Abstract
BackgroundThere is at present a lack of knowledge of time trends in health related quality of life (HRQL) in common patients with coronary artery disease (CAD) treated in ordinary care. The objective of this study is to assess and compare time trends of health related quality of life (HRQL) and chest pain in patients with coronary artery disease.Methods253 consecutive CAD patients in Stockholm County, Sweden – 197 males/56 females; 60 ± 8 years – were followed during two years. Perceived chest pain symptoms and three global assessments of HRQL were assessed at baseline, after one and after two years. EuroQol-5 dimension (EQ-5D) with a predefined focus on function and symptoms; the broader tapping global estimates of HRQL; EuroQol VAS (EQ-VAS) and Cardiac Health Profile (CHP) were used. Chest pain was ranked according to Canadian Cardiovascular Society (CCS). Change in HRQL was analysed by a repeated measurements ANOVA and chest pain symptoms were analysed by Friedman non-parametric ANOVA.ResultsPerceived chest pain decreased during the two years (p < 0.00022); CCS 0: 41–51%; CCS 1: 19–15%; CCS 2: 31–27%; CCS 3: 5–4% and CCS 4: 4–2%. By contrast, HRQL did not change: EQ-5D: 0.76 (CI 0.73–0.79) -0.78 (CI 0.75–0.81), EQ-VAS: 0.68 (CI 0.66–0.71)-0.68 (CI 0.65–0.71) and CHP: 0.66 (CI 0.64–0.69) -0.66 (CI 0.64–0.69).ConclusionHRQL did not increase despite a reduction in the severity of chest pain during two years. This implies that the major part of HRQL in these consecutive ordinary patients with CAD is unresponsive to change in chest pain symptoms.
Highlights
There is at present a lack of knowledge of time trends in health related quality of life (HRQL) in common patients with coronary artery disease (CAD) treated in ordinary care
Further details of the patient cohort, the inclusion procedure and two of the health related quality of life instruments used in this study; the Cardiac Health Profile questionnaire (CHP) and the EuroQol-VAS instrument (EQ-VAS) are available in a previous publication [9]
There were no significant differences in assessed total CHP scores between patients with or without a prior myocardial infarction or between those who had or had not passed an intervention – Percutaneous Coronary Intervention (PCI)/Coronary Artery Bypass Surgery (CABG) – at baseline
Summary
There is at present a lack of knowledge of time trends in health related quality of life (HRQL) in common patients with coronary artery disease (CAD) treated in ordinary care. The objective of this study is to assess and compare time trends of health related quality of life (HRQL) and chest pain in patients with coronary artery disease. Disease specific and all-cause mortality in patients with coronary artery disease (CAD) have declined during the last decades [1]. Patients with CAD have at present well treated physical symptoms and cardiovascular drugs help to reduce their risk of a new coronary event. Health related quality of life (HRQL) is often added as an outcome variable in randomised intervention clinical trials with the aim to assess the patient's perception of the disease. Some studies report improved perceived (page number not for citation purposes)
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