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Kontoangelos K, Soulis D, Soulaidopoulos S, Antoniou CK, Tsiori S, Papageorgiou C, Martinaki S, Mourikis I, Tsioufis K, Papageorgiou C, Katsi V. Health Related Quality of Life and Cardiovascular Risk Factors. Behav Med 2024; 50:186-194. [PMID: 37224009 DOI: 10.1080/08964289.2023.2202847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 04/10/2023] [Accepted: 04/10/2023] [Indexed: 05/26/2023]
Abstract
Cardiovascular diseases (CVD) is associated with deteriorating of quality of life (QOL) and exercise capacity (EC) but less is known on how EC interplays with QOL. The present study explores the relationship between quality of life and cardiovascular risk factors in people who present in cardiology clinics. A total of 153 adult presentations completed the SF-36 Health Survey and provided data for hypertension, diabetes mellitus, smoking, obesity, hyperlipidemia and history of coronary heart disease. Physical capacity was assessed by treadmill test. were correlated with the scores of the psychometric questionnaires. Participants with longer duration on treadmill exercise score higher on the scale of physical functioning. The study found that treadmill exercise intensity and duration were associated with improved scores in dimensions of the physical component summary and the physical functioning of SF-36, respectively. The presence of cardiovascular risk factors is related to a decreased quality of life. Patients with cardiovascular diseases should undergo particularly detailed analysis of the quality of life along with specific mental factors such as depersonalization and posttraumatic stress disorder.
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Affiliation(s)
- Konstantinos Kontoangelos
- 1st Department of Psychiatry, Eginition Hospital, Medical School National & Kapodistrian University of Athens, Athens, Greece
- University Mental Health Neurosciences and Precision Medicine Research Institute "Costas Stefanis", Athens, Greece
| | - Dimitris Soulis
- 1st Department of Cardiology, "Hippokration" Hospital, Medical School, National & Kapodistrian University of Athens, Athens, Greece
| | - Stergios Soulaidopoulos
- 1st Department of Cardiology, "Hippokration" Hospital, Medical School, National & Kapodistrian University of Athens, Athens, Greece
| | - Christos Konstantinos Antoniou
- 1st Department of Cardiology, "Hippokration" Hospital, Medical School, National & Kapodistrian University of Athens, Athens, Greece
| | - Sofia Tsiori
- 1st Department of Psychiatry, Eginition Hospital, Medical School National & Kapodistrian University of Athens, Athens, Greece
| | - Christos Papageorgiou
- University Mental Health Neurosciences and Precision Medicine Research Institute "Costas Stefanis", Athens, Greece
| | - Sofia Martinaki
- 1st Department of Psychiatry, Eginition Hospital, Medical School National & Kapodistrian University of Athens, Athens, Greece
| | - Iraklis Mourikis
- 1st Department of Psychiatry, Eginition Hospital, Medical School National & Kapodistrian University of Athens, Athens, Greece
| | - Konstantinos Tsioufis
- 1st Department of Cardiology, "Hippokration" Hospital, Medical School, National & Kapodistrian University of Athens, Athens, Greece
| | - Charalabos Papageorgiou
- University Mental Health Neurosciences and Precision Medicine Research Institute "Costas Stefanis", Athens, Greece
| | - Vasiliki Katsi
- 1st Department of Cardiology, "Hippokration" Hospital, Medical School, National & Kapodistrian University of Athens, Athens, Greece
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Lanini LLS, Euler S, Zuccarella-Hackl C, Fuentes Artiles R, Niederseer D, Auschra B, von Känel R, Jellestad L. Differential associations of sex and age with changes in HRQoL during outpatient cardiac rehabilitation. J Patient Rep Outcomes 2024; 8:11. [PMID: 38261156 PMCID: PMC10805744 DOI: 10.1186/s41687-024-00688-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 01/16/2024] [Indexed: 01/24/2024] Open
Abstract
INTRODUCTION Cardiovascular diseases (CVD) represent the world's leading cause of death. Health-related quality of life (HRQoL) is a widely applied concept of patients' perceived health and is directly linked to CVD morbidity, mortality, and re-hospitalization rates. Cardiac rehabilitation (CR) improves both cardiovascular outcomes and HRQoL. Regrettably, CR is still underutilized, especially in subgroups like women and elderly patients. The aim of our study was to investigate the predictive potential of sex and age on change of HRQoL throughout outpatient CR. METHODS 497 patients of outpatient CR were retrospectively assessed from August 2015 to September 2019 at the University Hospital Zurich. A final sample of 153 individuals with full HRQoL data both at CR entry and discharge was analyzed. HRQoL was measured using the 36-Item Short Form Survey (SF-36) with its physical (PCS) and mental (MCS) component scale. In two-factorial analyses of variance, we analyzed sex- and age-specific changes in HRQoL scores throughout CR, adjusting for psychosocial and clinical characteristics. Age was grouped into participants over and under the age of 65. RESULTS In both sexes, mean scores of physical HRQoL improved significantly during CR (p <.001), while mean scores of mental HRQoL improved significantly in men only (p =.003). Women under the age of 65 had significantly greater physical HRQoL improvements throughout CR, compared with men under 65 (p =.043) and women over 65 years of age (p =.014). Sex and age did not predict changes in mental HRQoL throughout CR. CONCLUSIONS Younger women in particular benefit from CR with regard to their physical HRQoL. Among older participants, women report equal improvements of physical HRQoL than men. Our results indicate that sex- and age-related aspects of HRQoL outcomes should be considered in CR.
