هماهنگي آنژين رز و شاهد الكترو كارديوگرافيك بيماري عروق كرونر در جمعيت شهري تهران : مطالعه قند و ليپيد تهران

The concordance between Rose angina and ECG-defined CHD in an Iranian Urban population: Tehran Lipid and Glucose Study

Introduction: The administered Rose questionnaire and rest ECG are frequently used to assess the prevalence of coronary heart disease (CHD) in large population-based surveys. It has been shown that cultural variability may have great impacts on the Rose questionnaire performance. The aim of this study was to evaluate the concordance between the Rose questionnaire and the more objective resting ECG in an urban Iranian adult population participating in the Tehran Lipid and Glucose Study (TLGS). Material and Methods: Individuals older than 30 years were included in this study (N=5539, mean age= 46.37±11.87 years, female to male ratio=1.23). Results: According to ECG findings, the age-adjusted prevalences of probable and possible CHD were 1.1% and 9.3%, respectively. On the other hand, the age-adjusted prevalences of grade-Il and grade-I Rose angina were 1.7% and 7.5%, respectively. In the whole population, the observed agreement between ECG-defined CHD (probable or possible) and Rose angina (grade-II or I) was 84.9%, with kappa coefficient of 0.07 (standard error: 0.02). The agreements between positive and negative results, calculated as Ppo5 and Pneg , were 0.15 and 0.92 , respectively. Though still poor, males showed higher kappa coefficients and Pp.. compared to females. The strongest concordance, was observed among 50-59 years old men and diabetic men (kappa=0.20). Conclusion: Rose angina shows a poor concordance with ECG-based coronary heart disease in our study population. However, this is largely due to disagreement between positive results, while the negative results show substantial agreement. Hence, in large population-based surveys, the angina found after Rose questionnaire administration may still need a more objective diagnostic method to verify it.