Dondo, T., Munyombwe, T., Hurdus, B. et al. (8 more authors) (2024) Association of baseline and changes in health-related quality of life with mortality following myocardial infarction: multicentre longitudinal linked cohort study. European Heart Journal - Quality of Care and Clinical Outcomes. qcae036. ISSN 2058-5225
Abstract
Background Health-related quality of life (HRQoL) for patients following myocardial infarction (MI) is frequently impaired. We investigated the association of baseline and changes in HRQoL with mortality following MI.
Methods and results Nationwide longitudinal study of 9474 patients admitted to 77 hospitals in England as part of the Evaluation of the Methods and Management of Acute Coronary Events study. Self-reported HRQoL was collected using EuroQol EQ-5D-3L during hospitalization and at 1, 6, and 12 months following discharge. The data was analysed using flexible parametric and multilevel survival models. Of 9474 individuals with MI, 2360 (25%) were women and 2135 (22.5%) died during the 9-year follow-up period. HRQoL improved over 12 months (baseline mean, mean increase: EQ-5D 0.76, 0.003 per month; EQ-VAS 69.0, 0.5 per month). At baseline, better HRQoL was inversely associated with mortality [Hazard ratio (HR) 0.55, 95% CI 0.47–0.63], and problems with self-care (HR 1.73, 1.56–1.92), mobility (1.65, 1.50–1.81), usual activities (1.34, 1.23–1.47), and pain/discomfort (1.34, 1.22–1.46) were associated with increased mortality. Deterioration in mobility, pain/discomfort, usual activities, and self-care over 12 months were associated with increased mortality (HR 1.43, 95% CI 1.31–1.58; 1.21, 1.11–1.32; 1.20, 1.10–1.32; 1.44, 1.30–1.59, respectively).
Conclusion After MI, poor HRQoL at baseline, its dimensions, and deterioration over time are associated with an increased risk of mortality. Measuring HRQoL in routine clinical practice after MI could identify at-risk groups for interventions to improve prognosis.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
Keywords: | Myocardial infarction, Health related quality of life, EQ-5D, Mortality, Prognosis, EMMACE, MINAP |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) > Clinical & Population Science Dept (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 09 May 2024 12:22 |
Last Modified: | 15 Apr 2025 15:57 |
Status: | Published online |
Publisher: | Oxford University Press |
Identification Number: | 10.1093/ehjqcco/qcae036 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:212337 |