Health related quality of life in coronary patients and its association with their cardiovascular risk profile: Results from the EUROASPIRE III survey
Introduction
Cardiovascular disease (CVD) remains the most common cause of disease burden in Europe, with coronary heart disease (CHD) being the single most important cause of death [1]. Conventional treatment focuses mainly on functional outcomes, survival and extending life. However, morbidity and mortality rates are incomplete measures of outcome, since they do not reflect all aspects of health. Many patients consider the quality of the additional life years gained equally important as the length of life. Indeed, the goal of today's medicine should be to increase both patients' quantity and quality of life [2]. In response, assessment of health-related quality of life (HRQoL) has been increasingly integrated in daily clinical practice. HRQoL is a subjective measure of overall well-being and reflects how a disease and its symptoms are perceived by a patient. Although there is no universal agreement on what constitutes HRQoL, current assessment focuses on the domains of social functioning, physical functioning and psychological functioning [3].
CHD patients are known to have an impaired HRQoL [4]. Recent studies have shown a significant influence of HRQoL on long-term outcomes. Poor HRQoL has been shown to predict morbidity and mortality in patients with CHD, even when controlling for standard risk factors [5], [6], [7].
The aim of our study was to examine the relationship between the cardiovascular profile of coronary patients and their HRQoL. Data were derived from the EUROASPIRE III (European Action on Secondary and Primary Prevention by Intervention to Reduce Events) survey wherein two commonly used instruments were employed to assess patient's HRQoL: the EQ-5D (EuroQol-5D) and the SF-12v2 (12-item short-form health survey).
Section snippets
Study population and data collection
The details of the EUROASPIRE III study have been reported elsewhere [8]. In brief, EUROASPIRE III, performed in 2006–07 in patients with established CHD, was a cross-sectional study to determine whether the European recommendations on CVD prevention were being followed in everyday clinical practice. Patients aged between 18 and 80 years, hospitalized for coronary artery bypass graft (CABG), percutaneous coronary intervention (PCI), acute myocardial infarction (AMI) or myocardial ischemia,
Results
HRQoL data (full information on at least 1 HRQoL instrument) were available for 8734 patients (Table 1). About three quarters (74.6%) of patients included in our analyses were males (n = 6516). The average age of patients was 63.2 years (SD = 9.5). About 60% of patients included, had a cardiac revascularization as recruiting diagnosis, 19.5% was diagnosed with AMI.
The overall mean PCS-12 and MCS-12 were 42.14 (SD = 10.15) and 49.15 (SD = 10.22) respectively. For the EQ-VAS a mean value of 66.42 (SD =
Discussion
In this study, including 8734 stabilized CHD patients from 22 European countries, we aimed to analyze the association between HRQoL and patient characteristics. As expected the overall HRQoL scores in our cohort of CHD patients were lower compared to the general population [13] and similar to previously reported results [4]. Furthermore, consistent with previous research and compared to the general population, having CHD seemed to have a limited influence on the mental health status, in
Acknowledgment
We thank the administrative staff, physicians, nurses, and other personnel at the hospitals in which the study was carried out, and all the patients who participated in the EUROASPIRE studies.
The EUROASPIRE survey was supported with the aid of unrestricted educational grants, which were given to the European Society of Cardiology by the following companies: main sponsors: AstraZeneca, Bristol-Myers Squibb, GlaxoSmithKline, Pfizer, Sanofi-Aventis, and Servier; sponsors: Merck/Schering-Plough and
References (46)
- et al.
Assessment of quality of life in patients with cardiac disease: the role of psychosomatic medicine
J Psychosom Res
(Apr 2000) - et al.
Validity and reliability of three commonly used quality of life measures in a large European population of coronary heart disease patients
Int J Cardiol
(2013) - et al.
Health-related quality of life after interventional or conservative strategy in patients with unstable angina or non-ST-segment elevation myocardial infarction: one-year results of the third Randomized Intervention Trial of unstable Angina (RITA-3)
J Am Coll Cardiol
(Jan 18 2005) - et al.
