This paper reports findings of a study to examine the independent contribution of chest pain, fatigue, and dyspnea to health-related quality of life in patients with chronic stable angina.
Patients with chronic stable angina experience poorer quality of life in multiple areas including physical and emotional health. Emerging evidence suggests the presence of concomitant symptoms, yet there are no systematic studies examining the impact of symptom clusters on quality of life in chronic angina patients.
Outpatients (n=134), recruited over a 16 month period in 2000 and 2001, with confirmed coronary heart disease and chronic angina completed reliable and valid questionnaires measuring chest pain frequency, fatigue, dyspnea and quality of life. Hierarchical multiple linear regression was used to examine the symptom cluster of chest pain frequency, fatigue, and dyspnea in predicting quality of life.
The sample was predominantly white (74.6%), males (59.7%) with a mean age of 63.4 (SD 12.12) years. Controlling for age, gender, social status, and comorbidities, the symptom cluster of chest pain frequency, dyspnea, and fatigue accounted for significant increase in unadjusted R2, (F of Δ, p < .05) for the models predicting physical limitation (R2 Δ 24.1%), disease perception (R2 Δ 24.6%), Short Form-36 Physical Component Score (R2 Δ 24.3%) and Mental Component Score (R2 Δ 07.0%).
Symptom assessment and management of patients with chronic stable angina should involve multiple symptoms. Greater fatigue predicted poorer quality of life in multiple areas. As a possible indicator of depression, it warrants further assessment and follow-up.