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Protocol - Angina

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Description:

The interviewer asks the respondent about his/her personal history of angina and chest discomfort characteristics to determine presence of angina.

Protocol:

1. Has a doctor ever told you that you had angina?

[] 1 Yes

[] 0 No

[] 9 Don't Know

2. Any chest discomfort ever/since last exam or medical history update?

[] 0 No

[] 1 Yes

[] 2 Maybe

[] 9 Don't Know

If Yes, fill the following and continue.

If No, end of protocol.

(please provide narrative comments in addition to checking the appropriate boxes)

3. Chest discomfort with exertion or excitement

[] 0 No

[] 1 Yes

[] 2 Maybe

[] 9 Don't Know

4. Chest discomfort when quiet or resting

[] 0 No

[] 1 Yes

[] 2 Maybe

[] 9 Don't Know

Chest Discomfort Characteristics

5. ____ / ___ ___ ___ ___ Date of onset (mo/yr)

[] 99/9999 Unknown

6. ___ ___ ___ Usual duration (minutes: 1=1 min or less, 900=15 hrs or more)

[] 999 Unknown

7. ___ ___ ___ Longest duration (minutes: 1=1 min or less, 900=15 hrs or more)

[] 999 Unknown

8. Location

[] 0 No

[] 1 Central sternum and upper chest

[] 2 Left upper Quadrant

[] 3 Left lower ribcage

[] 4 Right chest

[] 5 Other

[] 6 Combination

[] 9 Unknown

9. Radiation

[] 0 No

[] 1 Left shoulder or left arm

[] 2 Neck

[] 3 Right shoulder or arm

[] 4 Back

[] 5 Abdomen

[] 6 Other

[] 7 Combination

[] 9 Unknown

10. ___ ___ ___ Frequency (number in past month)

[] 999 Unknown

11. ___ ___ ___ Frequency (number in past year)

[] 999 Unknown

12. Type

[] 1 Pressure, heavy, vise

[] 2 Sharp

[] 3 Dull

[] 4 Other

[] 9 Unknown

13. Relief by nitroglycerine in <15 minutes

[] 0 No

[] 1 Yes

[] 8 Not tried

[] 9 Unknown

14. Relief by rest in <15 minutes

[] 0 No

[] 1 Yes

[] 8 Not tried

[] 9 Unknown

15. Relief spontaneously in <15 minutes

[] 0 No

[] 1 Yes

[] 8 Not tried

[] 9 Unknown

16. Relief by other cause in <15 minutes

[] 0 No

[] 1 Yes

[] 8 Not tried

[] 9 Unknown

17. Since your last exam, have you been told by a doctor you had a heart attack?

[] 0 No

[] 1 Yes

[] 2 Maybe

[] 9 Unknown

CHD First Opinions

18. Angina pectoris in interim

[] 0 No

[] 1 Yes

[] 2 Maybe

[] 9 Unknown

19. Angina pectoris since revascularization procedure

[] 0 No

[] 1 Yes

[] 2 Maybe

[] 9 Unknown

20. Coronary insufficiency in interim

[] 0 No

[] 1 Yes

[] 2 Maybe

[] 9 Unknown

21. Myocardial infarct in interim

[] 0 No

[] 1 Yes

[] 2 Maybe

[] 9 Unknown

22. Comments

________________________________________________________

Diagnostic Criteria:

History of:

1) chest discomfort with characteristic location (usually substernally or just to left of sternum but can be anywhere from epigastrium to the neck) and duration (lasting less than 30 minutes), and

2) provoked by exertion or emotional stress, and

3) relieved by rest or nitroglycerin.

The measurement then can result in four categories:

1. Typical angina (definite): all three characteristics

2. Atypical angina (probable): two characteristics

3. Non-cardiac chest pain: one or none of the characteristics

4. No chest pain

Note: Women are less likely to have typical chest pain either in terms of precipitating causes or in location of discomfort.

Protocol Name from Source:

The Expert Review Panel has not reviewed this measure yet.

