Abstract

Objectives To relate improvements in angina severity by antiischemic therapy to physical, social and mental domains of Quality of Life (QoL) in elderly men and women and to assess differences in this relation between both sexes.

Design Prospective comprehensive assessment of QoL before and 6 months after antiischemic drug or interventional treatment.

Setting Randomized Trial of Invasive vs. Medical therapy in the Elderly (TIME) with chronic angina.

Patients All 301 patients age iÝ75 years with angina class iÝ II despite iÝ two antianginal drugs.

Interventions Angina severity and full assessment of QoL by structured, self-administered and validated questionnaires at baseline and after 6 months optimal drug or revascularization therapy.

Results At baseline, angina severity correlated inversely with physical domains of QoL (p<0.0001) and daily activities (p=0.05) but not to social or mental domains. At similar angina levels, women had significantly lower QoL scores. On antiischemic therapy, not only physical domains and daily activities but also mental and social domains improved together with relief in angina (trend tests at least p<0.02). This was true for women and men and was more pronounced after revascularization than on medical therapy.

Conclusions These findings confirm the relation between angina severity and physical limitation. In addition, they show that antiischemic therapy not only relieves angina and improves physical components of QoL but also mental and social domains. This is true for women as well as for men despite lower overall scores of women and more pronounced after revascularization than on drug therapy alone.