Coronary disease & ACS

Assessing the Prognostic Value of Serial Seattle Angina Questionnaire Scores in Chronic Coronary Disease

Circ Popul Health OutcomesPublished Secondary analysis of a randomized controlled trial

Authors' conclusion

In patients with chronic coronary disease, the most recent SAQ-SS is the strongest health status predictor of future cardiovascular events. Serial SAQ-SS assessments provide a practical, dynamic, and patient-centered approach for updating prognosis in chronic coronary disease management.

Study context

Population
Patients with chronic coronary disease in the ISCHEMIA trial with serial Seattle Angina Questionnaire Summary Score (SAQ-SS) assessments (3-month score as prior, 6-month score as current)participants included in this analysis
Participants
3,405 patients
Comparison
Association of the prior score, the current score, and the change in scores with ISCHEMIA's primary composite end point, stratified by treatment strategy
  • Conservative managementn = 1,965
  • Invasive managementn = 1,440
Primary endpoint
ISCHEMIA's primary composite end point:
  • Cardiovascular death
  • Myocardial infarction
  • Hospitalization for unstable angina
  • Heart failure
  • Resuscitated cardiac arrest
Follow-up
Median 3.2 years
Methodological detailsISCHEMIA, global, multicenter, stratified by treatment strategy, Cox proportional hazards models adjusting for 17 clinical covariates
  • ISCHEMIA
  • Global, multicenter
  • Stratified by treatment strategy
  • Cox proportional hazards models adjusting for 17 clinical covariates

Primary result

As reported in the abstract

Hazard ratio (95% CI)
Each 5-point increase in the current SAQ-SS (conservative cohort)7% lower risk of the primary end point
0.93(0.90–0.96)
Each 5-point increase in the current SAQ-SS (invasive cohort)9% lower risk
0.91(0.86–0.96)

Each 5-point increase in the current SAQ-SS, as printed

Original publication

Assessing the Prognostic Value of Serial Seattle Angina Questionnaire Scores in Chronic Coronary Disease. Circ Popul Health Outcomes. Published 5 August 2026. doi:10.1161/circoutcomes.125.013063

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