Availability:

Publicly available

Personnel and Training Required

An interviewer who is trained to conduct personal interviews with individuals from the general population is required. The interviewer must be trained and found to be competent (i.e., tested by an expert) at the completion of personal interviews.* The interviewer should be trained to prompt respondents further if a "don't know" response is provided.

*There are multiple modes to administer this question (e.g., paper-and-pencil and computer-assisted interviews).

Equipment Needs

None

Requirements
Requirement CategoryRequired
Major equipment No
Specialized training No
Specialized requirements for biospecimen collection No
Average time of greater than 15 minutes in an unaffected individual No
Mode of Administration

Interviewer-administered questionnaire

Life Stage:

Adult

Participants:

Cardiovascular Health Study (CHS): ≥ 65 years old

Framingham Heart Study (FHS): ages 30-80 years old

Specific Instructions:

If the respondent answers "yes" to question 1 or question 2, then the interviewer will administer the remaining protocol questions. If the respondent answers "no" or "don't know" to question 1 and question 2, the protocol is deemed complete.

Selection Rationale

Vetted against other protocols, the Cardiovascular Health Study (CHS) and Framingham Heart Study (FHS) questions were selected because they come from major U.S. health studies and collect the necessary information to determine the presence of angina.

Language

English, Spanish

Standards
StandardNameIDSource
Common Data Elements (CDE) Person Angina Indicator 2935403 CDE Browser
Logical Observation Identifiers Names and Codes (LOINC) PhenX - angina protocol 62395-9 LOINC
Derived Variables

None

Process and Review

The Expert Review Panel has not reviewed this measure yet.

Source

U.S. Department of Health and Human Services. National Institutes of Health. National Heart, Lung and Blood Institute. Cardiovascular Health Study (CHS). Baseline Medical History Questionnaire. Page 4. Question 4 (source for question 1 in Protocol Text).

U.S. Department of Health and Human Services. National Institutes of Health. National Heart, Lung and Blood Institute and Boston University. Framingham Heart Study (FHS). Cohort Examination 29. Page 35. Medical History - Heart (source for questions 2–22 in Protocol Text).

Gibbons, R. J., Chatterjee, K., Daley, J., & American College of Cardiology/American Heart Association, American College of Physicians-American Society of Internal Medicine (ACC/AHA/ACP-ASIM). (2002). Guidelines for the management of patients with chronic stable angina. Journal of the American College of Cardiology, 41, 160–168 (source for Diagnostic Criteria).

General References

Ives, D. G., Fitzpatrick, A. L., Bild, D. E., Psaty, B. M., Kuller, L. H., Crowley, P. M., Cruise, R. G., & Theroux, S. (1995). Surveillance and ascertainment of cardiovascular events. The Cardiovascular Health Study. Annals of Epidemiology, 5, 278–285.

Psaty, B. M., Kuller, L. H., Bild, D., Burke, G. L., Kittner, S. J., Mittelmark, M., Price, T. R., Rautaharju, P. M., & Robbins, J. (1995) Methods of assessing prevalent cardiovascular disease in the Cardiovascular Health Study. Annals of Epidemiology, 5(4), 270–277.

Protocol ID:

