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Simple tool forecasts on angina risks

GPs have gained a new aid in the treatment of angina with the development of a simple tool to predict the risk of death or myocardial infarction.

The tool, which is based on six key clinical indicators, predicts risk over the course of the next year and could help guide GPs' decisions over treatment and referral.

The European research team which developed the risk score claimed it was simpler to use than existing systems, including one recently reported in Pulse (15 October).

They said it was also 'more applicable' to primary care, as its study population was less highly selected than in trials.

Study leader Dr Caroline Daly, specialist registrar at the Chelsea and Westminster Hospital in London, said: 'This is a very simple risk prediction score that doesn't require multiple variables which makes it very user friendly. It's better if you can quantify things and for the clinician, it's better if you can put a figure on things.'

She said the score, developed from results collected in the Euro heart survey of stable angina, would help doctors explain patients' risk and how they could reduce it.

The study, published online by the BMJ this week, assessed various indicators of outcome after one year in 3,031 patients who had a new diagnosis of stable angina.

The score estimates risk of death or non-fatal myocardial infarction based on comorbidity, diabetes, severity of angina, left ventricular dysfunction and ST changes on resting electrocardiogram.

The rate of death and non-fatal heart attack was 2.3 per 100 patient-years. Positive non-invasive stress tests were not significantly associated with adverse outcome.

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