The MacNew Heart Disease Health-Related Quality of Life Questionnaire in Patients with Angina and Patients with Ischemic Heart Failure

Objective: Patient-reported outcomes including health-related quality of life are important in clinical care and research studies. The MacNew Heart Disease health-related quality of life questionnaire has been validated in English-speaking patients with myocardial infarction. The aim of this study was to validate the MacNew in English-speaking patients with angina or ischemic heart failure. Methods: Canadian and American patients with angina or ischemic heart failure completed the MacNew, the Short Form-36 Health Survey, and the Hospital Anxiety and Depression Scale. Results: We administered questionnaires to 276 patients with angina (mean age, 65.9 years) and 155 patients with ischemic heart failure (mean age, 70.3 years). The mean +/- SD MacNew global score in patients with ischemic heart failure (5.1 +/- 1.2) was statistically (P < 0.001), but not clinically, poorer than in patients with angina (5.3 +/- 1.1). The three-factor measurement model explained 46.1% of the observed variance in the MacNew in patients with angina and 46.5% in patients with ischemic heart failure. Internal consistency was >= 0.90, and test-retest reliability was >= 0.70 for each MacNew scale and the a priori convergent and discriminative validity hypotheses were confirmed in both diagnoses. The MacNew was highly accepted by patients with little respondent or administrative burden. Conclusions: The English version of the MacNew is reliable and valid in patients with angina or ischemic heart failure. This permits health-related quality of life outcome comparisons in patients with angina, ischemic heart failure, and myocardial infarction with the MacNew and provides a better understanding of the full range of health-related quality of life outcomes.