OBJECTIVE: To describe perceived work performance of patients with the diagnosis of acute coronary syndrome (ACS) and to determine predictive relationships of several patient-specific independent variables. METHODS: All ACS patients discharged from a university affiliated hospital during a 3-year period were mailed a questionnaire that included the Work Performance Scale (WPS). Independent variables included the SF-8 (PCS-8, MCS-8), the EQ-5D General Health Visual Analog Scale (VAS), cardiac functional status [Duke Activity Status Index (DASI)], symptom count (Symptom Distress Checklist), comorbidity index (Charlson self-administered), patient-perceived cardiac disease severity, medication count, compliance score, job satisfaction, current employment duration, patient demographics, and ACS type [unstable angina (UA) or myocardial infarction (MI)]. This analysis includes respondents who indicated current employment. Stepwise-elimination (p<0.05) linear regression models determined the combined predictive ability of independent variables on WPS. Due to the high correlation between the PCS-8, VAS, and DASI, three separate models were used with each one as a predictor variable. RESULTS: To date, 414 of 1230 patients (34%) have responded, including 122 (29.5%) currently working. Current workers averaged 57.6(±8.6) years of age; 80.3% male; 94.3% Caucasian; 69.2% history of MI; 13.4% severe or worse perceived cardiac disease severity. Respondents reported the following mean(s.d.) responses: DASI 26.0(±7.4); comorbidity index 1.7(±1.4); medications 7.2(±4.1); compliance score 4.8(±0.6); symptoms 6.2(±4.4); PCS-8 59.2(±7.9); MCS-8 51.2(±8.1); and VAS 82.4(±16.0). The mean WPS was 4.6(±0.5); mean employment duration of 14.6(±12.3) years and 2.5% reporting job dissatisfaction. Of the 3 models tested, that with the highest explanatory ability (r-square=0.36) included number of symptoms, age, perceived cardiac severity, and PCS-8, with more symptoms, higher perceived severity, higher age, and lower PCS-8 scores associated with lower perceived work performance. CONCLUSIONS: Currently employed ACS patients report a high level of work performance. Symptomology, perceived disease severity, age, and physical function appear to be associated with work performance.