4.7 Article

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

Journal

EUROPEAN HEART JOURNAL
Volume 30, Issue 4, Pages 436-443

Publisher

OXFORD UNIV PRESS
DOI: 10.1093/eurheartj/ehn509

Keywords

Health-related quality of life; EQ-5D; Myocardial infarction; KORA; Health utilities; Germany

Funding

  1. Helmholtz Zentrum Munchen-German Research Center for Environmental Health
  2. German Federal Ministry of Education, Science, Research, and Technology
  3. German Federal Ministry of Health

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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. 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. 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.

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