Health-Related Quality of Life of Coronary Artery Disease Patients under Secondary Prevention: A Cross-Sectional Survey from South India
HRQOL in CAD Patients Under Secondary Prevention
DOI:
https://doi.org/10.1532/hsf.3261Keywords:
Quality of life, secondary prevention, coronary artery disease, myocardial infarction, percutaneous coronary intervention, coronary artery bypass graftingAbstract
Background: Health-related quality of life (HRQOL) is emerging as an important outcome among patients with documented coronary artery disease (CAD). The primary objective of this study was to report the HRQOL of CAD patients under secondary prevention-related treatment and follow-up using the 36-Item Short Form (SF-36) tool.
Methods: This was an analytical cross-sectional survey done in a hospital/clinic setting. We recruited CAD patients 30 to 80 years old with 1 to 6 years of follow-up. Patients self-reported HRQOL using SF-36.
Results: We recruited 1206 patients, among whom 879 (72.9%) were male. The mean age of patients was 61.3 (9.6) years. Mean (± standard deviation) scores for physical functioning, role limitations due to physical health, pain, and general health were 66.48 ± 29.41, 78.96 ± 28.01, 80.96 ± 21.15, and 51.49 ± 20.19, respectively. The scores for role limitations due to emotional problems, energy/fatigue, emotional well-being, and social functioning were 76.62 ± 28.0, 66.18 ± 23.92, 76.91 ± 20.47, and 74.49 ± 23.55. In subgroup analysis, age, sex, type of CAD, and treatment showed no significant association with any of the 8 domains of QOL. In addition, hypertension and diabetes showed no significant association with the individual domains of HRQOL.
Conclusion: Patients with coronary artery disease under secondary prevention-related treatment have suboptimal HRQOL under both physical and mental domains. The role of demographic factors, comorbidities, disease subtypes, and treatment options in modifying HRQOL among patients with CAD appears to be minimal.
References
Bahall M and Khan K. Quality of life of patients with first-time AMI: A descriptive study. Health Qual Life Outcomes 2018;16:32.
Beck CA, Joseph L, Bélisle P, Pilote L; QOLAMI Investigators. Predictors of quality of life 6 months and 1 year after acute myocardial infarction. Am Heart J 2001;142:271-279.
Brown N, Melville M, Gray D, et al. Quality of life four years after acute myocardial infarction: Short Form 36 scores compared with a normal population. Heart 1999;81:352-358.
Busija L, Pausenberger E, Haines TP, Haymes S, Buchbinder R, Osborne RH. Adult measures of general health and health-related quality of life: Medical Outcomes Study Short Form 36-Item (SF-36) and Short Form 12-Item (SF-12) Health Surveys, Nottingham Health Profile (NHP), Sickness Impact Profile (SIP), Medical Outcomes Study Short Form 6D (SF-6D), Health Utilities Index Mark 3 (HUI3), Quality of Well-Being Scale (QWB), and Assessment of Quality of Life (AQoL). Arthritis Care Res (Hoboken) 2011;63(suppl 11):S383-S412.
Cohen DJ, Van Hout B, Serruys PW, et al. Quality of life after PCI with drug-eluting stents or coronary-artery bypass surgery. N Engl J Med 2011;364:1016-1026.
da Silva SA, Passos SR, Carballo MT, Figueiró M. Quality of life assessment after acute coronary syndrome: Systematic review. Arq Bras Cardiol 2011;97:526-540.
Eriksson M, Asplund K, Hochwälder J, Svedlund M. Changes in hope and health-related quality of life in couples following acute myocardial infarction: A quantitative longitudinal study. Scand J Caring Sci 2013;27:295-302.
Gijsberts CM, Agostoni P, Hoefer IE, et al. Gender differences in health-related quality of life in patients undergoing coronary angiography. Open Heart 2015;2:e000231.
Hawkes AL, Patrao TA, Ware R, Atherton JJ, Taylor CB, Oldenburg BF. Predictors of physical and mental health-related quality of life outcomes among myocardial infarction patients. BMC Cardiovasc Disord 2013;13:69.
Höfer S, Lim L, Guyatt G, Oldridge N. The MacNew Heart Disease health-related quality of life instrument: A summary. Health Qual Life Outcomes 2004;2:3.
Höfer S, Doering S, Rumpold G, Oldridge N, Benzer W. Determinants of health-related quality of life in patients with coronary artery disease. Eur J Cardiovasc Prev Rehabil 2006;13:398-406.
India State-Level Disease Burden Initiative Collaborators. Nations within a nation: Variations in epidemiological transition across the states of India, 1990-2016 in the Global Burden of Disease Study. Lancet 2017;390:2437-2460.
