Testing the effectiveness of converting patients to long-acting antianginal medications: The Quality of Life in Angina Research Trial (QUART).
OBJECTIVE
Our purpose was to test the hypothesis that converting patients with stable angina to long-acting antianginal medications would improve their functional status, symptom control, treatment satisfaction, and quality of life.


RESULTS
A single-blind randomized trial of 100 patients with stable coronary artery disease was performed in the outpatient clinic of a Veterans Affairs Health System. Outpatients with chronic stable angina taking at least 2 antianginal medications were studied. Patients were randomized to one of two treatments: optimal adjustment of their usual antianginal medications or conversion to solely long-acting medications (long-acting diltiazem +/- nitroglycerin patches +/- atenolol) with subsequent optimization. The primary outcome was the 3-month change in Seattle Angina Questionnaire scores. Although no differences in physical limitation scores were noted, patients randomized to receive long-acting medications had improved symptom control (3-month improvement in anginal stability [19.1 vs 5.6, P =.02] and anginal frequency [17.8 vs 5.5, P =.006]), more treatment satisfaction (3-month improvement of 8.2 vs 3.0, P =.057), and better quality of life (3-month improvement of 11.2 vs 5.6, P =.09) compared with patients whose pretrial medications were optimized. The improvement in symptom control was statistically significant.


CONCLUSIONS
Converting patients with chronic, stable angina to long-acting antianginal medications resulted in substantial improvements in symptom control with a trend toward better treatment satisfaction and quality of life.
Spertus
J A
JA
Department of Cardiology, University of Missouri-Kansas City School of Medicine, Kansas City, MO 64111, USA. jspertus@cctr.umkc.edu
Dewhurst
T
T
Dougherty
C M
CM
Nichol
P
P
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage*; D000787:Angina Pectoris / Q000188:drug therapy*; D002121:Calcium Channel Blockers / Q000008:administration & dosage*; D002908:Chronic Disease; D006305:Health Status Indicators; D006801:Humans; D005996:Nitroglycerin / Q000008:administration & dosage*; D011446:Prospective Studies; D011788:Quality of Life; D016037:Single-Blind Method
D000319:Adrenergic beta-Antagonists; D002121:Calcium Channel Blockers; D005996:Nitroglycerin