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Affiliation(s)
- Lorenza L S Lanini
- Faculty of Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
| | - Sebastian Euler
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Claudia Zuccarella-Hackl
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - David Niederseer
- Department of Cardiology, University Heart Center, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Bianca Auschra
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Lena Jellestad
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Radley A, Lees JS, Stevens KI. Cardiovascular disease in older women with CKD. Clin Kidney J 2023; 16:2304-2308. [PMID: 38046012 PMCID: PMC10689181 DOI: 10.1093/ckj/sfad235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Indexed: 12/05/2023] Open
Affiliation(s)
- Alice Radley
- Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, UK
| | - Jennifer S Lees
- Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, UK
| | - Kate I Stevens
- Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, UK
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Lima Dos Santos CC, Matharoo AS, Pinzón Cueva E, Amin U, Perez Ramos AA, Mann NK, Maheen S, Butchireddy J, Falki VB, Itrat A, Rajkumar N, Zia Ul Haq M. The Influence of Sex, Age, and Race on Coronary Artery Disease: A Narrative Review. Cureus 2023; 15:e47799. [PMID: 38021526 PMCID: PMC10676710 DOI: 10.7759/cureus.47799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2023] [Indexed: 12/01/2023] Open
Abstract
Cardiovascular disease has remained one of the leading causes of mortality in the world. The basic pathophysiology of coronary artery disease (CAD) is a reduction of the blood flow in coronary vessels, leading to restricted blood flow to the heart muscle. Both modifiable and non-modifiable risk factors contribute to its multifactorial etiology. The clinical presentation ranges from asymptomatic to typical symptoms like chest pain, shortness of breath, and left arm or jaw pain. The purpose of this review is to investigate and analyze the variation of CAD depending on the biological sex, age, race, or ethnicity and how it might differ in the studied population while comparing the symptoms and prognosis of CAD. For this research, PubMed's database was used. A total of 926 articles were selected using pre-determined inclusion and exclusion criteria, with 74 articles eligible to be included in the narrative review. Studies were selected from the general population of patients with CAD, regardless of their severity, stage of diagnosis, and treatment plan. The scale for the assessment of non-systematic review articles (SANRA) was used to assess the quality of the study. As humans age, the incidence of CAD increases, and people over 75 are more likely to have multiple-vessel CAD. It has been observed that South Asians have the highest rate of CAD at 24%, while the White population has the lowest at 8%. The prevalence of CAD also depends on race, with the White population having the lowest rate at 3.2%, followed by Hispanics at 5%, Black women at 5.2%, and Black men at 5.7%. Younger Black women tend to have more chest pain. Men with CAD commonly experience chest pain, and women are more likely to present with atypical symptoms. Modifiable risk factors such as smoking and alcoholism are more commonly observed in young men than in young women. Coronary artery disease in the elderly, female, minority, and Black patients is associated with a higher mortality rate. Acknowledging the prevalence of certain risk factors, signs, results, and responses to treatment in certain socio-demographic groups, as well as the provision and accessibility of diagnosis and treatment, would lead to a better outcome for all individuals. The impact of this shift can range from an earlier diagnosis of CAD to a faster and more customized treatment plan tailored to each patient's individual requirements.
