Quality of life several years after myocardial infarction: comparing the MONICA/KORA registry to the general population

• Published in: European heart journal 2009-02, Vol.30 (4), p.436-443
• Main Authors: Schweikert, Bernd, Hunger, Matthias, Meisinger, Christa, König, Hans-Helmut, Gapp, Oliver, Holle, Rolf
• Format: Article
• Language: English
• Subjects: Activities of Daily Living; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Body Mass Index; Cardiology. Vascular system; Coronary heart disease; Depressive Disorder - etiology; Epidemiologic Methods; EQ-5D; Female; Germany; Health utilities; Health-related quality of life; Heart; Humans; KORA; Male; Medical sciences; Middle Aged; Myocardial infarction; Myocardial Infarction - complications; Myocardial Infarction - psychology; Myocardial Infarction - therapy; Myocardial Reperfusion - methods; Myocarditis. Cardiomyopathies; Pain - etiology; Quality of Life; Registries; Surveys and Questionnaires; Survivors
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1093/eurheartj/ehn509

Aims The aim of this study was to assess the impact of myocardial infarction (MI) on health-related quality of life (HRQL) in MI survivors measured by EuroQol (EQ-5D) and to compare it with the general population. Methods and results A follow-up study of all MI survivors included in the MONICA/KORA registry was performed. About 2950 (67.1%) patients responded. Moderate or severe problems were most frequent in EQ-5D dimension pain/discomfort (55.0%), anxiety/depression (29.2%), and mobility (27.9%). Mean EQ VAS score was 65.8 (SD 18.5). Main predictors of lower HRQL included older age, diabetes, increasing body mass index, current smoking, and experience of re-infarction. Type of revascularizational treatment showed no impact on HRQL. Compared with the general population, adjusted EQ VAS was 6.2 (95% confidence interval 3.4–8.9) points lower in 45-year-old MI patients converging with growing age up to the age of 80. With regard to HRQL dimensions, MI survivors had a significantly higher risk of incurring problems in the dimension pain/discomfort, usual activities, and especially in anxiety/depression which was more pronounced in younger age. Mobility was the single dimension, in which MI showed an inverse effect. Conclusion MI is combined with significant reduction in HRQL compared with the general population. The main impairments occur in the dimension pain/discomfort, usual activities, and particularly anxiety/depression. The relative impairment decreases with higher ages.