).

CONCLUSION: Women with angina reported significantly worse self-reported health on most instruments compared to women with unspecific chest pain. Adverse outcomes varied between groups, with women diagnosed with angina experiencing more events.

REGISTRATION: ClinicalTrials.gov (NCT01926145).

Original language	English
Journal	European Journal of Cardiovascular Nursing
Volume	22
Issue number	5
Pages (from-to)	506-515
ISSN	1474-5151
DOIs	https://doi.org/10.1093/eurjcn/zvac085
Publication status	Published - 19. Jul 2023

Bibliographical note

Keywords

Angina Pectoris/complications
Chest Pain/diagnosis
Cohort Studies
Coronary Artery Disease/complications
Female
Humans
Self Report
Chest pain
Patient-reported outcomes
Angina pectoris
Women's health
Revascularization

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10.1093/eurjcn/zvac085

Open Access VersionAccepted manuscript, 375 KB

1 Journal article

My experience as a woman with chest pain
Schmidt, D. & Lange Dalsgaard, J. (Member of author group), Mar 2024, In: European Journal of Cardiovascular Nursing. 23, 2, p. E20 1 p.
Research output: Contribution to journal › Journal article › Communication

Cite this

Dalsgaard, J. L., Hansen, M. S., Thrysoee, L., Ekholm, O., Thorup, C. B., Mols, R., Rasmussen, T. B., Christensen, A. V., Berg, S. K., Pedersen, A. K., Jensen, L. O., Mogensen, C. B., & Borregaard, B. (2023). Self-reported health and adverse outcomes among women living with symptoms of angina or unspecific chest pain but no diagnosis of obstructive coronary artery disease: findings from the DenHeart study. European Journal of Cardiovascular Nursing, 22(5), 506-515. https://doi.org/10.1093/eurjcn/zvac085

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title = "Self-reported health and adverse outcomes among women living with symptoms of angina or unspecific chest pain but no diagnosis of obstructive coronary artery disease: findings from the DenHeart study",

abstract = "AIMS: The objectives were to describe differences in self-reported health at discharge between women diagnosed with angina or unspecific chest pain and investigate the association between self-reported health and adverse outcomes within three years.METHODS AND RESULTS: Data from a national cohort study were used, including data from the DenHeart survey combined with three years of register-based follow-up. The population included two groups of women with symptoms of angina but no diagnosis of obstructive coronary artery disease at discharge (women with angina and women with unspecific chest pain). Self-reported health measured with validated instruments was combined with register-based follow-up on adverse outcomes (a composite of unplanned cardiac readmissions, revascularisation, or all-cause mortality). Associations between self-reported health and time to first adverse outcomes were investigated with Cox Proportional Hazard Models; reported as hazards ratios (HR) with 95% confidence intervals (CI).In total, 1770 women completed the questionnaire (49%). Women with angina (n = 931) reported significantly worse self-reported health on several outcomes than women with unspecific chest pain (n = 839). Within the three years follow-up, women with angina were more often readmitted (29% vs 23%, p = 0.011) and more underwent revascularisation (10% vs 1%, p < 0.001), whereas mortality rates were similar (4% vs 4%, p = 0.750). Self-reported health (physical and mental) was associated with adverse outcomes between both groups (on most instruments).CONCLUSION: Women with angina reported significantly worse self-reported health on most instruments compared to women with unspecific chest pain. Adverse outcomes varied between groups, with women diagnosed with angina experiencing more events.REGISTRATION: ClinicalTrials.gov (NCT01926145).",

keywords = "Angina Pectoris/complications, Chest Pain/diagnosis, Cohort Studies, Coronary Artery Disease/complications, Female, Humans, Self Report, Chest pain, Patient-reported outcomes, Angina pectoris, Women's health, Revascularization",

author = "Dalsgaard, {Jane Lange} and Hansen, {Michael Skov} and Lars Thrysoee and Ola Ekholm and Thorup, {Charlotte Brun} and Rikke Mols and Rasmussen, {Trine Bernholdt} and Christensen, {Anne Vinggaard} and Berg, {Selina Kikkenborg} and Pedersen, {Andreas Kristian} and Jensen, {Lisette Okkels} and Mogensen, {Christian Backer} and Britt Borregaard",

year = "2023",

month = jul,

day = "19",

doi = "10.1093/eurjcn/zvac085",

language = "English",

volume = "22",

pages = "506--515",

journal = "European Journal of Cardiovascular Nursing",

issn = "1474-5151",

publisher = "Oxford University Press",

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Dalsgaard, JL , Hansen, MS, Thrysoee, L, Ekholm, O, Thorup, CB, Mols, R, Rasmussen, TB, Christensen, AV, Berg, SK, Pedersen, AK, Jensen, LO, Mogensen, CB & Borregaard, B 2023, 'Self-reported health and adverse outcomes among women living with symptoms of angina or unspecific chest pain but no diagnosis of obstructive coronary artery disease: findings from the DenHeart study', European Journal of Cardiovascular Nursing, vol. 22, no. 5, pp. 506-515. https://doi.org/10.1093/eurjcn/zvac085

Self-reported health and adverse outcomes among women living with symptoms of angina or unspecific chest pain but no diagnosis of obstructive coronary artery disease: findings from the DenHeart study. / Dalsgaard, Jane Lange ; Hansen, Michael Skov; Thrysoee, Lars et al.
In: European Journal of Cardiovascular Nursing, Vol. 22, No. 5, 19.07.2023, p. 506-515.

