Stable angina in Spain and its impact on quality of life. The AVANCE registry

Abstract

Introduction and objectives: Mortality from acute coronary syndrome has fallen but a substantial number of chronic patients remain symptomatic. The present study was designed to determine the clinical characteristics and therapeutic treatment of patients with stable angina and its impact on their quality of life.

Methods: A cross-sectional, multicenter, observational study of 2039 patients with stable angina attended in outpatient clinics was performed. Data were collected on clinical variables and on the subjective perception of the severity of angina and the resulting limitations. Patients completed questionnaires on their perception of severity and quality of life.

Results: We analyzed data on 2024 patients; 73% were men (mean age 68[10] years). Some 50.3% were asymptomatic (<1 angina attack per week in the previous 4 weeks), 39.2% reported 1-3 attacks per week and 10.5% reported >3 attacks per week; 66% had previously undergone revascularization, and 59% of these developed recurrent angina. Patients rated the severity of their condition higher than did their physicians (4.5 [2.5] vs 4.3 [2.3]; P=.002). Physicians' and patients' perceptions of the repercussions of angina showed little concordance (kappa<0.3). The patients believed their condition was much more severe, more debilitating, and had a greater negative impact on their quality of life.

Conclusions: A high proportion of patients with stable angina remains symptomatic and their quality of life is impaired. Their perception of the condition is worse than that of their physicians.