Cost-utility analysis of eprosartan compared to enalapril in primary prevention and nitrendipine in secondary prevention in Europe—the HEALTH model
Value Health
(Sep 2009) - et al.
Smoking and health outcomes after percutaneous coronary intervention
Am Heart J
(Apr 2003) - et al.
Smoking cessation has no influence on quality of life in patients with peripheral arterial disease 5 years post-vascular surgery
Eur J Vasc Endovasc Surg
(Sep 2010) - et al.
Determinants for an impaired quality of life 10 years after coronary artery bypass surgery
Int J Cardiol
(Feb 28 2005) - et al.
Clustering of cardiovascular disease risk factors and health-related quality of life among US adults
Value Health
(Jul 2008) - et al.
European cardiovascular disease statistics
(2008) - et al.
The Euro Cardio-QoL Project. An international study to develop a core heart disease health-related quality of life questionnaire, the HeartQoL
Eur J Cardiovasc Prev Rehabil
(Apr 2005)
Patient-reported health status in coronary heart disease in the United States: age, sex, racial, and ethnic differences
Circulation
Health-related quality of life as a predictor of mortality following coronary artery bypass graft surgery. Participants of the Department of Veterans Affairs Cooperative Study Group on Processes, Structures, and Outcomes of Care in Cardiac Surgery
JAMA
Self-rated health status as a risk factor for future vascular events and mortality in patients with symptomatic and asymptomatic atherosclerotic disease: the SMART study
J Intern Med
Health status predicts long-term outcome in outpatients with coronary disease
Circulation
EUROASPIRE III: a survey on the lifestyle, risk factors and use of cardioprotective drug therapies in coronary patients from 22 European countries
Eur J Cardiovasc Prev Rehabil
European guidelines on cardiovascular disease prevention in clinical practice. Third joint task force of European and other societies on cardiovascular disease prevention in clinical practice
Eur Heart J
How to score version 2 of the SF-12 health survey (with a supplement documenting version 1)
Comparing the SF-12 and SF-36 health status questionnaires in patients with and without obesity
Health Qual Life Outcomes
Comparison of population health status in six European countries: results of a representative survey using the EQ-5D questionnaire
Med Care
Measuring self-reported population health: an international perspective based on EQ-5D
Reduced quality of life after myocardial infarction in women compared with men
Clin Cardiol
Health-related quality of life in women and men one year after acute myocardial infarction
Qual Life Res
Gender differences and determinants of health related quality of life in coronary patients: a follow-up study
BMC Cardiovasc Disord
Cited by (90)
Gender differences in health-related quality of life and psychological distress among coronary patients: Does comorbidity matter? Results from the ESC EORP EUROASPIRE V registry
2023, International Journal of CardiologyCitation Excerpt :Another strength is its large sample size. Indeed, the EUROASPIRE V study is one of the largest surveys across Europe investigating HRQoL and psychological distress in a coronary population [38]. Therefore, we believe that the EUROASPIRE V survey provides reliable information on gender differences in HRQoL in relation with comorbidity burden among European coronary patients.
Impact of the Educational Level on Non-Fatal Health Outcomes following Myocardial Infarction
2022, Current Problems in CardiologyImpacts of gestational diabetes on quality of life in Chinese pregnant women in urban Tianjin, China
2020, Primary Care DiabetesCitation Excerpt :Indeed, the QoL measure has been used widely in outcomes research. Many chronic diseases such as diabetes [12], stroke [13], cardiovascular diseases [14] and cancer [15] were reported to substantially reduce QoL. On the other hand, a few studies have evaluated associations of GDM with QoL and its domains during pregnancy, with inconclusive findings.
Anaesthesia geriatric evaluation to guide patient selection for preoperative multidisciplinary team care in cardiac surgery
2020, British Journal of Anaesthesia
- 1
This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.