A PROMISE Fulfilled That Quality-of-Life Assessments Afford Incremental Value to Coronary Artery Disease Management

Current ACC/AHA Clinical Practice Guidelines for patients with coronary artery disease (CAD) advocate dual goals of management: 1) to reduce incident rates of death or myocardial infarction; 2) to improve angina and enhance the patient's functional capacity, or quality of life.(1) For certain subsets of patients, notably those with acute coronary syndromes, studies have shown that both goals can be achieved when optimal medical therapy (OMT) is combined with myocardial revascularization. For subjects with chronic angina and stable CAD, however, revascularization has not been shown to reduce either short-term or long-term rates of death or myocardial infarction (MI) as compared with OMT alone.(2,3) In such instances, therefore, treatment is primarily directed toward symptom control and improving quality of life.