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Angina Control Correlates With Quality of Life: Presented at ACC

By Jill Stein

ORLANDO, FL -- March 14, 2005 -- The quality of life of cardiac patients can be improved markedly by relieving their angina, according to study data presented here March 9^th at the American College of Cardiology 54^th Scientific Session.

The change in quality of life scores in patients with significant coronary artery disease (CAD) correlated with the change in angina frequency, said Patricia Cowper, PhD, assistant research professor, Duke University Medical Center, Durham, North Carolina, United States. The impact of relieving angina was stronger on physical quality of life scores than on mental health scores.

"As patients live longer, quality of life is becoming an increasingly important outcome of medical care," Dr. Cowper said.

Dr. Cowper and colleagues measured the effect that angina frequency had on health-related quality of life in 1,641 patients with significant CAD who were catheterized at Duke Medical Center.

The study selected elderly subjects preferentially, such that the mean age of participants was 66 years. Angina frequency was measured using the Seattle Angina Questionnaire; quality of life was assessed using Sort Form-36 (SF-36) physical and mental subscales. The SF-36 is scored on a 100-point scale, with lower scores reflecting poorer health.

Seventy one percent of patients underwent revascularization (coronary artery bypass graft in 35% and percutaneous coronary intervention in 36%) and 29% received medical therapy only.

Baseline quality of life scores were significantly lower in patients with angina compared with those whose angina was well controlled. The mean physical component score on the SF-36 was six points lower in patients with angina (36 vs. 42; P <.001) and the mean mental component score was five points lower (46 vs. 51; P <.001) compared with patients without angina.

At 6 months, 75% of patients in the study were free of angina.

"Consistent with this trend, the mean quality of life improved between baseline and 6 months," said Dr. Cowper.

The researchers found that after adjusting for other baseline factors likely to affect quality of life, there was a positive association between reduction of angina and improved quality of life. "This correlation was observed for both the physical and mental components of quality of life, although the association was stronger for physical aspects of quality of life," Dr. Cowper said.

At 6 months, 47% of patients reported clinically significant improvements in physical component scores, and 35% reported clinically significant improvements in mental component scores. Improvements in quality of life were related significantly to reductions in angina relief, regardless of treatment, she said.

John Rumsfeld, MD, staff cardiologist, Denver VA Medical Center, Denver, Colorado, United States, said, "There is significant evidence of gaps of care that we provide for chronic angina, yet it's largely ignored over the treatment of acute coronary syndromes."

"This study shows that if we pay attention and target angina by whatever treatment mechanism, and we reduce angina, we actually improve the quality of life of our patients," Dr. Rumsfeld said.

Approximately 6 million Americans have chronic angina, he added.


[Presentation title: The Relation Between Angina, Treatment and Quality of Life in Cardiac Patients. Abstract 870-3]

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