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Affiliation(s)
| | | | | | - Uzma Amin
- Pathology, Rawalpindi Medical University, Rawalpindi, PAK
| | | | - Navpreet K Mann
- Cardiology, Government Medical College and Rajindra Hospital, Patiala, IND
| | - Sara Maheen
- General Medicine, Odessa National Medical University, Odessa, UKR
| | - Jyothsna Butchireddy
- Cardiology, Government Medical College, Omandurar Government Estate, Chennai, IND
| | | | - Abeeha Itrat
- Cardiology, Lutheran General Hospital, Illinois, USA
| | | | - Muhammad Zia Ul Haq
- Epidemiology and Public Health, Emory University Rollins School of Public Health, Atlanta, USA
- Noncommunicable Diseases and Mental Health, World Health Organization, Cairo, EGY
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Ranasinghe S, Merz CNB, Khan N, Wei J, George M, Berry C, Chieffo A, Camici PG, Crea F, Kaski JC, Marzilli M, Gulati M. Sex Differences in Quality of Life in Patients with Ischemia with No Obstructive Coronary Artery Disease (INOCA): A Patient Self-Report Retrospective Survey from INOCA International. J Clin Med 2023; 12:5646. [PMID: 37685713 PMCID: PMC10488627 DOI: 10.3390/jcm12175646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 08/17/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
Women with obstructive coronary artery disease (CAD) have a relatively lower quality of life (QoL) compared to men, but our understanding of sex differences in QoL in ischemia with no obstructive coronary artery disease (INOCA) is limited. We conducted a survey of patient members of INOCA International with an assessment of self-reported health measures. Functional capacity was retrospectively estimated using the Duke Activity Status Index (DASI), assessing levels of activities performed before and after INOCA symptom onset. Of the 1579 patient members, the overall survey completion rate was 21%. Women represented 91% of the respondents. Estimated functional capacity, expressed as metabolic equivalents (METs), was higher before compared to after INOCA diagnosis comparably for both women and men. For every one MET decline in functional capacity, there was a significantly greater decline in QoL for men compared with women in physical health (4.0 ± 1.1 vs. 2.9 ± 0.3 days/month, p < 0.001), mental health (2.4 ± 1.2 vs. 1.8 ± 0.3 days/month, p = 0.001), and social health/recreational activities (4.1 ± 1.0 vs. 2.9 ± 0.3 days/month, p = 0.0001), respectively. In an international survey of patients living with INOCA, despite similar diagnoses, clinical comorbidities, and symptoms, INOCA-related functional capacity declines are associated with a greater adverse impact on QoL in men compared to women.
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Affiliation(s)
- Sachini Ranasinghe
- Barbra Streisand Women’s Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - C. Noel Bairey Merz
- Barbra Streisand Women’s Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | - Najah Khan
- Houston Methodist Hospital, Houston, TX 77030, USA
| | - Janet Wei
- Barbra Streisand Women’s Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
| | | | - Colin Berry
- British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow G12 8QQ, UK
| | - Alaide Chieffo
- IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy
- Department of Medicine, Vita Salute San Raffaele University, 20132 Milan, Italy
| | | | - Filippo Crea
- Department of Cardiology, Catholic University of the Sacred Heart, 00168 Rome, Italy
| | - Juan Carlos Kaski
- Molecular and Clinical Sciences Research Institute, St. George’s University of London, London SW17 0RE, UK
| | - Mario Marzilli
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine-Cardiology Division, University of Pisa, 56126 Pisa, Italy
| | - Martha Gulati
- Barbra Streisand Women’s Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA 90048, USA
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Mutagaywa RK, Cramer MJ, Chillo P, Khamis RH, Boniface R, Muhozya A, Barongo A, Byomuganyizi M, Kwesigabo G, Kamuhabwa A, Nyangasa B, Kisenge P, Chamuleau S. Health related quality of life of patients following mechanical valve replacement surgery for rheumatic mitral stenosis in Tanzania. J Cardiothorac Surg 2023; 18:159. [PMID: 37085912 PMCID: PMC10122295 DOI: 10.1186/s13019-023-02235-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 04/02/2023] [Indexed: 04/23/2023] Open
Abstract
BACKGROUND The assessment of outcomes of interventions based on the patient's perspective using patient-reported outcome measures (PROMs) has been increasingly highlighted in clinical practice. However, health related quality of life (HRQoL), one of the common constructs measured by PROMs remain unknown among patients after heart valve replacement (HVR) in Tanzania. OBJECTIVES To assess the HRQoL amongst patients operated on for rheumatic mitral stenosis at Jakaya Kikwete Cardiac Institute (JKCI). METHODS A prospective study of patients operated on due to rheumatic mitral stenosis at JKCI from January 2020 to April 2021 was undertaken. The HRQoL was assessed by using the MacNew questionnaire, addressing three domains (physical, emotional, and social function); the score ranges from 0 to 7. We categorized HRQoL as low (mean score ≤ 4.9), moderate (5-6) and high (> 6). We analysed several sociodemographic and clinical variables for HRQoL. RESULTS Out of 54 patients, there were 34 females and 20 males. Their mean (± SD) age was 37.98 (± 12.58) years. The reliability of translated Kiswahili version of MacNew was good. The mean (± SD) global scores were 3.47 ± 0.59, 4.88 ± 0.71 and 6.14 ± 0.50 preoperatively, at 3 months and 6 months respectively (p-values < 0.001 preoperatively vs. 3 months, preoperatively vs. 6 months and at 3 months vs. 6 months). The median of individual mean difference HRQoL score pre-operatively and at 6 months was 2.67. The preoperative and 6 months mean difference HRQoL scores were higher among patients with vs. without atrial fibrillation (2.95 ± 0.59 vs. 2.45 ± 0.53, p = 0.003) and those on anticoagulants (preoperatively) vs. not on anticoagulants (3.14 ± 0.58 vs. 2.57 ± 0.57, 0.009). The mean difference HRQoL scores were similar for sociodemographic and other clinical parameters, including those with stroke vs. without stroke. CONCLUSION Six months after HVR the overall MacNew HRQoL scores improved markedly. This improvement in HRQoL was regardless of the presence of comorbidities (e.g. stroke and atrial fibrillation) which underscores the importance of considering valvular surgery if they fit the criteria. Clinicians and researchers in low-resource settings should collaborate to promote the utilization of PROMs in the routine care of patients.
