Correlation of the disease-specific Canadian Cardiovascular Society (CCS) classification and health-related quality of life (15D) in coronary artery disease patients

Abstract

Background Generic health-related quality of life (HRQoL) and disease-specific instruments measure HRQoL from different aspects, although generic instruments often contain dimensions that reflect common symptoms. We evaluated how the change in 15D HRQoL and Canadian Cardiovascular Society (CCS) grading of angina severity correlate among coronary artery disease patients during 12-month follow-up. Methods Altogether 1 271 patients scheduled for coronary angiography between June 2015 and February 2017 returned the 15D HRQoL and CCS questionnaires before angiography and after one-year follow-up as a part of routine clinical practice. Spearman correlations between one-year changes in the CCS and the 15D and its dimensions were evaluated. Changes in 15D were classified into 5 categories based on the reported minimal important difference (MID) for the instrument. Results Change in the CCS grade correlated moderately with the MID-based change in the 15D (r = 0.33, 95% confidence interval 0.27–0.39). Correlations between these instruments were similar in different age groups, between sexes and treatment modalities. Of the individual 15D dimensions, changes in breathing (r = 0.40) and vitality (r = 0.30) had the strongest correlations with CCS change. Conclusion The symptom-based evaluation of the change in the CCS grade may not catch the full benefit or harm of the treatment and vice versa, a generic instrument, such as 15D, likely does not fully capture change in disease-specific symptoms. Thus, generic and disease-specific instruments are complementary and should be used in conjunction.

Cardiac surgery risk prediction using ensemble machine learning to incorporate legacy risk scores: A benchmarking study

“…ES II also includes a new comorbidity variable for diabetes and new symptom-based classification systems such as the New York Heart Association (NYHA) classification for assessing severity of heart failure 7 – 9 and the Canadian Cardiovascular Society classification system for severity of angina in patients with coronary artery disease. 10 Although the ES II has been considered as a more accurate predictor of surgical risk, it no longer includes the post infarct septal rupture variable from LogES due to insufficient number of cases at the time of collection and missingness of newly included variables in periods before 2011 have not been well documented for cardiac centre data in the UK. ES II is more complex to calculate, less well known and less validated than LogES.…”