Severity of angina as a predictor of quality of life changes six months after coronary artery bypass surgery

Background. Although the fact that chest pain has a negative influence on the quality of life is well known, it is not completely clear whether the preoperative severity of angina can be a predictor of the quality of life change after coronary artery bypass grafting (CABG). Methods. We studied 243 consecutive patients who underwent elective CABG. The Nottingham Health Profile Questionnaire part 1 was used as the model for determination of quality of life. We distributed the questionnaire to all patients before and six months after coronary artery bypass surgery. Two hundred and twenty-six patients filled in the postoperative questionnaire. Severity of angina was estimated by Canadian Cardiovascular Society (CCS) classification of angina. Results. Quality of life (before and after CABG surgery) in all sections was significantly worse in patients with higher CCS angina class (p < 0.001). The CCS angina class was 1.89 +/- 0.97 at baseline and improved to 0.46 +/- 0.75 (p < 0.001) after CABG. Six months after the operation, quality of life significantly improved in patients with all classes of angina (p < 0.01). The improvement in quality of life was related to higher CCS angina class in sections of physical mobility (r = 0.4, p < 0.001), energy (r = 0.31, p < 0.001), and pain (r = 0.48, p < 0.001). High CCS angina class before CABG was an independent predictor of quality of life improvement after coronary artery bypass surgery in sections of physical mobility (p = 0.005; odds ratio [OR] = 2.11; confidence interval [CI] 1.25 to 3.55), energy (p = 0.021; OR = 1.77; CI 1.09 to 2.87), and pain (p < 0.001; OR = 3.99; CI 2.2 to 7.22). Conclusions. Patients with higher CCS angina class had worse preoperative and postoperative quality of life. Patients with preoperative higher CCS angina class had greater improvement in sections of physical mobility, energy, and pain. High CCS angina class before CABG was the independent predictor of quality of life improvement six months after CABG.