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Affiliation(s)
- Reuben K Mutagaywa
- School of Medicine, Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, P.O. BOX 5539, Dar es Salaam, Tanzania.
- Muhimbili Orthopaedic Institute, Dar es Salaam, Tanzania.
- Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania.
- Division of Heart and Lung, Department of Cardiology, University Medical Centre Utrecht, Utrecht, Netherlands.
| | - Maarten J Cramer
- Division of Heart and Lung, Department of Cardiology, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Pilly Chillo
- School of Medicine, Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, P.O. BOX 5539, Dar es Salaam, Tanzania
- Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Ramadhan H Khamis
- School of Medicine, Department of Surgery (Cardiothoracic& vascular section), Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Anjela Muhozya
- Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Aileen Barongo
- Department of Paediatrics, Mwananyamala Regional Referral Hospital, Dar es Salaam, Tanzania
| | - Moses Byomuganyizi
- School of Medicine, Department of Surgery (Cardiothoracic& vascular section), Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Gideon Kwesigabo
- School of Public Health, Department of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Appolinary Kamuhabwa
- School of Pharmacy, Department of Pharmacology and Clinical Pharmacy and Pharmacology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | | | - Peter Kisenge
- Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania
| | - Steven Chamuleau
- Heart Center, Department of Cardiology and Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centre, Amsterdam, Netherlands
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Dondo TB, Munyombwe T, Hall M, Hurdus B, Soloveva A, Oliver G, Aktaa S, West RM, Hall AS, Gale CP. Sex differences in health-related quality of life trajectories following myocardial infarction: national longitudinal cohort study. BMJ Open 2022; 12:e062508. [PMID: 36351712 PMCID: PMC9644325 DOI: 10.1136/bmjopen-2022-062508] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES To investigate sex-based differences in baseline values and longitudinal trajectories of health-related quality of life (HRQoL) in a large cohort of myocardial infarction (MI) survivors after adjusting for other important factors. DESIGN Longitudinal cohort study. SETTING Population-based longitudinal study the Evaluation of the Methods and Management of Acute Coronary Events study linked with national cardiovascular registry. Data were collected from 77 hospitals in England between 1 November 2011 and 24 June 2015. PARTICIPANTS 9551 patients with MI. Patients were eligible for the study if they were ≥18 years of age. PRIMARY AND SECONDARY OUTCOME MEASURES HRQoL was measured by EuroQol five-dimension, visual analogue scale (EQ-5D, EQ VAS) survey at baseline, 1, 6 and 12 months after discharge. Multi-level linear and logistic regression models coupled with inverse probability weighted propensity scoring were used to evaluate sex differences in HRQoL following MI. RESULTS Of the 9551 patients with MI and complete data on sex, 25.1% (2,397) were women. At baseline, women reported lower HRQoL (EQ VAS (mean (SD) 59.8 (20.4) vs 64.5 (20.9)) (median (IQR) 60.00 (50.00-75.00) vs 70.00 (50.00-80.00))) (EQ-5D (mean (SD) 0.66 (0.31) vs 0.74 (0.28)) (median (IQR) 0.73 (0.52-0.85) vs 0.81 (0.62-1.00))) and were more likely to report problems in each HRQoL domain compared with men. In the covariate balanced and adjusted multi-level model sex differences in HRQoL persisted during follow-up, with lower EQ VAS and EQ-5D scores in women compared with men (adjusted EQ VAS model sex coefficient: -4.41, 95% CI -5.16 to -3.66 and adjusted EQ-5D model sex coefficient: -0.07, 95% CI -0.08 to -0.06). CONCLUSIONS Women have lower HRQoL compared with men at baseline and during 12 months follow-up after MI. Tailored interventions for women following an MI could improve their quality of life. TRIAL REGISTRATION NUMBER ClinicalTrials.gov (NCT04598048, NCT01808027, NCT01819103.
