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According to national health insurance data, the number of patients treated for angina in Korea showed a generally consistent trend between 2018 and 2022, with a slight increase overall. The annual number of patients was 665,070 in 2018, 680,350 in 2019, 669,599 in 2020, 711,164 in 2021, and 705,259 in 2022. [1] 

The age-standardized mortality rate for ischemic heart disease was 30.9 per 100,000 in men and 25.6 per 100,000 in women. [2] 

In 2022, a total of 429,437 male and 275,822 female patients received medical care for angina. The male-to-female ratio was approximately 1.56:1. [1]  

The prevalence of angina by age group from national health insurance data in 2022 was as follow: 0–9 years: 41 (0.0%), 10–19 years: 967 (0.1%), 20–29 years: 4,756 (0.6%), 30–39 years: 10,255 (1.4%), 40–49 years: 34,788 (4.7%), 50–59 years: 110,964 (15.0%), 60–69 years: 235,624 (31.9%), 70–79 years: 221,792 (30.0%), 80+ years: 119,195 (16.1%). [1] 

Notable regional differences in angina were generally not observed in Korea. In the 2013 CHS, Gwangju (2.8%) and Chungnam (2.7%) showed the highest prevalence, whereas Ulsan (1.3%) and Gyeonggi (1.7%) had the lowest prevalence. [3] 

Based on ICD-10 codes from national insurance claims data (2012–2016), angina pectoris (I20) accounted for the largest proportion (68.4%) among ischemic heart disease cases, followed by chronic ischemic heart disease (I25, 21.0%) and acute myocardial infarction (I21, 9.6%). Other Classifications, including I22–I24, accounted for less than 1% each. [4] 

In patients with coronary artery disease (CAD), the most common presentation is asymptomatic, and in some cases, the first manifestation may be syncope or sudden death due to myocardial infarction. [5] 

Myocardial infarction or angina pectoris (MIAP) was more strongly associated with total cholesterol than other variables in men (adjusted OR = 0.436 [0.384-0.495]) and women (adjusted OR = 0.541 [0.475-0.618]). The waist-to-height ratio (adjusted OR = 1.325 [1.082-1.623]) and waist circumference (adjusted OR = 1.290 [1.072-1.553]) showed a significant association with MIAP in men, with no association between obesity indices and MIAP in women after adjustment. [6]

Angina is a symptom-based clinical diagnosis. Typical angina is defined when all of the following three characteristics are present: A sensation of pressure or discomfort localized to the chest, neck, jaw, shoulder, or arm, Onset of symptoms with physical exertion or emotional stress, Relief of symptoms within five minutes by rest or administration of nitrates. When only two of these criteria are met, the condition is classified as atypical angina. If only one or none of the features is present, the condition is categorized as non-anginal chest pain. [5]

In procedures, drug-eluting stent was the most frequently used device (93.2%), followed by balloon angioplasty (5.5%) and bare metal stents (1.3%). The mean number of stents per patient was 1.39±0.64. At discharge, dual-anti platelet therapy, statin, beta-blockers, and angiotensin converting enzyme inhibitor or angiotensin receptor blocker were provided to 76,292 (94.1%), 71,411 (88.0%), 57,429 (70.8%), and 54,418 (67.1%) patients, respectively. [7]

The study patients were divided into two groups: group I (stable angina pectoris, n = 60, 48 men, 62 ± 10 years) and group II (acute coronary syndrome, n = 388, 291 men, 64 ± 10 years). Stent implantation techniques and use of intravascular ultrasound guidance were not different between two groups. In-hospital mortality was 0% in group I and 7% in group II (p = 0.035). One-month mortality was 0% in group I and 7.7% in group II (p = 0.968). Two-year survival rate was 93% in the group I and 88.4% in the group II (p = 0.921). [8]

Genetic polymorphisms in the endothelin-1 [9], rho-associated kinase 2 [10], interferon gamma gene [11], OPG, RANK, and RANKL [12] were associated with angina in Korean population.

[1] Statistics on Medical Practices for Everyday Diseases. Wonju: Health Insurance Review & Assessment Service; 2023. [2] Thirty-six Year Trends in Mortality from Diseases of Circulatory System in Korea. Korean Circ J. 2021 Apr;51(4):320-332. [3] Social Security Information Service. A study on the evolution of the medical use interregional gap using healthcare big data (2016) [4] Health Insurance Review and Assessment Service, Policy Research Institute. Analysis of Treatment Trends for Ischemic Heart Disease Over the Past 5 Years. Wonju: Health Insurance Review and Assessment Service; September 2017. [5] Pathophysiology and Role of Coronary CT Angiography in Stable Angina. The Korean Society of Radiology. 2022 Jan;83(1):42-53. Korean. [6] Association of myocardial infarction and angina pectoris with obesity and biochemical indices in the South Korean population. Sci Rep. 2022 Aug 12;12(1):13769. [7] Trends, Characteristics, and Clinical Outcomes of Patients Undergoing Percutaneous Coronary Intervention in Korea between 2011 and 2015. Korean Circ J. 2018 Apr;48(4):310-321. [8] Two-year clinical outcomes in stable angina and acute coronary syndrome after percutaneous coronary intervention of left main coronary artery disease. Korean J Intern Med. 2016;31(6):1084-1092. [9] Association of endothelin-1 gene polymorphisms with variant angina in Korean patients. Clin Chem Lab Med. (2008) 46: 1575-1580 [10] Rho-Associated Kinase 2 Polymorphism in Patients With Vasospastic Angina. Korean Circ J. (2012) 42: 406-413 [11] Polymorphisms of the Interferon gamma gene and coronary artery disease in the Korean population. Mol Biol Rep. (2012) 39: 5425-5432 [12] Association between OPG, RANK and RANKL gene polymorphisms and susceptibility to acute coronary syndrome in Korean population. J Genet. (2012) 91: 87-89