Quality of life in patients with ischaemic heart disease: a prospective controlled study

Abstract

Abstract. Westin L, Carlsson R, Israelsson B, Willenheimer R, Cline C, McNeil TF (University of Lund, University Hospital, Malmö, Sweden). Quality of life in patients with ischaemic heart disease: a prospective controlled study. J Intern Med 1997; 242: 239-47.Objectives. To assess quality of life in patients after acute myocardial infarction (AMI), coronary artery by-pass grafting surgery (CABG) and percutaneous transluminal coronary angioplasty (PTCA) as compared with healthy controls. Design. Self-administered questionnaires were completed 1 month and 1 year after the event. Setting. Department of Cardiology, University Hospital, Malmö, Sweden; 1989. Subjects. 296 AMI, 99 CABG, 18 PTCA patients and 88 randomly selected healthy controls were included; 349 patients completed the entire programme. Main outcome measures. Quality of life in the dimensions of perceived general health, thoracic pain, breathlessness, feeling of arrhythmia, anxiety, depression, self-esteem, experience of social life and sex life.Results. Patients differed from controls in both psychological and somatic aspects of QL after 1 month. Furthermore, 1 month after the event AMI patients experienced more anxiety (P ϭ 0.001) than CABG patients, whilst CABG patients experienced a poorer sex life (P Ͻ 0.001) than AMI patients. One year after the event patients differed from controls primarily in somatic symptoms; no significant differences were found across patient groups. Patients who sought emergency out-patient care during the follow-up year for clinically diagnosed angina pectoris or cardiac incompensation had reported higher levels of thoracic pain (P Ͻ 0.001) and breathlessness (P Ͻ 0.001) at 1 month follow-up than patients who did not seek such care. Conclusions. Quality of life is considerably affected in patients following a cardiac event, especially during the initial recovery phase. Although substantial improvement in quality of life occurs over time, the persistence of residual distress at 1-year follow-up is a challenge for clinicians concerned with the full rehabilitation of the cardiac patient.

Health-related quality of life in patients after the acute myocardial infarction

“…The overall quality of life (QL) comprises all factors which influence on someones health and health-related quality of life (HRQL) comprises only those factors which are the part of someone's health [3,4]. AMI has negative consequences on the HRQL of the patients and that leads to the lowering of their HRQL even several years after the AMI [6][7][8][9].During the first month after the AMI patients are very vulnerabile physically, mentally and emotionally [10]. According to the results of investigations it was determined that HRQL among the patients was disordered and lower and the main reason for that was the presence of the chest pain or discomfort and the lowering of the overall physical function [11][12][13].…”

“…AMI has negative consequences on the HRQL of the patients and that leads to the lowering of their HRQL even several years after the AMI [6][7][8][9].…”

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.…”

Improving Quality of Life for Patients with Angina Pectoris

“…[8,[65][66][67][68] Despite this recognition, inequality of care is currently received by patients with coronary heart disease in different social classes and different geographical areas. [2] The gap between rich and poor in respect to levels of heart disease is widening.…”