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Affiliation(s)
- Tatendashe Bernadette Dondo
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
| | - Theresa Munyombwe
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
| | - Marlous Hall
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
| | - Ben Hurdus
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
- Department of Cardiology, Leeds General Infirmary, Leeds, West Yorkshire, UK
| | - Anzhela Soloveva
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
| | | | - Suleman Aktaa
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
- Department of Cardiology, Leeds General Infirmary, Leeds, West Yorkshire, UK
| | - Robert M West
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Alistair S Hall
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
- Department of Cardiology, Leeds General Infirmary, Leeds, West Yorkshire, UK
| | - Chris P Gale
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
- Leeds Institute for Data Analytics, University of Leeds, Leeds, UK
- Department of Cardiology, Leeds General Infirmary, Leeds, West Yorkshire, UK
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8
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Barsky L, Speier W, Fuller G, Cheng S, Kim A, Joung S, Arnold C, Dhawan S, Lopez M, Mastali M, van den Broek I, Wei J, Spiegel B, Van Eyk JE, Bairey Merz CN, Shufelt C. Sex-based differences in remote monitoring of biometric, psychometric and biomarker indices in stable ischemic heart disease. Biol Sex Differ 2022; 13:15. [PMID: 35410392 PMCID: PMC8996611 DOI: 10.1186/s13293-022-00423-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 03/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sex-based differences are crucial to consider in the formulation of a personalized treatment plan. We evaluated sex-based differences in adherence and remotely monitored biometric, psychometric, and biomarker data among patients with stable ischemic heart disease (IHD). METHODS The Prediction, Risk, and Evaluation of Major Adverse Cardiac Events (PRE-MACE) study evaluated patients with stable IHD over a 12-week period. We collected biometric and sleep data using remote patient monitoring via FitBit and psychometric data from Patient-Reported Outcomes Measurement Information System (PROMIS), Kansas City Cardiomyopathy (KCC) and Seattle Angina Questionnaire-7 (SAQ-7) questionnaires. Serum biomarker levels were collected at the baseline visit. We explored sex-based differences in demographics, adherence to study protocols, biometric data, sleep, psychometric data, and biomarker levels. RESULTS There were 198 patients enrolled, with mean age 65.5 ± 11 years (± Standard deviation, SD), and 60% were females. Females were less adherent to weekly collection of PROMIS, KCC and SAQ-7 physical limitations questionnaires (all p < 0.05), compared to males. There was no difference in biometric physical activity. There was a statistically significant (p < 0.05) difference in sleep duration between sexes, with females sleeping 6 min longer. However, females reported higher PROMIS sleep disturbance scores (p < 0.001) and poorer psychometric scores overall (p < 0.05). A higher proportion of males had clinically significant elevations of median N-terminal pro-brain natriuretic peptide (p = 0.005) and high-sensitivity cardiac troponin levels (p < 0.001) compared to females. CONCLUSIONS Among females and males with stable IHD, there are sex-based differences in remote monitoring behavior and data. Females are less adherent to psychometric data collection and report poorer psychometric and sleep quality scores than males. Elevated levels of biomarkers for MACE are more common in males. These findings may improve sex-specific understanding of IHD using remote patient monitoring.
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Affiliation(s)
- Lili Barsky
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3206, Los Angeles, CA, 90048, USA
| | - William Speier
- Medical Imaging and Informatics Group, University of California, Los Angeles, CA, USA
| | - Garth Fuller
- Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA, USA
| | - Susan Cheng
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3206, Los Angeles, CA, 90048, USA
| | - Andy Kim
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3206, Los Angeles, CA, 90048, USA
| | - Sandy Joung
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3206, Los Angeles, CA, 90048, USA
| | - Corey Arnold
- Medical Imaging and Informatics Group, University of California, Los Angeles, CA, USA
| | - Shivani Dhawan
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3206, Los Angeles, CA, 90048, USA
| | - Mayra Lopez
- Cedars-Sinai Center for Outcomes Research and Education (CS-CORE), Los Angeles, CA, USA
| | - Mitra Mastali
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3206, Los Angeles, CA, 90048, USA.,Cedars-Sinai Medical Center, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA
| | - Irene van den Broek
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3206, Los Angeles, CA, 90048, USA.,Cedars-Sinai Medical Center, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA
| | - Janet Wei
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3206, Los Angeles, CA, 90048, USA
| | - Brennan Spiegel
- Cedars-Sinai Medical Center, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA
| | - Jennifer E Van Eyk
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3206, Los Angeles, CA, 90048, USA.,Cedars-Sinai Medical Center, Advanced Clinical Biosystems Research Institute, Cedars-Sinai Smidt Heart Institute, Los Angeles, CA, USA
| | - C Noel Bairey Merz
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3206, Los Angeles, CA, 90048, USA.