Lee YM, Kim RB, Lee HJ, Kim K et al. Relationships among medication adherence, lifestyle modification, and health-related quality of life in patients with acute myocardial infarction: A cross-sectional study. Health Qual Life Outcomes 2018;16:100.
Leidl R, Sintonen H, Abbühl B, Hoffmann C, von der Schulenburg J, König H. Do physicians accept quality of life and utility measurement? An Austrian, Finnish, and German survey. Eur J Health Econ 2001;2:170-175.
Lindsay GM, Hanlon P, Smith LN, Wheatley DJ. Assessment of changes in general health status using the short-form 36 questionnaire 1 year following coronary artery bypass grafting. Eur J Cardiothorac Surg 2000;18:557-564.
Lins L, Carvalho FM. SF-36 total score as a single measure of health-related quality of life: Scoping review. SAGE Open Med 2016;4:2050312116671725.
Mahesh PKB, Gunathunga MW, Jayasinghe S, Arnold SM, Haniffa R, De Silva AP. Pre-event quality of life and its influence on the post-event quality of life among patients with ST elevation and non-ST elevation myocardial infarctions of a premier province of Sri Lanka. Health Qual Life Outcomes 2017;15:154.
Manavalan M, Majumdar A, Harichandra Kumar K T, Priyamvada PS. Assessment of health-related quality of life and its determinants in patients with chronic kidney disease. Indian J Nephrol 2017;27:37-43.
Martin LM, Holmes SD, Henry LL, et al. Health-related quality of life after coronary artery bypass grafting surgery and the role of gender. Cardiovasc Revasc Med 2012;13:321-327.
Mollon L, Bhattacharjee S. Health related quality of life among myocardial infarction survivors in the United States: A propensity score matched analysis. Health Qual Life Outcomes 2017;15:235.
Norris CM, Murray JW, Triplett LS, Hegadoren KM. Gender roles in persistent sex differences in health-related quality of life outcomes of patients with coronary artery disease. Gend Med 2010;7:330-339.
Pilote L, Lauzon C, Huynh T, et al. Quality of life after acute myocardial infarction among patients treated at sites with and without on-site availability of angiography. Arch Intern Med 2002;162:553-559.
Rumsfeld JS, Magid DJ, Plomondon ME, et al. Health-related quality of life after percutaneous coronary intervention versus coronary bypass surgery in high-risk patients with medically refractory ischemia. J Am Coll Cardiol 2003;41:1732-1738.
Saleem SM. Modified Kuppuswamy scale updated for year 2018. Indian J Res 2018;7:6-7.
Schweikert B, Hunger M, Meisinger C, König HH, Gapp O, Holle R. Quality of life several years after myocardial infarction: Comparing the MONICA/KORA registry to the general population. Eur Heart J 2009;30:436-443.
Sheridan PJ, Crossman DC. Critical review of unstable angina and non-ST elevation myocardial infarction. Postgrad Med J 2002;78:717-726.
Shivaprasad C, Rakesh B, Anish K, Annie P, Amit G, Dwarakanath CS. Impairment of health-related quality of life among Indian patients with hypothyroidism. Indian J Endocr Metab 2018;22:335-338.
Simpson E, Pilote L. Quality of life after acute myocardial infarction: A comparison of diabetic versus non-diabetic acute myocardial infarction patients in Quebec acute care hospitals. Health Qual Life Outcomes 2005;3:80.
Sinha R, van den Heuvel WJ, Arokiasamy P. Validity and reliability of MOS Short Form Health Survey (SF-36) for use in India. Indian J Commun Med 2013;38:22-26.
Spertus JA, Winder JA, Dewhurst TA, Deyo RA, Prodzinski J, McDonell M,Fihn SD. Development and evaluation of the Seattle Angina Questionnaire: A new functional status measure for coronary artery disease. J Am Coll Cardiol 1995;25:333-341.
Spertus JA, Nerella R, Kettlekamp R, et al. Risk of restenosis and health status outcomes for patients undergoing percutaneous coronary intervention versus coronary artery bypass graft surgery. Circulation 2005;111:768-773.
Sudevan R, Vasudevan D, Raj M, et al. Compliance to secondary prevention strategies for coronary artery disease: a hospital-based cross-sectional survey from Ernakulam, South India. BMJ Open 2020;10:e037618.
van Domburg RT, Daemen J, Pedersen SS, et al. Short- and long- term health related quality-of-life and anginal status after randomisation to coronary stenting versus bypass surgery for the treatment of multivessel disease: Results of the Arterial Revascularisation Therapy Study (ARTS). EuroIntervention 2008;3:506-511.
