Background: Eliminating angina is a primary goal in the management of chronic coronary artery disease (CAD). There are few data quantifying the prevalence, severity and intensity of angina treatment in contemporary cardiology practice in the United States.
Methods: Leveraging the ACC PINNACLE registry, we conducted a cross-sectional study across 23 US outpatient cardiology clinics to examine the burden and management of angina in patients with stable CAD. Angina was assessed using the Seattle Angina Questionnaire (SAQ) angina frequency (AF) domain score and categorized as daily/weekly (SAQ AF < or = 60), monthly (score 61-99), and no (score =100) angina. At each site, we examined the proportion of patients with daily/weekly (frequent) angina and the proportion of patients with frequent angina who were treated with optimal medical treatment (> 2 anti-anginal medications).
Results: Among 1154 patients from 23 sites, 8.0% (n=93) reported daily/weekly angina, 24.3% (n=280) monthly angina, and 67.7% (n=781) no angina. The proportion of patients with frequent angina at each site ranged from 2.0-24.0%. Among these patients, 53.8% (n=50) were on optimal medical treatment, with wide variability noted across sites (0%-100%; Figure).
Conclusion: Nearly a third of CAD outpatients followed by cardiologists report angina, with 8.0% having frequent symptoms. Among frequent angina patients, just over half were on optimal medical management with wide variability across sites, suggesting important opportunities to improve care in chronic CAD.