| | - Chrisandra Shufelt
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, 127 S. San Vicente Blvd, Suite A3206, Los Angeles, CA, 90048, USA
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9
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Lansky A, Baron SJ, Grines CL, Tremmel JA, Al-Lamee R, Angiolillo DJ, Chieffo A, Croce K, Jacobs AK, Madan M, Maehara A, Mehilli J, Mehran R, Ng V, Parikh PB, Saw J, Abbott JD. SCAI Expert Consensus Statement on Sex-Specific Considerations in Myocardial Revascularization. JOURNAL OF THE SOCIETY FOR CARDIOVASCULAR ANGIOGRAPHY & INTERVENTIONS 2022; 1:100016. [PMID: 39132570 PMCID: PMC11307953 DOI: 10.1016/j.jscai.2021.100016] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/21/2021] [Indexed: 08/13/2024]
Affiliation(s)
| | | | - Cindy L. Grines
- Northside Hospital Cardiovascular Institute, Atlanta, Georgia
| | | | | | | | - Alaide Chieffo
- University of Florida Health Sciences Center, Jacksonville, Florida
| | - Kevin Croce
- IRCCS San Raffaele Scientific Institute, Milan, Italy
- Brigham and Women's Hospital, Boston, Massachusetts
| | - Alice K. Jacobs
- Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts
| | - Mina Madan
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Akiko Maehara
- Columbia University College of Physicians and Surgeons, New York, New York
| | | | - Roxana Mehran
- Icahn School of Medicine at Mount Sinai, New York, New York
| | - Vivian Ng
- Columbia University Irving Medical Center, New York, New York
| | - Puja B. Parikh
- Stony Brook University Medical Center, Stony Brook, New York
| | - Jacqueline Saw
- Vancouver General Hospital, Vancouver, British Columbia, Canada
| | - J. Dawn Abbott
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
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10
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Hiremath PG, Aversano T, Spertus JA, Lemmon CC, Naiman DQ, Czarny MJ. Sex Differences in Health Status and Clinical Outcomes After Nonprimary Percutaneous Coronary Intervention. Circ Cardiovasc Interv 2022; 15:e011308. [PMID: 35067071 DOI: 10.1161/circinterventions.121.011308] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND Greater insight into sex-based differences in health status can lay the foundation for more equitable health care. This study compares differences in health status of women and men in the CPORT-E trial (Cardiovascular Patient Outcomes Research Team Non-Primary Percutaneous Coronary Intervention) undergoing nonprimary percutaneous coronary intervention. METHODS We compared Seattle Angina Questionnaire scores at baseline, 6 weeks, and 9 months for 6851 women and 12 016 men undergoing nonprimary percutaneous coronary intervention. RESULTS Proportions of angina-free patients increased from 26.2% and 29.8% at baseline to 71.6% and 78.7% at 6 weeks to 78.1% and 83.0% at 9 months in women and men, respectively (P<0.001 for all). After adjusting for clinical and procedural characteristics as well as baseline angina, freedom from angina in women was 34% less likely at 6 weeks (odds ratio, 0.66 [95% CI, 0.61-0.71]; P<0.001) and 32% less likely at 9 months (odds ratio, 0.68 [95% CI, 0.62-0.74]; P<0.001) compared with men. CONCLUSIONS Although health status increased significantly after percutaneous coronary intervention in both women and men, women had poorer health status outcomes than men before and after percutaneous coronary intervention. Additional investigation into therapies that address the causes of poorer health status in women with coronary artery disease is needed. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT00549796.
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Affiliation(s)
- Pranoti G Hiremath
- Division of Cardiology, School of Medicine (P.G.H., T.A., C.C.L., M.J.C.), Johns Hopkins University, Baltimore, MD
| | - Thomas Aversano
- Division of Cardiology, School of Medicine (P.G.H., T.A., C.C.L., M.J.C.), Johns Hopkins University, Baltimore, MD
| | - John A Spertus
- Saint Luke's Mid-America Heart Institute Kansas City and the University of Missouri-Kansas City, MO (J.A.S.)
| | - Cynthia C Lemmon
- Division of Cardiology, School of Medicine (P.G.H., T.A., C.C.L., M.J.C.), Johns Hopkins University, Baltimore, MD
| | - Daniel Q Naiman
- Department of Applied Mathematics and Statistics (D.Q.N.), Johns Hopkins University, Baltimore, MD
| | - Matthew J Czarny
- Division of Cardiology, School of Medicine (P.G.H., T.A., C.C.L., M.J.C.), Johns Hopkins University, Baltimore, MD
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11
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Sex differences in sleep and psychological disturbances among patients admitted for cardiovascular diseases. Sleep Breath 2022; 26:1-9. [DOI: 10.1007/s11325-021-02544-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 11/24/2021] [Accepted: 11/30/2021] [Indexed: 10/19/2022]
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12
