TY - JOUR
T1 - Quality of life trajectories in survivors of acute myocardial infarction: a national longitudinal study
AU - Munyombwe, Theresa
AU - Hall, Marlous
AU - Dondo, Tatendashe Bernadette
AU - Alabas, Oras A.
AU - Gerard, Oliver
AU - West, Robert M.
AU - Pujades-Rodriguez, Mar
AU - Hall, Alistair
AU - Gale, Chris P.
N1 - Funding Information:
Funding This research was funded by the national institute for health research (nihr/cs/009/004) and BhF Project grant no. Pg/19/54/34511. cPg was funded by the national institute for health research (nihr/cs/009/004). TBD and Mh were funded by the British heart Foundation (Pg/13/81/30474).
Publisher Copyright:
© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/1
Y1 - 2020/1
N2 - Aim To define trajectories of perceived health-related quality of life (HRQoL) among survivors of acute myocardial infarction (AMI) and identify factors associated with trajectories. Methods Data on HRQoL among 9566 survivors of AMI were collected from 77 National Health Service hospitals in England between 1 November 2011 and 24 June 2015. Longitudinal HRQoL was collected using the EuroQol five-dimension questionnaire measured at hospitalisation, 1, 6 and 12 months post-AMI. Trajectories of perceived HRQoL post-MI were determined using multilevel regression analysis and latent class growth analysis (LCGA). Results One or more percieved health problems in mobility, self-care, usual activities, pain/discomfort and anxiety/depression was reported by 69.1% (6607/9566) at hospitalisation and 59.7% (3011/5047) at 12 months. Reduced HRQoL was associated with women (-4.07, 95% CI-4.88 to-3.25), diabetes (-2.87, 95% CI-3.87 to-1.88), previous AMI (-1.60, 95% CI-2.72 to-0.48), previous angina (-1.72, 95% CI-2.77 to-0.67), chronic renal failure (-2.96, 95% CI-5.08 to-0.84;-3.10, 95% CI-5.72 to-0.49), chronic obstructive pulmonary disease (-3.89, 95% CI-5.07 to-2.72) and cerebrovascular disease (-2.60, 95% CI-4.24 to-0.96). LCGA identified three subgroups of HRQoL which we labelled: improvers (68.1%), non-improvers (22.1%) and dis-improvers (9.8%). Non-improvers and dis-improvers were more likely to be women, non-ST-elevation myocardial infarction (NSTEMI) and have long-term health conditions, compared with improvers. Conclusions Quality of life improves for the majority of survivors of AMI but is significantly worse and more likely to decline for women, NSTEMI and those with long-term health conditions. Assessing HRQoL both in hospital and postdischarge may be important in determining which patients could benefit from tailored interventions. Trial registration NCT01808027 and NCT01819103
AB - Aim To define trajectories of perceived health-related quality of life (HRQoL) among survivors of acute myocardial infarction (AMI) and identify factors associated with trajectories. Methods Data on HRQoL among 9566 survivors of AMI were collected from 77 National Health Service hospitals in England between 1 November 2011 and 24 June 2015. Longitudinal HRQoL was collected using the EuroQol five-dimension questionnaire measured at hospitalisation, 1, 6 and 12 months post-AMI. Trajectories of perceived HRQoL post-MI were determined using multilevel regression analysis and latent class growth analysis (LCGA). Results One or more percieved health problems in mobility, self-care, usual activities, pain/discomfort and anxiety/depression was reported by 69.1% (6607/9566) at hospitalisation and 59.7% (3011/5047) at 12 months. Reduced HRQoL was associated with women (-4.07, 95% CI-4.88 to-3.25), diabetes (-2.87, 95% CI-3.87 to-1.88), previous AMI (-1.60, 95% CI-2.72 to-0.48), previous angina (-1.72, 95% CI-2.77 to-0.67), chronic renal failure (-2.96, 95% CI-5.08 to-0.84;-3.10, 95% CI-5.72 to-0.49), chronic obstructive pulmonary disease (-3.89, 95% CI-5.07 to-2.72) and cerebrovascular disease (-2.60, 95% CI-4.24 to-0.96). LCGA identified three subgroups of HRQoL which we labelled: improvers (68.1%), non-improvers (22.1%) and dis-improvers (9.8%). Non-improvers and dis-improvers were more likely to be women, non-ST-elevation myocardial infarction (NSTEMI) and have long-term health conditions, compared with improvers. Conclusions Quality of life improves for the majority of survivors of AMI but is significantly worse and more likely to decline for women, NSTEMI and those with long-term health conditions. Assessing HRQoL both in hospital and postdischarge may be important in determining which patients could benefit from tailored interventions. Trial registration NCT01808027 and NCT01819103
KW - EQ-5D
KW - Growth modelling
KW - Health-related quality-of-life
KW - Outcomes research
KW - myocardial infarction
U2 - 10.1136/heartjnl-2019-315510
DO - 10.1136/heartjnl-2019-315510
M3 - Article
SN - 1355-6037
VL - 106
SP - 33
EP - 39
JO - Heart
JF - Heart
IS - 1
ER -