Research output: Contribution to journal › Journal article › Research › peer-review

TY - JOUR

T1 - Self-reported health and adverse outcomes among women living with symptoms of angina or unspecific chest pain but no diagnosis of obstructive coronary artery disease

T2 - findings from the DenHeart study

AU - Dalsgaard, Jane Lange

AU - Hansen, Michael Skov

AU - Thrysoee, Lars

AU - Ekholm, Ola

AU - Thorup, Charlotte Brun

AU - Mols, Rikke

AU - Rasmussen, Trine Bernholdt

AU - Christensen, Anne Vinggaard

AU - Berg, Selina Kikkenborg

AU - Pedersen, Andreas Kristian

AU - Jensen, Lisette Okkels

AU - Mogensen, Christian Backer

AU - Borregaard, Britt

PY - 2023/7/19

Y1 - 2023/7/19

N2 - AIMS: The objectives were to describe differences in self-reported health at discharge between women diagnosed with angina or unspecific chest pain and investigate the association between self-reported health and adverse outcomes within three years.METHODS AND RESULTS: Data from a national cohort study were used, including data from the DenHeart survey combined with three years of register-based follow-up. The population included two groups of women with symptoms of angina but no diagnosis of obstructive coronary artery disease at discharge (women with angina and women with unspecific chest pain). Self-reported health measured with validated instruments was combined with register-based follow-up on adverse outcomes (a composite of unplanned cardiac readmissions, revascularisation, or all-cause mortality). Associations between self-reported health and time to first adverse outcomes were investigated with Cox Proportional Hazard Models; reported as hazards ratios (HR) with 95% confidence intervals (CI).In total, 1770 women completed the questionnaire (49%). Women with angina (n = 931) reported significantly worse self-reported health on several outcomes than women with unspecific chest pain (n = 839). Within the three years follow-up, women with angina were more often readmitted (29% vs 23%, p = 0.011) and more underwent revascularisation (10% vs 1%, p < 0.001), whereas mortality rates were similar (4% vs 4%, p = 0.750). Self-reported health (physical and mental) was associated with adverse outcomes between both groups (on most instruments).CONCLUSION: Women with angina reported significantly worse self-reported health on most instruments compared to women with unspecific chest pain. Adverse outcomes varied between groups, with women diagnosed with angina experiencing more events.REGISTRATION: ClinicalTrials.gov (NCT01926145).

AB - AIMS: The objectives were to describe differences in self-reported health at discharge between women diagnosed with angina or unspecific chest pain and investigate the association between self-reported health and adverse outcomes within three years.METHODS AND RESULTS: Data from a national cohort study were used, including data from the DenHeart survey combined with three years of register-based follow-up. The population included two groups of women with symptoms of angina but no diagnosis of obstructive coronary artery disease at discharge (women with angina and women with unspecific chest pain). Self-reported health measured with validated instruments was combined with register-based follow-up on adverse outcomes (a composite of unplanned cardiac readmissions, revascularisation, or all-cause mortality). Associations between self-reported health and time to first adverse outcomes were investigated with Cox Proportional Hazard Models; reported as hazards ratios (HR) with 95% confidence intervals (CI).In total, 1770 women completed the questionnaire (49%). Women with angina (n = 931) reported significantly worse self-reported health on several outcomes than women with unspecific chest pain (n = 839). Within the three years follow-up, women with angina were more often readmitted (29% vs 23%, p = 0.011) and more underwent revascularisation (10% vs 1%, p < 0.001), whereas mortality rates were similar (4% vs 4%, p = 0.750). Self-reported health (physical and mental) was associated with adverse outcomes between both groups (on most instruments).CONCLUSION: Women with angina reported significantly worse self-reported health on most instruments compared to women with unspecific chest pain. Adverse outcomes varied between groups, with women diagnosed with angina experiencing more events.REGISTRATION: ClinicalTrials.gov (NCT01926145).

KW - Angina Pectoris/complications

KW - Chest Pain/diagnosis

KW - Cohort Studies

KW - Coronary Artery Disease/complications

KW - Female

KW - Humans

KW - Self Report

KW - Chest pain

KW - Patient-reported outcomes

KW - Angina pectoris

KW - Women's health

KW - Revascularization

U2 - 10.1093/eurjcn/zvac085

DO - 10.1093/eurjcn/zvac085

M3 - Journal article

C2 - 36124692

SN - 1474-5151

VL - 22

SP - 506

EP - 515

JO - European Journal of Cardiovascular Nursing

JF - European Journal of Cardiovascular Nursing

IS - 5

ER -

Dalsgaard JL , Hansen MS, Thrysoee L, Ekholm O, Thorup CB, Mols R et al. Self-reported health and adverse outcomes among women living with symptoms of angina or unspecific chest pain but no diagnosis of obstructive coronary artery disease: findings from the DenHeart study. European Journal of Cardiovascular Nursing. 2023 Jul 19;22(5):506-515. Epub 2022 Sept 16. doi: 10.1093/eurjcn/zvac085

Self-reported health and adverse outcomes among women living with symptoms of angina or unspecific chest pain but no diagnosis of obstructive coronary artery disease: findings from the DenHeart study

Abstract

Bibliographical note

Keywords

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Related research output

My experience as a woman with chest pain

Cite this