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Goicoechea S, Walsh M, Soult M, Halandras PM, Bechara C, Aulivola B, Crisostomo P. Female Gender Increases Risk of Stroke and Readmission after CEA and CAS. J Vasc Surg 2021; 75:1935-1944. [PMID: 34740804 DOI: 10.1016/j.jvs.2021.10.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Accepted: 10/21/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Carotid endarterectomy (CEA) has historically demonstrated a higher rate of perioperative adverse events for female patients. However, recent evidence suggests similar outcomes for CEA between genders. In contrast, fewer studies have examined gender in carotid artery stenting (CAS). Using contemporary data from the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database, we aim to determine if gender impacts differences in postoperative complications in patients who undergo CEA or CAS. METHODS The ACS NSQIP database was queried from 2005-2017 using Current Procedural Terminology (CPT) and International Classification of Diseases (ICD) codes for retrospective review. Patients with carotid intervention (CEA or CAS) were stratified into asymptomatic vs symptomatic cohorts to determine the effect of gender on 30-day postoperative outcomes. Symptomatic patients were defined as those with perioperative transient cerebral ischemic attack or stenosis of carotid artery with cerebral infarction. Descriptive statistics were calculated. Risk-adjusted odds of 30-day postoperative outcomes were calculated using multivariate regression analysis with fixed effects for age, race, and comorbidities. RESULTS There were 106,568 patients with CEA or CAS (104,412 CEA and 2,156 CAS). Average age was 70.9 years old and female patients accounted for 39.9% of the population. For asymptomatic patients that underwent CEA or CAS, female gender was associated with significantly higher rates of CVA/stroke (13%, p=0.005), readmission (10%, p=0.004), bleeding complication (32%, p=0.001), and UTI (54%, p=0.001) as well as less infection (26%, p=0.001). In the symptomatic cohort, female gender was associated with significantly higher rates of CVA/stroke (32%, p=0.034), bleeding complication (203%, p=0.001), and UTI (70%, p=0.011), while female gender was associated with a lower rate of pneumonia (39%, p=0.039). Subset analysis found that, compared to male patients, female patients <75yo have an increased rate of CVA/stroke (21%, p=0.001) and readmission (15%, p<0.001), while female patients ≥75yo did not. In asymptomatic and symptomatic patients that underwent CEA, female gender was associated with significantly higher rates of CVA/stroke (13%, p=0.006 and 31%, p=0.044, respectively), but this finding was present not in patients undergoing CAS. CONCLUSION In patients undergoing carotid intervention, female gender was associated with significantly increased rates of postoperative CVA/stroke in the asymptomatic and symptomatic cohorts as well as readmission in the asymptomatic cohort. Female gender was associated with higher rates of CVA/stroke following CEA, but not CAS. We recommend that randomized control trials ensure adequate representation of female patients to better understand gender-based disparities in carotid intervention.
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Affiliation(s)
- Steven Goicoechea
- Department of Surgery, Loyola University Medical Center, Maywood, IL
| | - Martin Walsh
- Department of Surgery, Loyola University Medical Center, Maywood, IL
| | - Michael Soult
- Department of Surgery, Division of Vascular Surgery and Endovascular Therapy, Loyola University Medical Center, Maywood, IL
| | - Pegge M Halandras
- Department of Surgery, Division of Vascular Surgery and Endovascular Therapy, Loyola University Medical Center, Maywood, IL
| | - Carlos Bechara
- Department of Surgery, Division of Vascular Surgery and Endovascular Therapy, Loyola University Medical Center, Maywood, IL
| | - Bernadette Aulivola
- Department of Surgery, Division of Vascular Surgery and Endovascular Therapy, Loyola University Medical Center, Maywood, IL
| | - Paul Crisostomo
- Department of Surgery, Division of Vascular Surgery and Endovascular Therapy, Loyola University Medical Center, Maywood, IL.
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13
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Moon H, Jo YS, Kim SJ, Jo S, Park K. Comparison of ticagrelor with clopidogrel on quality of life in patients with acute coronary syndrome. Health Qual Life Outcomes 2021; 19:242. [PMID: 34656119 PMCID: PMC8520288 DOI: 10.1186/s12955-021-01875-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 10/02/2021] [Indexed: 11/22/2022] Open
Abstract
Background Ticagrelor has a Class I recommendation for use following percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS). However, ticagrelor needs to be taken twice a day, as compared to clopidogrel. Its adverse effects, such as dyspnea or bleeding, are known to be more common than with clopidogrel. Dyspnea may tend to be uncomfortable and limit activity. Major bleeding often leads to hospitalization or transfusions, and frequent minor bleeding, which might not result in patients seeking medical care, can make ACS patients feel unhealthy. Thus, these characteristics may affect the health-related quality of life (HQOL). Methods In the PLEIO (comParison of ticagreLor and clopidogrEl on mIcrocirculation in patients with acute cOronary syndrome) trial, we randomized 120 participants to receive ticagrelor 90 mg twice daily or clopidogrel 75 mg once daily for at least 12 months. We carried out an HQOL assessment with the Short Form 36 Health Survey (SF-36) questionnaire on the day of discharge following PCI, as well as six months later. Results At discharge, the HQOL measures were similar in the ticagrelor and clopidogrel groups, both having a physical component summary (PCS) and a mental component summary (MCS) score. A six-month HQOL follow-up assessment showed that there were no differences between the two study groups in either the PCS or the MCS scores. In both groups, the PCS scores significantly increased over six months of treatment (both p < 0.01). However, the MCS score did not differ significantly. A baseline MCS score is an independent predictor of better physical and mental health status at six months. Conclusions Ticagrelor, as compared to clopidogrel, did not significantly reduce the HQOL during the six months following PCI in patients with ACS. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT02618733.
