Health‐Related Quality of Life in Patients 7 Months After a Myocardial Infarction: Factors Affecting the Short Form‐12

Abstract

We assessed patients' health-related quality of life after myocardial infarction and identified related variables. Clinical data were obtained retrospectively from medical records of consecutive patients admitted to a Midwestern university-affiliated medical center with diagnosis of myocardial infarction from July 1999-July 2000. Telephone interviews 7 months after discharge were made to administer the Short Form-12 (SF-12) and obtain patient, disease, drug, and intervention data. Complete information was obtained from 200 patients (mean age 63.4 +/- 13.1 yrs, 68% men). The mean Physical Component Summary (PCS)-12 score was 40.6 +/- 12.0, and the mean Mental Component Summary (MCS)-12 score was 52.1 +/- 10.0. Based on univariate analyses, low PCS-12 scores were associated with women; non-Q-wave infarctions; greater number of illnesses; history of myocardial infarction, chronic heart failure (CHF), transient ischemic attack (TIA), renal disease, peripheral vascular disease, or percutaneous coronary intervention (PCI); rehospitalization during the interim period; and unscheduled PCI since index myocardial infarction. Low MCS-12 scores were associated with age below 65 years, low overall self-reported drug therapy compliance, low self-reported compliance with angiotensin-converting enzyme inhibitor and lipid-lowering therapy, no history of coronary artery bypass graft, and no stress test since index myocardial infarction. A multivariate regression model for PCS-12 kept the following variables: greater number of illnesses, history of CHF or TIA, and rehospitalization since index myocardial infarction. The MCS-12 model contained age below 65 years, low overall compliance, and low compliance with lipid-lowering therapy. Further work is necessary to determine noncardiovascular predictors of quality of life and whether interventions for these patients will result in improved quality of life.

Health Related Quality of Life in Coronary Patients

“…Also, studying the factors related to HRQL at 6 months, the same authors observed that depression, assessed by the 28-item General Health Questionnaire, a previous history of Coronary Heart Disease (CHD), or the associated comorbidity had a negative effect on quality of life, with a worse clinical course in these patients when compared with those without these conditions. This results are in agreement with Ormel et al (Ormel et al, 2007) and Höfer et al (Höfer et al, 2005) who found that depression and anxiety are the most significant factors influencing HRQL in patients with heart disease, and with McBurney et al (McBurney et al, 2002), who observed that the presence of other illnesses had a negative effect on the PCS-12 seven months after an AMI, and that having more comorbidity tends to lower HRQL in all dimensions.…”

Understanding sex differences in health-related quality of life following myocardial infarction

“…Several studies have demonstrated poorer HRQoL in women than men [1,[9][10][11][12][13][14][15], while others have not [16][17][18][19][20][21][22][23].…”

“…Age, time since the MI, symptoms and manifestations of CAD, comorbidity, depression, and baseline HRQoL have all been reported to affect HRQoL after MI [10,19,20,22,[24][25][26]. However, whether the different determinants operate equally in both men and women has not been established.…”

Association Between the Use of 4 Recommended Drug Categories and Patient Perceptions of Health Status Following an ACS Event

“…3 Studies of patients with myocardial infarction have measured the effect of illness and interventions on HRQL. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Many of these studies are conducted in the context of controlled clinical trials assessing the effectiveness of an intervention. In health services research, in which the focus of measurement is typically the process of care, ongoing measurement of patient-reported health status provides a way to move from measuring process outcomes to improving care for groups and individual patients.…”

“…The influence of the residual effects of acute myocardial ischemic events on patients' functional and health status has been the focus of many research studies over the past several decades. [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] These studies have identified many patient, disease, and treatment characteristics associated with health status or HRQOL, including the type of ACS event. The present analysis was not able to control for the type of ACS event because of inconsistent documentation in the ACS registry, the source of data for this project.…”