Angina Prevalence and Provider Evaluation of Angina Relief (APPEAR)

The purpose of this study is describe the frequency of chest pain and how chest pain impacts patients' quality of life in the outpatients with chronic coronary artery disease in contemporary cardiology practice settings.

Study Overview

• Status: Completed
• Conditions: Stable Coronary Artery Disease CAD

Detailed Description

The primary goals in the management of stable coronary artery disease (CAD) are to reduce risk factors for heart attack and to control the symptoms of angina (chest pain). Ideally angina is well controlled with medications alone, but invasive procedures are a valuable option for patients with persistent angina. The amount of angina among patients with stable CAD in the outpatient setting, however, is unknown. An Australian study reported that almost 1 in 3 patients with stable angina being treated by primary care doctors had angina at least once a week, which was associated with worse quality of life. We propose to examine the burden of angina in outpatients with stable CAD who are being medically managed by cardiologists in the United States through administration of a one-time survey. The information from this study could ultimately help improve management of stable CAD and angina and illuminate potential underuse of revascularization. While cardiologists are generally expected to provide better angina control than primary care doctors, establishing the prevalence of angina among the best providers will help with a framework for interpreting symptom control among other practitioners.

• Study Type: Observational
• Enrollment (Actual): 1246

Contacts and Locations

Study Locations

• United States
  • Missouri
    • Kansas City, Missouri, United States, 64111
      • Saint Luke's Hospital of Kansas City

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Outpatient cardilogy practice.

Description

Inclusion Criteria:

• Coronary artery disease patients being seen in a participating cardiology office for a scheduled clinic visit who agree to take the survey.

Exclusion Criteria:

• Too ill to take survey
• Previously completed this survey
• Refused to participate

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Only
• Time Perspectives: Prospective

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Outpatient Coronary Artery Disease Patient; CAD patients being seen in a participating cardiology office for a scheduled clinic visit who agree to take the survey.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Seattle Angina Questionnaire	Percentage of patients with frequent angina (>1 episode/week) as measured by the Seattle Angina Questionnaire (SAQ).	One time cardiology office visit.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Quality of Life	Evaluate the impact of frequent angina on Quality of Life (as measured by the SAQ)	One time cardiology office visit.
Physician Perspective	Identifying differences between patients' and cardiologists' assessment of angina control	One time cardiology office visit.
Cardiology practices angina control.	Evaluate the differences in angina control between cardiology practices.	One time cardiology office visit.

Collaborators and Investigators

• Sponsor: Saint Luke's Health System
• Collaborators: Gilead Sciences
• Investigators: Principal Investigator: Faraz Kureshi, MD, Saint Luke's Hospital of Kansas City

Publications and helpful links

General Publications

• Beltrame JF, Weekes AJ, Morgan C, Tavella R, Spertus JA. The prevalence of weekly angina among patients with chronic stable angina in primary care practices: The Coronary Artery Disease in General Practice (CADENCE) Study. Arch Intern Med. 2009 Sep 14;169(16):1491-9. doi: 10.1001/archinternmed.2009.295.

Study record dates

Study Major Dates

• Study Start: July 1, 2013
• Primary Completion (Actual): July 1, 2015
• Study Completion (Actual): July 22, 2015

Study Registration Dates

• First Submitted: September 25, 2012
• First Submitted That Met QC Criteria: October 10, 2012
• First Posted (Estimate): October 12, 2012

Study Record Updates

• Last Update Posted (Actual): October 19, 2021
• Last Update Submitted That Met QC Criteria: October 14, 2021
• Last Verified: October 1, 2021

More Information

Terms related to this study

• Keywords: Quality of Life; Angina; Stable ischemic heart disease; Seattle Angina Questionnaire (SAQ)
• Additional Relevant MeSH Terms: Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Vascular Diseases; Arteriosclerosis; Arterial Occlusive Diseases; Pain; Neurologic Manifestations; Coronary Disease; Chest Pain; Coronary Artery Disease; Angina Pectoris
• Other Study ID Numbers: IN-US-259-0157

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No