Health-related qualify of life, angina type and coronary artery disease in patients with stable chest pain

Nina Rieckmann*, Konrad Neumann, Sarah Feger, Paolo Ibes, Adriane Napp, Daniel Preuß, Henryk Dreger, Gudrun Feuchtner, Fabian Plank, Vojtěch Suchánek, Josef Veselka, Thomas Engstrøm, Klaus F. Kofoed, Stephen Schröder, Thomas Zelesny, Matthias Gutberlet, Michael Woinke, Pál Maurovich-Horvat, Béla Merkely, Patrick DonnellyPeter Ball, Jonathan D. Dodd, Mark Hensey, Bruno Loi, Luca Saba, Marco Francone, Massimo Mancone, Marina Berzina, Andrejs Erglis, Audrone Vaitiekiene, Laura Zajanckauskiene, Tomasz Harań, Malgorzata Ilnicka Suckiel, Rita Faria, Vasco Gama-Ribeiro, Imre Benedek, Ioana Rodean, Filip Adjić, Nada Čemerlić Adjić, José Rodriguez-Palomares, Bruno Garcia Del Blanco, Katriona Brooksbank, Damien Collison, Gershan Davis, Erica Thwaite, Juhani Knuuti, Antti Saraste, Cezary Kȩpka, Mariusz Kruk, Theodora Benedek

*Corresponding author for this work

Research output: Contribution to journalArticle (journal)peer-review

12 Citations (Scopus)


Background: Health-related quality of life (HRQoL) is impaired in patients with stable angina but patients often present with other forms of chest pain. The aim of this study was to compare the pre-diagnostic HRQoL in patients with suspected coronary artery disease (CAD) according to angina type, gender, and presence of obstructive CAD. Methods: From the pilot study for the European DISCHARGE trial, we analysed data from 24 sites including 1263 patients (45.9% women, 61.1 ± 11.3 years) who were clinically referred for invasive coronary angiography (ICA; 617 patients) or coronary computed tomography angiography (CTA; 646 patients). Prior to the procedures, patients completed HRQoL questionnaires: the Short Form (SF)-12v2, the EuroQoL (EQ-5D-3 L) and the Hospital Anxiety and Depression Scale. Results: Fifty-five percent of ICA and 35% of CTA patients had typical angina, 23 and 33% had atypical angina, 18 and 28% had non-anginal chest discomfort and 5 and 5% had other chest discomfort, respectively. Patients with typical angina had the poorest physical functioning compared to the other angina groups (SF-12 physical component score; 41.2 ± 8.8, 43.3 ± 9.1, 46.2 ± 9.0, 46.4 ± 11.4, respectively, all age and gender-adjusted p < 0.01), and highest anxiety levels (8.3 ± 4.1, 7.5 ± 4.1, 6.5 ± 4.0, 4.7 ± 4.5, respectively, all adjusted p < 0.01). On all other measures, patients with typical or atypical angina had lower HRQoL compared to the two other groups (all adjusted p < 0.05). HRQoL did not differ between patients with and without obstructive CAD while women had worse HRQoL compared with men, irrespective of age and angina type. Conclusions: Prior to a diagnostic procedure for stable chest pain, HRQoL is associated with chest pain characteristics, but not with obstructive CAD, and is significantly lower in women. Trial registration:, NCT02400229.

Original languageEnglish
Article number140
Pages (from-to)140
JournalHealth and Quality of Life Outcomes
Issue number1
Publication statusPublished - 14 May 2020


  • Angina
  • Chest pain
  • Computed tomography angiography
  • Coronary artery disease
  • Health-related quality of life
  • Invasive coronary angiography


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