Invasive treatment in unstable coronary artery disease promotes health-related quality of life: results from the FRISC II trial

Am Heart J. 2004 Jul;148(1):114-21. doi: 10.1016/j.ahj.2003.11.026.


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.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angina, Unstable / therapy*
  • Angioplasty, Balloon, Coronary
  • Anticoagulants / therapeutic use
  • Dalteparin / therapeutic use
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Myocardial Revascularization / methods*
  • Quality of Life*
  • Surveys and Questionnaires


  • Anticoagulants
  • Dalteparin