Protocol - Angina
Description
The interviewer asks the respondent about his/her personal history of angina and chest discomfort characteristics to determine presence of angina.
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 "dont know" to question 1 and question 2, the protocol is deemed complete.
Availability
Protocol
1. Has a doctor ever told you that you had angina?
[ ] 1 Yes
[ ] 0 No
[ ] 9 Dont Know
2. Any chest discomfort ever/since last exam or medical history update?
[ ] 0 No
[ ] 1 Yes
[ ] 2 Maybe
[ ] 9 Dont 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 Dont Know
4. Chest discomfort when quiet or resting
[ ] 0 No
[ ] 1 Yes
[ ] 2 Maybe
[ ] 9 Dont 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.
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 "dont 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 Category | Required |
|---|---|
| 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
Lifestage
Adult
Participants
Cardiovascular Health Study (CHS): ≥ 65 years old
Framingham Heart Study (FHS): ages 30-80 years old
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
Chinese, English, Other languages available at source
Standards
| Standard | Name | ID | Source |
|---|---|---|---|
| Logical Observation Identifiers Names and Codes (LOINC) | PhenX - angina protocol | 62395-9 | LOINC |
| Human Phenotype Ontology | Angina pectoris | HP:0001681 | HPO |
| caDSR Form | PhenX PX040601 - Angina | 5828161 | caDSR Form |
Derived Variables
None
Process and Review
Not applicable.
Protocol Name from Source
Cardiovascular Health Study (CHS), Baseline Medical History Questionnaire & Framingham Heart Study (FHS)
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 Name | Variable ID | Variable Description | dbGaP Mapping | |
|---|---|---|---|---|
| PX040601_Angina_Pectoris_Interim | ||||
| PX040601180000 | CHD First Opinions Angina pectoris in interim | N/A | ||
| PX040601_Angina_Pectoris_Revascularization | ||||
| PX040601190000 | CHD First Opinions Angina pectoris since more | N/A | ||
| PX040601_Chest_Discomfort_Exertion | ||||
| PX040601030000 | Chest discomfort with exertion or excitement | Variable Mapping | ||
| PX040601_Chest_Discomfort_Frequency_Past_Month | ||||
| PX040601100000 | Chest Discomfort Characteristics Frequency more | Variable Mapping | ||
| PX040601_Chest_Discomfort_Frequency_Past_Month_Coded | ||||
| PX040601100100 | Chest Discomfort Characteristics Frequency more | N/A | ||
| PX040601_Chest_Discomfort_Frequency_Past_Year | ||||
| PX040601110000 | Chest Discomfort Characteristics Frequency more | Variable Mapping | ||
| PX040601_Chest_Discomfort_Frequency_Past_Year_Coded | ||||
| PX040601110100 | Chest Discomfort Characteristics Frequency more | N/A | ||
| PX040601_Chest_Discomfort_Location | ||||
| PX040601080000 | Chest Discomfort Characteristics Location | Variable Mapping | ||
| PX040601_Chest_Discomfort_Longest_Duration_Minute | ||||
| PX040601070000 | Chest Discomfort Characteristics Longest more | Variable Mapping | ||
| PX040601_Chest_Discomfort_Longest_Duration_Minute_Coded | ||||
| PX040601070100 | Chest Discomfort Characteristics Longest more | N/A | ||
| PX040601_Chest_Discomfort_Onset_Month | ||||
| PX040601050100 | Chest Discomfort Characteristics Date of more | N/A | ||
| PX040601_Chest_Discomfort_Onset_Month_Coded | ||||
| PX040601050101 | Chest Discomfort Characteristics Date of more | N/A | ||
| PX040601_Chest_Discomfort_Onset_Year | ||||
| PX040601050200 | Chest Discomfort Characteristics Date of more | N/A | ||
| PX040601_Chest_Discomfort_Onset_Year_Coded | ||||
| PX040601050201 | Chest Discomfort Characteristics Date of more | N/A | ||
| PX040601_Chest_Discomfort_Quite | ||||
| PX040601040000 | Chest discomfort when quiet or resting | Variable Mapping | ||
| PX040601_Chest_Discomfort_Radiation | ||||
| PX040601090000 | Chest Discomfort Characteristics Radiation | Variable Mapping | ||
| PX040601_Chest_Discomfort_Relief_Nitroglycerine | ||||
| PX040601130000 | Chest Discomfort Characteristics Relief by more | Variable Mapping | ||
| PX040601_Chest_Discomfort_Relief_Other | ||||
| PX040601160000 | Chest Discomfort Characteristics Relief by more | Variable Mapping | ||
| PX040601_Chest_Discomfort_Relief_Rest | ||||
| PX040601140000 | Chest Discomfort Characteristics Relief by more | Variable Mapping | ||
| PX040601_Chest_Discomfort_Relief_Spontaneously | ||||
| PX040601150000 | Chest Discomfort Characteristics Relief more | Variable Mapping | ||
| PX040601_Chest_Discomfort_Since_LastExam | ||||
| PX040601020000 | Any chest discomfort ever/since last exam or more | Variable Mapping | ||
| PX040601_Chest_Discomfort_Type | ||||
| PX040601120000 | Chest Discomfort Characteristics Type | Variable Mapping | ||
| PX040601_Chest_Discomfort_Usual_Duration_Minute | ||||
| PX040601060000 | Chest Discomfort Characteristics Usual more | Variable Mapping | ||
| PX040601_Chest_Discomfort_Usual_Duration_Minute_Coded | ||||
| PX040601060100 | Chest Discomfort Characteristics Usual more | N/A | ||
| PX040601_Comments | ||||
| PX040601220000 | Comment | N/A | ||
| PX040601_Coronary_Insufficiency_Interim | ||||
| PX040601200000 | CHD First Opinions Coronary insufficiency in more | Variable Mapping | ||
| PX040601_Have_Angina | ||||
| PX040601010000 | Has a doctor ever told you that you had angina? | Variable Mapping | ||
| PX040601_Heart_Attack_Since_LastExam | ||||
| PX040601170000 | Since your last exam, have you been told by more | Variable Mapping | ||
| PX040601_Myocardial_Infarct_Interim | ||||
| PX040601210000 | CHD First Opinions Myocardial infarct in interim | Variable Mapping | ||
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
Measure Protocols
| Protocol ID | Protocol Name |
|---|---|
| 40601 | Angina |
Publications
Philibert, R., et al. (2023) Validation of an Integrated Genetic-Epigenetic Test for the Assessment of Coronary Heart Disease Journal of the American Heart Association. 2023 November; 12(22): e030934. doi: 10.1161/JAHA.123.030934