Gender differences in quality of life in coronary artery disease patients with comorbidities undergoing coronary revascularization

Abstract

In comparison to male patients with coronary artery disease, female patients suffer from more comorbidities, experience symptoms of coronary artery disease differently and report poorer health-related quality of life (HRQoL) after coronary revascularization. However, there is limited data on the impact of comorbidity burden on the recovery in HRQoL in female and male patients. We investigated the impact of comorbidity burden on the change in HRQoL following coronary revascularization in female patients versus male patients. 230 patients (60 female) with coronary artery disease were assessed before, and two weeks, three months and six months after coronary revascularization. Disease-specific HRQoL was measured with the Short-Form Seattle Angina Questionnaire. Physical and mental health was measured with the Short-Form Health Survey. Comorbidity burden was assessed by the total number of identified comorbidity conditions and by the Charlson comorbidity score. Linear mixed models were used to estimate the effects of time, gender and comorbidity burden on HRQoL. Whereas HRQoL improved after coronary revascularization in all patients, female patients reported poorer physical health and disease-specific HRQoL and their physical health improved more slowly than male patients. A higher comorbidity burden was related with poorer physical health and disease-specific HRQoL in male patients, but not in female patients. A higher comorbidity burden was associated with slower improvement in HRQoL for both female and male patients. Female patients reported poorer HRQoL and their physical health improved more slowly after coronary revascularization, irrespective of comorbidity burden. Higher comorbidity burden was associated with poorer physical health and disease-specific HRQoL in male patients only. Our results indicate that

Quality of Life After Coronary Artery Bypass Surgery: A Systematic Review and Meta-Analysis

“…Regarding the countries where the studies were performed, n = 3 were conducted in the USA ( n = 3) [ 14 , 15 , 16 ] and n = 5 in Sweden [ 17 , 18 , 19 , 20 , 21 ]. Of the selected studies, which were performed between 1997 and 2020, 11 involved elective surgery [ 22 , 23 , 24 , 25 ]. The 16 studies evaluated quality of life prior to surgery, coinciding with the preoperative angiography performed at the surgical hospitalisation appointment.…”

“…Physical problems improved according to the functional capacity of the patients prior to surgery [ 14 ]. Female sex [ 18 , 29 ], age, hypertension, obesity, renal failure, cerebrovascular disease, unstable angina [ 28 ], being a smoker, and having a psychiatric pathology [ 16 ] are all factors that have been shown to delay the recovery of post-surgery quality of life [ 19 , 20 , 24 ].…”

“…The studies that analysed quality of life using the SF questionnaire all showed quality improvements in both physical and mental aspects [ 14 , 15 , 16 , 22 , 23 , 24 , 25 , 26 ]. The least physical improvement was 2.2 points [ 14 ] and the most was 8.2 points [ 15 , 22 ].…”

Quality of Life After Primary Pci in Pakistani Population – Does It Really Change?

“…Literature also support these findings that QOL is better in males than females who underwent same PCI procedure. [16][17][18] Uchmanowicz et al also found that female patients scored lesser than males in all domains of SF-36. 19 It may be due to the fact that females are at greater risk recurrent angina post PCI as compared to males.…”

Assessment of utility values and QALYs after primary PCI with DP-Xience and BP-Biomatrix stents

“…Gender and age are well known predictors of QoL [ 20 ]. Female patients with CAD have more age than male counterparts and therefore experience comparatively poorer HRQOL [ 31 ]. Our study has found a significant association between utility value and gender (P = 0.042) but not with VAS value, however, the mean VAS value was more in males than females.…”