Risk factors in relation to prognosis

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To advise the patient concerning the relative merits of coronary artery surgery, the physician must know those factors that are prognostically important. It is generally accepted that the rubric, coronary heart disease, includes a number of subgroups, not all of which can be expected to increase longevity with surgical management. The ability to determine this prognosis from a noninvasive clinical evaluation would allow the primary care physician to identify those patients requiring subsequent arteriographic studies. The purpose of this report is to relate the utility of various demographic, biochemical, and clinical variables in estimating the severity of coronary artery disease and the risk of subsequent death. Such estimates can be compared with findings from known data on survival in relation to angiographic findings to determine when and to what extent prognostic evaluation is improved with coronary arteriography.

The reference population consisted of all patients referred to the University of Alabama Medical Center in Birmingham between February 1967 and June 1975 for evaluation and treatment of ischemic heart disease on whom coronary arteriography was performed. Pertinent clinical data were collected during the admission for coronary arteriography. Baseline traits were used to determine the likelihood of survival 2 years from the date of the arteriogram. In addition to demographic data, these baseline traits included major risk factors, the symptom complex relating to angina and congestive heart failure, drug usage, risk factors, heart size, electrocardiographic variables, and extensive clinical data. All patients were followed for a period of at least 2 years.

The . . .



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