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Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2014

Open Access 01-12-2014 | Research

Impact of angina frequency on health utility values of patients with chronic stable angina

Authors: Christine G Kohn, Matthew W Parker, Brendan L Limone, Craig I Coleman

Published in: Health and Quality of Life Outcomes | Issue 1/2014

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Abstract

Background

Chronic angina is a profoundly symptomatic disease. We evaluated the relationship between angina frequency and health utility.

Methods

We used data from stable angina patients reporting ≥3 attacks/week enrolled in the Efficacy of Ranolazine in Chronic Angina (ERICA) trial. Angina frequency was classified using the Seattle Angina Questionnaire angina frequency (SAQAF) domain into no (100); monthly (61-99); weekly (31-60); and daily (0-30) angina. EuroQol (EQ)-5D health utility scores were derived from SAQ data using two mapping equations. Median EQ-5D utility scores for each SAQAF classification after the 6-week trial period were calculated (reported as: Equation 1/Equation 2). Changes in EQ-5D utility scores from baseline to end-of-trial for patients achieving and not achieving a ≥20-point improvement in SAQAF score and improving and not improving ≥1 SAQAF classification were compared.

Results

Median EQ-5D utility scores (n = 548) were 0.68/0.60. Compared to patients reporting no angina symptoms (n = 28; 0.89/0.87) patients reporting monthly (n = 188; 0.80/0.76), weekly (n = 283; 0.72/0.65) and daily (n = 49; 0.65/0.54) symptoms had poorer health utility (p < 0.001 for both equations). Patients improving ≥1SAQAF classification (n = 254/541, 47%) experienced a median 0.05/0.07 greater improvement in EQ-5D health utility compared to those not improving ≥1 classification (p < 0.001 for both equations). Patients improving ≥20-points on the SAQAF (n = 355/541, 66%) experienced a median 0.06/0.07 greater improvement in health utility compared to those not achieving a ≥20-point improvement (p < 0.001 for both).

Conclusions

Chronic angina patient health utility decreases as angina frequency increases. Patients reporting clinically important improvement in angina frequency experience a tangible improvement in health utility.