40601

Variables:
Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping
PX040601_Angina_Pectoris_Interim PX040601180000 CHD First Opinions Angina pectoris in interim 4 N/A
PX040601_Angina_Pectoris_Revascularization PX040601190000 CHD First Opinions Angina pectoris since revascularization procedure 4 N/A
PX040601_Chest_Discomfort_Exertion PX040601030000 Chest discomfort with exertion or excitement 4 N/A
PX040601_Chest_Discomfort_Frequency_Past_Month PX040601100000 Chest Discomfort Characteristics Frequency (number in past month) 4 N/A
PX040601_Chest_Discomfort_Frequency_Past_Month_Coded PX040601100100 Chest Discomfort Characteristics Frequency (number in past month) 4 N/A
PX040601_Chest_Discomfort_Frequency_Past_Year PX040601110000 Chest Discomfort Characteristics Frequency (number in past year) 4 N/A
PX040601_Chest_Discomfort_Frequency_Past_Year_Coded PX040601110100 Chest Discomfort Characteristics Frequency (number in past year) 4 N/A
PX040601_Chest_Discomfort_Location PX040601080000 Chest Discomfort Characteristics Location 4 N/A
PX040601_Chest_Discomfort_Longest_Duration_Minute PX040601070000 Chest Discomfort Characteristics Longest duration (minutes) 4 N/A
PX040601_Chest_Discomfort_Longest_Duration_Minute_Coded PX040601070100 Chest Discomfort Characteristics Longest duration (minutes) 4 N/A
PX040601_Chest_Discomfort_Onset_Month PX040601050100 Chest Discomfort Characteristics Date of onset (mo) 4 N/A
PX040601_Chest_Discomfort_Onset_Month_Coded PX040601050101 Chest Discomfort Characteristics Date of onset (mo) 4 N/A
PX040601_Chest_Discomfort_Onset_Year PX040601050200 Chest Discomfort Characteristics Date of onset (yr) 4 N/A
PX040601_Chest_Discomfort_Onset_Year_Coded PX040601050201 Chest Discomfort Characteristics Date of onset (yr) 4 N/A
PX040601_Chest_Discomfort_Quite PX040601040000 Chest discomfort when quiet or resting 4 N/A
PX040601_Chest_Discomfort_Radiation PX040601090000 Chest Discomfort Characteristics Radiation 4 N/A
PX040601_Chest_Discomfort_Relief_Nitroglycerine PX040601130000 Chest Discomfort Characteristics Relief by nitroglycerine in <15 minutes 4 N/A
PX040601_Chest_Discomfort_Relief_Other PX040601160000 Chest Discomfort Characteristics Relief by other cause in <15 minutes 4 N/A
PX040601_Chest_Discomfort_Relief_Rest PX040601140000 Chest Discomfort Characteristics Relief by rest in <15 minutes 4 N/A
PX040601_Chest_Discomfort_Relief_Spontaneously PX040601150000 Chest Discomfort Characteristics Relief spontaneously in <15 minutes 4 N/A
PX040601_Chest_Discomfort_Since_LastExam PX040601020000 Any chest discomfort ever/since last exam or medical history update? 4 N/A
PX040601_Chest_Discomfort_Type PX040601120000 Chest Discomfort Characteristics Type 4 N/A
PX040601_Chest_Discomfort_Usual_Duration_Minute PX040601060000 Chest Discomfort Characteristics Usual duration (minutes) 4 N/A
PX040601_Chest_Discomfort_Usual_Duration_Minute_Coded PX040601060100 Chest Discomfort Characteristics Usual duration (minutes) 4 N/A
PX040601_Comments PX040601220000 Comment 4 N/A
PX040601_Coronary_Insufficiency_Interim PX040601200000 CHD First Opinions Coronary insufficiency in interim 4 N/A
PX040601_Have_Angina PX040601010000 Has a doctor ever told you that you had angina? 4 N/A
PX040601_Heart_Attack_Since_LastExam PX040601170000 Since your last exam, have you been told by a doctor you had a heart attack? 4 N/A
PX040601_Myocardial_Infarct_Interim PX040601210000 CHD First Opinions Myocardial infarct in interim 4 N/A
Research Domain Information
Measure Name:

Angina

Release Date:

September 9, 2009

Definition

Measure to assess chest discomfort that may indicate the presence of angina.

Purpose

To determine the presence of angina as a sign of significant coronary artery disease. Patients with angina are at risk of developing a heart attack or myocardial infarction.

Keywords

cardiovascular, coronary artery disease, heart attack, myocardial infarction, Framingham Heart Study, FHS, Cardiovascular Health Study, CHS, angina, angina pectoris, chest discomfort, nitroglycerin, CHD, coronary heart disease, personal history