COMPARISON OF MULTIPLE-DOSE AND ONCE-DAILY NITRATE THERAPY IN PATIENTS WITH STABLE ANGINA-PECTORIS - EFFECTS ON QUALITY-OF-LIFE INDEXES

In a 6-month self-controlled study, the effects of multiple-dose and o nce-daily nitrate therapy on anginal symptoms and quality of life were evaluated in 1212 patients with stable angina pectoris, Quality of li fe was assessed by a test battery based on the exercise tolerance inde x of Wiklund et al, the psychological well-being index of Dupuy, and t he Short-Form 36 questionnaire of Stewart et al, The internal consiste ncy and reliability of the multi-item scales were estimated by Cronbac h's alpha coefficients, The effects of the two treatment regimens on p ain index and number of additional sublingual nitrate tablets required were similar, However, based on New York Heart Association (NYHA) ang ina classification, patients showed a statistically significant better improvement with the once-daily than with the multiple-dose regimen: between the first and second evaluation 281 patients improved by one c ategory and 62 patients worsened by one category, Mobility and psychol ogical distress indices also indicated statistically significant highe r scores for the once-daily treatment regimen, It can be concluded fro m this study that once-daily nitrate not only provides a better NYHA a ngina classification than multiple-dose therapy but also provides a be tter quality of life as estimated by improvement of mobility and distr ess indices, Patient compliance, estimated by using the number of pati ents who reported forgetting to take medication, was greatly improved (from 16% to 21% improvement).