Invasive treatment in unstable coronary artery disease promotes health-related quality of life: results from the FRISC II trial.
BACKGROUND
Treatment strategies, either invasive or noninvasive, for patients with unstable coronary artery disease still vary. There are no published studies comparing the strategies for health-related quality of life.


METHODS
A total of 2457 patients with unstable coronary artery disease were randomized. We prospectively recorded the patients' health-related quality of life using 2 questionnaires, the generic Medical Outcomes Study Short Form 36 (SF-36) and the disease-specific Angina Pectoris Quality of Life Questionnaire (APQLQ), at randomization and after 3, 6, and 12 months of follow-up.


RESULTS
There was a high response rate (92%) at randomization, with 2251 respondents. The invasively treated group showed a significantly better quality of life in all 8 scales and both component scores at the 3- and 6-month follow-up (P <.01) than the noninvasively treated group. These differences remained at the 12-month follow-up, with significance in 7 of the scales and in the physical component score. The disease-specific quality of life results were similar until the 6-month follow-up. At randomization, the unstable population showed a remarkably lower quality of life in all 8 scales and the component scores compared with an age- and sex-matched normative population.


CONCLUSIONS
Patients receiving early invasive intervention after an unstable episode had substantial improvement in health-related quality of life until the 1-year follow-up, compared with patients receiving noninvasive treatment. Health-related quality of life in an unstable coronary artery disease population is remarkably lower than in a matched normative population.
Janzon
Magnus
M
Department of Medicine and Care, Linköping University, Linköping, Sweden. Magnus.Janzon@imv.liu.se
Levin
Lars-Ake
LA
Swahn
Eva
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary; D000925:Anticoagulants / Q000627:therapeutic use; D017985:Dalteparin / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000379:methods*; D011788:Quality of Life; D011795:Surveys and Questionnaires
D000925:Anticoagulants; D017985:Dalteparin