Association between illness perception and health-related quality of life in patients with preexisting premature coronary artery disease

Objectives: Illness perception in younger age differs from that in older age. We aimed to examine the association between illness perception and health-related quality of life (HRQoL) in patients with premature coronary artery disease (CAD). Methods: In a cross-sectional design, between November 2016 and September 2017, a total of 779 adults (52.5% female) with premature CAD (diagnosed in men aged <= 45 y and women aged <= 55 y) completed the Beck Depression Inventory-II, the Beck Anxiety Inventory, the Brief Illness Perception, and the Short-Form Health Survey 36 questionnaires in an outpatient clinic 8 years after the diagnosis. Results: The patients were treated with coronary artery bypass graft surgery (24.6%), percutaneous coronary intervention (39.5%), and medical treatment (35.8%). The cognitive, emotional, and comprehension aspects of illness perception had significant associations with both physical and mental health in univariable analysis (all Ps < 0.001). After adjustments for potential confounding factors, higher cognitive perception was independently associated with greater physical health [OR = 4.13, Confidence interval (CI): 3.53-4.72] and mental health (OR = 3.17, CI: 2.57-3.77). Additionally, emotional perception was also directly associated with higher physical (OR = 1.62, CI: 1.17-2.06) and mental (OR = 1.52, CI: 1.07-1.96) health; all Ps < 0.001. Conclusions: Of the 3 different aspects of illness perception, cognitive perception appeared to have the greatest influence on HRQoL, either physical or mental health. Further studies are needed to investigate whether cognitive interventions can improve HRQoL in premature CAD patients and, thus, their outcome.