How gender-specific are predictors of post-MI HRQoL? A longitudinal study

Abstract

Purpose: Extant research shows that health-related quality of life (HRQoL) differs between female and male survivors of myocardial infarction (MI), but the reasons for this are not fully understood. We aimed to examine the predictors of HRQoL in female and male survivors during the first year after MI. Methods: At timepoints 1 and 2, the sample comprised 222 MI survivors (59 women and 163 men; mean age 53.84 years, range 24–65) referred for in-patient cardiac rehabilitation. This number dropped to 140 participants (42 women and 98 men) at the third timepoint, approximately one year after the MI. We examined the gender differences in various predictors of physical and mental HRQoL: demographic factors (e.g., age, education, marital status), disease-related factors (pre- and post-MI), personality and coping with stress. Results: Initially, both physical and mental HRQoL were lower in women than men, but the differences disappeared at timepoint 3. Stepwise regressions performed separately for men and women revealed that the factors shaping HRQoL were different in both genders; they also changed over time. Substantially fewer factors predicted physical HRQoL in women than in men. Trait anxiety seems to play a similarly negative role in both genders. Conclusions: The psychosocial resources that influence HRQoL were different for women and men. There were also differences concerning predictors of HRQoL dimensions. Further studies with a different or broader range of predictors are needed, especially among women.

The Association of Marital/Partner Status with Patient-Reported Health Outcomes Following Acute Myocardial Infarction or Stroke: Protocol for a Systematic Review and Meta-analysis

“…The results of these studies are inconsistent. For example, three studies found that marital status was associated with quality of life among those who had an AMI or stroke, (13,14,16) This systematic review will face several challenges. First, although studies with proxy responses are eligible for inclusion in the review, patients who have specific stroke-related deficits such as aphasia or cognitive impairments may be excluded from some studies according to their prespecified criteria, introducing potential bias.…”

“…The results of these studies are inconsistent. For example, three studies found that marital status was associated with quality of life among those who had an AMI or stroke,(13,14,16) but another found no association. (15) By systematically reviewing the literature and assessing the available evidence, we aim to clarify and quantify the association of marital/partner status with patient-centered outcomes measured using PROMs and explore differences by sex.…”

“…(12) Prior studies assessed patient-reported health status outcomes among AMI and stroke patients using different PROMs, but the results regarding the association between marital/partner status and outcomes are inconsistent. (13)(14)(15)(16) No systematic review investigates and synthesizes the association of marital/partner status with PROMs among individuals who have had an AMI or stroke. Further, although women may not benefit from marriage to the same extent as men regarding outcomes such as mortality and major adverse cardiac events, (2,17,18) less is known about whether there are sex differences in the degree of "protection" conferred by marriage or partnership during AMI and stroke recovery as assessed with PROMs.…”