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Association between angina and treatment satisfaction after myocardial infarction.

Plomondon ME, Magid DJ, Masoudi FA, Jones PG, Barry LC, Havranek E, Peterson ED, Krumholz HM, Spertus JA, Rumsfeld JS,

Cardiovascular Outcomes Research, Eastern Colorado Health Care System, Denver VA Medical Center, Denver, CO, USA. Meg.Plomondon@va.gov

BACKGROUND: Patient satisfaction is increasingly recognized as a quality indicator and important outcome of care. Little is known about the clinical factors associated with satisfaction after myocardial infarction (MI). OBJECTIVE: To assess the hypothesis that angina after MI is independently associated with lower treatment satisfaction. METHODS: We evaluated 1,815 MI patients from 19 U.S. centers. Angina was measured at 1 and 6 months after MI using the Seattle Angina Questionnaire (SAQ). Treatment satisfaction was measured using the SAQ at 6 months. Multivariable regression was used to evaluate the association between 1- and 6-month angina and 6-month treatment satisfaction. RESULTS: Sixty-two percent of patients had no angina at 1 and 6 months after MI, 14% had transient angina (angina at 1 month, no angina at 6 months), 11% had new angina (angina at 6 months only), and 13% had persistent angina (angina at both 1 and 6 months). In unadjusted analysis, the presence of angina at 6 months, whether new or persistent, was associated with lower treatment satisfaction (p < 0.001). In multivariable analysis, angina was associated with lower treatment satisfaction [relative risk (RR) 2.9, 95% confidence interval (CI) 2.4-3.5 patients with new angina; RR 3.1, 95% CI 2.5-3.9 patients with persistent angina, vs patients with no angina]. CONCLUSIONS: In conclusion, angina in the 6 months following MI is present in almost 1 in 4 patients and is strongly associated with lower treatment satisfaction. This suggests the importance of angina surveillance and management after MI as a possible target to improve treatment satisfaction and, thereby, quality of care.

Published 3 January 2008 in J Gen Intern Med, 23(1): 1-6.
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