This study was undertaken to identify psychosocial and physical characteristics that independently predict anginal pain relief. The original study group comprised over 570 patients in whom the characteristics were identified at the time of coronary arteriography and who were followed up after 6 months of standard medical therapy. In the subset of 382 of these patients who were assessed as having NYHA Class III or IV angina at the time of angiography, a multivariable analysis of 101 baseline descriptors showed that higher scores on the MMPI hypochondriasis scale, unemployment, and more severe right coronary occlusion were significant independent predictors of failure to achieve two-class improvement at follow-up. These three characteristics also predicted continuing severe angina in a subsequent, independent sample of 91 new patients. These findings could help physicians select appropriate treatment by prospectively identifying patients who are unlikely to respond to standard medical treatment of angina.