The integration of aspects of health-related quality of life (QL) into diagnosis, therapy and rehabilitation of patients with advanced coronary artery disease (CAD), especially with therapy-resistant angina pectoris, is important for at least two reasons. First, restrictions in patients QL often confronts the treating cardiologist with problems which could be overcome by a more comprehensive, psychosocially oriented intervention approach. Secondly, reduced QL was shown to have a negative impact on the course of CAD and on survival. Both aspects are discussed with reference to current scientific evidence, including our own study on effects of a comprehensive lifestyle change on QL in CAD patients.