Clinical trial registration

NCT00091429
Appendix
Available only for authorised users
Literature
1.
Go AS, Mozaffarian D, Roger VL, Benjamin EJ, Berry JD, Borden WB, Bravata DM, Dai S, Ford ES, Fox CS, Franco S, Fullerton HJ, Gillespie C, Hailpern SM, Heit JA, Howard VJ, Huffman MD, Kissela BM, Kittner SJ, Lackland DT, Lichtman JH, Lisabeth LD, Magid D, Marcus GM, Marelli A, Matchar DB, McGuire DK, Mohler ER, Moy CS, Mussolino ME, et al.: Heart disease and stroke statistics–2013 update: a report from the American Heart Association. Circulation 2013, 127: e6-e245. 10.1161/CIR.0b013e31828124adCrossRefPubMed
2.
McGillion M, Croxford R, Watt-Watson J, LeFort S, Stevens B, Coyte P: Cost of illness for chronic stable angina patients enrolled in a self-management education trial. Can J Cardiol 2008, 24: 759–764. 10.1016/S0828-282X(08)70680-9PubMedCentralCrossRefPubMed
3.
Spertus JA, Winder JA, Dewhurst TA, Deyo RA, Prodzinski J, McDonell M, Fihn SD: Development and evaluation of the Seattle Angina Questionnaire: a new functional status measure for coronary artery disease. J Am Coll Cardiol 1995, 25: 333–341. 10.1016/0735-1097(94)00397-9CrossRefPubMed
4.
Stone PH, Gratsiansky NA, Blokhin A, Huang IZ, Meng L, ERICA Investigators: Antianginal efficacy of ranolazine when added to treatment with amlodipine: the ERICA (Efficacy of Ranolazine in Chronic Angina) trial. J Am Coll Cardiol 2006, 48: 566–575. 10.1016/j.jacc.2006.05.044CrossRefPubMed
5.
Kosiborod M, Arnold SV, Spertus JA, McGuire DK, Li Y, Yue P, Ben-Yehuda O, Katz A, Jones PG, Olmsted A, Belardinelli L, Chaitman BR, ERICA Investigators: Evaluation of Ranolazine in Patients With Type 2 Diabetes Mellitus and Chronic Stable Angina: Results From the TERISA Randomized Clinical Trial (Type 2 Diabetes Evaluation of Ranolazine in Subjects With Chronic Stable Angina). J Am Coll Cardiol 2013, 61: 2038–2045. 10.1016/j.jacc.2013.02.011CrossRefPubMed
6.
Morrow DA, Scirica BM, Karwatowska-Prokopczuk E, Murphy SA, Budaj A, Varshavsky S, Wolff AA, Skene A, McCabe CH, Braunwald E, MERLIN-TIMI 36 Trial Investigators: Effects of ranolazine on recurrent cardiovascular events in patients with non-ST-elevation acute coronary syndromes: the MERLIN-TIMI 36 randomized trial. JAMA 2007, 297: 1775–1783. 10.1001/jama.297.16.1775CrossRefPubMed
7.
Boden WE, O’Rourke RA, Teo KK, Hartigan PM, Maron DJ, Kostuk WJ, Knudtson M, Dada M, Casperson P, Harris CL, Chaitman BR, Shaw L, Gosselin G, Nawaz S, Title LM, Gau G, Blaustein AS, Booth DC, Bates ER, Spertus JA, Berman DS, Mancini GB, Weintraub WS: Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med 2007, 356: 1503–1516. 10.1056/NEJMoa070829CrossRefPubMed
8.
Spertus JA, Jones P, McDonell M, Fan V, Fihn S: Health status predicts long-term outcome in outpatients with coronary disease. Circulation 2002, 106: 43–49. 10.1161/01.CIR.0000020688.24874.90CrossRefPubMed
9.
Spertus JA, Salisbury AC, Jones PG, Conaway DG, Thompson RC: Predictors of quality-of-life benefit after percutaneous coronary intervention. Circulation 2004, 110: 3789–3794. 10.1161/01.CIR.0000150392.70749.C7CrossRefPubMed
10.
Arnold SV, Morrow DA, Lei Y, Cohen DJ, Mahoney EM, Braunwald E, Chan PS: Economic impact of angina after an acute coronary syndrome: insights from the MERLIN-TIMI 36 trial. Circ Cardiovasc Qual Outcomes 2009, 2: 344–353. 10.1161/CIRCOUTCOMES.108.829523CrossRefPubMed
11.
Zhang Z, Kolm P, Boden WE, Hartigan PM, Maron DJ, Spertus JA, O’Rourk RA, Shaw LJ, Sedlis SP, Mancini GB, Berman DS, Dada M, Teo KK, Weintraub WS: The cost-effectiveness of percutaneous coronary intervention as a function of angina severity in patients with stable angina. Circ Cardiovasc Qual Outcomes 2011, 4: 172–182. 10.1161/CIRCOUTCOMES.110.940502CrossRefPubMed
12.
Schafermeyer KW, Coleman CI: Chapter 19: Pharmacoeocnomics. In Introduction to Health Care Delivery. 5th edition. Sudbury, MA: Jones and Bartlett Publishers; 2012.
13.
Longworth L, Rowen D: National Institute for Health and Clinical Excellence (NICE) Decision Support Unit (DSU) Technical Support Document 10: The use of mapping methods to estimate health state utility values. 2011.
14.
Kind P: The EuroQol instrument: An index of health-related quality of life. Quality of life and pharmacoeconomics in clinical trials. 2nd edition. Philadelphia: Lippincott-Raven Publishers; 1996.
15.
Johnson JA, Coons SJ, Ergo A, Szava-Kovats G: Valuation of EuroQOL (EQ-5D) health states in an adult US sample. Pharmacoeconomics 1998, 13: 421–433. 10.2165/00019053-199813040-00005CrossRefPubMed
16.
Wijeysundera HC, Tomlinson G, Norris CM, Ghali WA, Ko DT, Krahn MD: Predicting EQ-5D utility scores from the Seattle Angina Questionnaire in coronary artery disease: a mapping algorithm using a Bayesian framework. Med Decis Making 2011, 31: 481–493. 10.1177/0272989X10386800CrossRefPubMed
17.
Goldsmith KA, Dyer MT, Buxton MJ, Sharples LD: Mapping of the EQ-5D index from clinical outcome measures and demographic variables in patients with coronary heart disease. Health Qual Life Outcomes 2010, 8: 54. 10.1186/1477-7525-8-54PubMedCentralCrossRefPubMed
18.
Robertus KA, Arnold SV, Wang K, Lei Y, Mahoney EM, Morrow DA, Kempf JA, Cohen DJ: Association between angina frequency as measured using the Seattle Angina Questionnaire and utility scores derived from the EQ-5D: findings from the MERLIN-TIMI 36 trial [abstract]. Circulation 2008, 117: e454.
Metadata
Title
Impact of angina frequency on health utility values of patients with chronic stable angina
Authors
Christine G Kohn
Matthew W Parker
Brendan L Limone
Craig I Coleman
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2014
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-12-39

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