At the end of the study, however, angina improved in more patients in the invasive group and persisted unchanged in more patients in the medical group ( Table 3 and Fig. Moreover, symptoms similarly relieved in nearly 40% of patients in both groups. At 12 months, no difference between invasive and medical groups was observed in CCS angina grading and in SAQ-7 summary score. However, these differences no longer persisted throughout the study period. Consistently with the CCS angina grading and the self-assessment scale, the SAQ-7 summary score at 1 month was lower, indicating a worse angina related status, in patients referred for the invasive strategy ( Table 3 Fig. Table 1 Baseline characteristics, risk factors, angina presentation and drugs at study entry.Ĭlinical characteristics and comorbidities, n (%)Īfter 1 month of medical therapy, as expected, more patients in CCS class III and IV and with unchanged or worsened angina were referred for an invasive strategy ( Table 3 Fig. Combined medical and invasive strategies left 28.5% of patients still symptomatic at the end of the study. No difference between invasive and medical groups was found at 12 months in symptoms, quality of life and MACEs, except for a greater improvement in self-assessed symptoms in the invasive group. Among these, 38.2% had normal coronary arteries and 47% actually underwent revascularization.

After one month of medical therapy, 40.6% of patients were referred for coronary angiography and revascularization for resistant symptoms (invasive strategy). The rate of MACEs was low (2.9%) in the overall population. Patients in CCS class I significantly increased from 28.4% at enrollment to 67.1% at 12 months, and the SAQ-7 score from 58.4 ± 20 to 85.9 ± 14. After one month of therapy, angina relieved or improved in 47% of the overall population. Upon enrollment, all patients were prescribed guidelines directed medical therapy.

A composite end-point of MACEs (all-cause death, non-fatal myocardial infarction, non-fatal stroke or hospitalization for unstable angina) at 1 year was considered. Symptoms and quality of life were evaluated with the CCS angina grading, with a self-assessment scale and with the SAQ-7. Eight hundred thirty-three patients with newly diagnosed, stable angina were enrolled in a prospective, observational, nationwide registry and followed for 1 year.

Class iii angina