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Quality of life after myocardial infarction: more PROgress needed
  1. Jacob A Doll
  1. Division of Cardiology, University of Washington, Seattle, WA 98195-6422, USA
  1. Correspondence to Dr Jacob A Doll, Division of Cardiology, University of Washington, Seattle, WA 98195-6422, USA; Jdoll{at}uw.edu

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The past several decades have seen a marked improvement in outcomes for patients with myocardial infarction (MI). New drug and device discovery, coupled with high-quality randomised trials, have provided clinicians with an armamentarium of evidence-based treatments for MI. MI care is also the focus of numerous regional and national quality improvement efforts, and MI care processes and outcomes are commonly used as measures of overall hospital quality. As a result, treating a patients with MI has become structured and protocoled in many hospitals. Patients with MI receive a common package of interventions and medications and have generally benefited with improved survival and avoidance of recurrent ischaemic events.1

Despite this success, MI remains a feared diagnosis for patients that can have long-term implications for health and quality of life (QOL). Available treatments for MI, and the clinical trials that bring them to market, are primarily focused on reduction of cardiovascular mortality, MI and stroke. The impact of MI on patient-reported outcomes (PROs) such as angina and QOL is often not assessed in trials or examined only in secondary analyses. Interventions specifically targeted to improve QOL, such as cardiac rehabilitation, are underused. To address this lack of focus on PROs, clinicians and researchers have developed a variety of measures to quantity symptom burden and QOL, some designed specifically for patients with cardiovascular disease. Instruments …

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