Weinstein MC, Siegel JE, Gold MR, Kamlet MS, Russell LB. Recommendations of the Panel on Cost-effectiveness in Health and Medicine. JAMA 1996;276:1253-1258.
Weintraub WS, Spertus JA, Kolm P, et al. Effect of PCI on quality of life in patients with stable coronary disease. N Engl J Med 2008;359:677-687.
World Health Organization; 2017. Available at: https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds) (Accessed November 9, 2020).
Zhang Z, Mahoney EM, Stables RH, et al. Disease-specific health status after stent-assisted percutaneous coronary intervention and coronary artery bypass surgery: One-year results from the Stent or Surgery trial. Circulation 2003;108:1694-1700.
Published
How to Cite
Issue
Section
Author Disclosure & Copyright Transfer Agreement
In order to publish the original work of another person(s), The Heart Surgery Forum® must receive an acknowledgment of the Author Agreement and Copyright Transfer Statement transferring to Forum Multimedia Publishing, L.L.C., a subsidiary of Carden Jennings Publishing Co., Ltd. the exclusive rights to print and distribute the author(s) work in all media forms. Failure to check Copyright Transfer agreement box below will delay publication of the manuscript.
A current form follows:
The author(s) hereby transfer(s), assign(s), or otherwise convey(s) all copyright ownership of the manuscript submitted to Forum Multimedia Publishing, LLC (Publisher). The copyright transfer covers the exclusive rights to reproduce and distribute the article and the material contained therein throughout the world in all languages and in all media of expression now known or later developed, including but not limited to reprints, photographic reproduction, microfilm, electronic data processing (including programming, storage, and transmission to other electronic data record(s), or any other reproductions of similar nature), and translations.
However, Publisher grants back to the author(s) the following:
- The right to make and distribute copies of all or part of this work for use of the author(s) in teaching;
- The right to use, after publication in The Heart Surgery Forum, all or part of the material from this work in a book by the author(s), or in a collection of work by the author(s);
- The royalty-free right to make copies of this work for internal distribution within the institution/company that employs the author(s) subject to the provisions below for a work-made-for-hire;
- The right to use figures and tables from this work, and up to 250 words of text, for any purpose;
- The right to make oral presentations of material from this work.
Publisher reserves the right to grant or refuse permission to third parties to republish all or part of the article or translations thereof. To republish, such third parties must obtain written permission from the Publisher. (This is in accordance with the Copyright Statute, United States Code, Title 17. Exception: If all authors were bona fide officers or employees of the U.S. Government at the time the paper was prepared, the work is a “work of the US Government” (prepared by an officer or employee of the US Government as part of official duties), and therefore is not subject to US copyright; such exception should be indicated on signature lines. If this work was prepared under US Government contract or grant, the US Government may reproduce, royalty-free, all or portions of this work and may authorize others to do so, for official US Government purposes only, if the US Government contract or grant so requires.
I have participated in the conception and design of this work and in the writing of the manuscript and take public responsibility for it. Neither this manuscript nor one with substantially similar content under my authorship has been published, has been submitted for publication elsewhere, or will be submitted for publication elsewhere while under consideration by The Heart Surgery Forum, except as described in an attachment. I have reviewed this manuscript (original version) and approve its submission. If I am listed above as corresponding author, I will provide all authors with information regarding this manuscript and will obtain their approval before submitting any revision. I attest to the validity, accuracy, and legitimacy of the content of the manuscript and understand that Publisher assumes no responsibility for the validity, accuracy, and legitimacy of its content. I warrant that this manuscript is original with me and that I have full power to make this Agreement. I warrant that it contains no matter that is libelous or otherwise unlawful or that invades individual privacy or infringes any copyright or other proprietary right. I agree to indemnify and hold Publisher harmless of and from any claim made against Publisher that relates to or arises out of the publication of the manuscript and agree that this indemnification shall include payment of all costs and expenses relating to the defense of any such claim, including all reasonable attorney’s fees.
I warrant that I have no financial interest in the drugs, devices, or procedures described in the manuscript (except as disclosed in the attached statement).
I state that the institutional Human Subjects Committee and/or the Ethics Committee approved the clinical protocol reported in this manuscript for the use of experimental techniques, drugs, or devices in human subjects and appropriate informed consent documents were utilized.
Furthermore, I state that any and all animals used for experimental purposes received humane care in USDA registered facilities in compliance with the “Principles of Laboratory Animal Care” formulated by the National Society for Medical Research and the “Guide for the Care and Use of Laboratory Animals” prepared by the Institute of Laboratory Animal Resources and published by the National Institutes of Health (NIH Publication No. 85-23, revised 1985).