Time trends of chest pain symptoms and health related quality of life in coronary artery disease

Abstract

Background: 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. Methods: 253 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. Results: Perceived 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). Conclusion: HRQL 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. © 2007 Kiessling and Henriksson; licensee BioMed Central Ltd.