A Persistent Immune Response to an Acute Virus

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. Background 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. However, the patient's perception of disease is to a large extent unexplored. 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. HRQL is – in contrast to morbidity and mortality – a multidimensional construct without a golden standard or definition. HRQL is always assessed and defined by the individual patient. Objective – e g patency – and subjective – e g HRQL – results are often in conflict [2,3]. Some studies report improved perceived Published: 6 March 2007 Health and Quality of Life Outcomes 2007, 5:13 doi:10.1186/1477-7525-5-13 Received: 6 December 2006 Accepted: 6 March 2007 This article is available from: http://www.hqlo.com/content/5/1/13 © 2007 Kiessling and Henriksson; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.