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Affiliation(s)
- Hyeyeon Moon
- Regional Cardiovascular Center, Dong-A University Hospital, Division of Cardiology, Department of Internal Medicine, Dong-A University College of Medicine, Daesingongwon 26, Seo-gu, Busan, 49201, Republic of Korea
| | - Yoon-Sung Jo
- Regional Cardiovascular Center, Dong-A University Hospital, Division of Cardiology, Department of Internal Medicine, Dong-A University College of Medicine, Daesingongwon 26, Seo-gu, Busan, 49201, Republic of Korea
| | - Soo-Jin Kim
- Regional Cardiovascular Center, Dong-A University Hospital, Division of Cardiology, Department of Internal Medicine, Dong-A University College of Medicine, Daesingongwon 26, Seo-gu, Busan, 49201, Republic of Korea
| | - Sua Jo
- Regional Cardiovascular Center, Dong-A University Hospital, Division of Cardiology, Department of Internal Medicine, Dong-A University College of Medicine, Daesingongwon 26, Seo-gu, Busan, 49201, Republic of Korea
| | - Kyungil Park
- Regional Cardiovascular Center, Dong-A University Hospital, Division of Cardiology, Department of Internal Medicine, Dong-A University College of Medicine, Daesingongwon 26, Seo-gu, Busan, 49201, Republic of Korea.
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14
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Lawal OA, Awosoga O, Santana MJ, James MT, Wilton SB, Norris CM, Lix LM, Sajobi TT. Measurement invariance of the Seattle Angina Questionnaire in coronary artery disease. Qual Life Res 2021; 31:1223-1236. [PMID: 34495443 DOI: 10.1007/s11136-021-02987-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE The Seattle Angina Questionnaire (SAQ) is a widely used patient-reported measure of health status in patients with coronary artery disease. Comparisons of SAQ scores amongst population groups and over time rely on the assumption that its factorial structure is invariant. This study evaluates the measurement invariance of the SAQ across different demographic and clinical groups and over time. METHODS Data were obtained from the Alberta Provincial Project on Outcome Assessment in Coronary Heart Disease registry, a registry of patients who received coronary angiogram in Alberta, Canada. The study cohort consists of adult patients who completed the paper-based version of the 16-item Canadian version of the SAQ (SAQ-CAN) 2 weeks and 1-year post-coronary angiogram between 2009 and 2016. Multi-group confirmatory factor analysis was used to assess configural, weak, strong, and strict measurement invariance across age groups, sex, angina type, treatment, and over time. Model fit was assessed using the comparative fit index and root mean square error of approximation. RESULTS Of the 8101 patients included in these analysis, 1300 (16.1%) were at least 75 years old, while 1755 (21.7%) were female, 5154 (63.6%) were diagnosed with acute coronary syndrome, 1177 (14.5%) received coronary artery bypass graft treatment, and 3279 had complete data on the SAQ-CAN at both occasions. There was evidence of strict invariance across age, sex, and angina type, and treatment groups, but partial strict invariance was established over time. CONCLUSION SAQ-CAN can be used to compare the health status of coronary artery disease patients across population groups and over time.
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Affiliation(s)
- Oluwaseyi A Lawal
- Department of Community Health Sciences & O'Brien Institute for Public Health, University of Calgary, 3280 Hospital Drive, Calgary, T2N 4Z6, Canada
| | | | - Maria J Santana
- Department of Community Health Sciences & O'Brien Institute for Public Health, University of Calgary, 3280 Hospital Drive, Calgary, T2N 4Z6, Canada
| | - Matthew T James
- Department of Community Health Sciences & O'Brien Institute for Public Health, University of Calgary, 3280 Hospital Drive, Calgary, T2N 4Z6, Canada
| | - Stephen B Wilton
- Department of Cardiac Sciences, University of Calgary, Calgary, Canada
| | | | - Lisa M Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Tolulope T Sajobi
- Department of Community Health Sciences & O'Brien Institute for Public Health, University of Calgary, 3280 Hospital Drive, Calgary, T2N 4Z6, Canada.
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15
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Predictors of long-term HRQOL following cardiac surgery: a 5-year follow-up study. Health Qual Life Outcomes 2021; 19:197. [PMID: 34404411 PMCID: PMC8371845 DOI: 10.1186/s12955-021-01838-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 08/08/2021] [Indexed: 11/15/2022] Open
Abstract
Background The study aimed to evaluate the long-term change of health-related quality of life (HRQOL) and to identify predictors of HRQOL 5 years after cardiac surgery. Methods Consecutive adult patients, undergoing elective cardiac surgery were enrolled in the study. HRQOL was measured using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) questionnaire before and 5-years after cardiac surgery. A multivariate latent change modeling approach was used for data analysis. Results 210 participants (30.5% female) were reached at 5-year follow-up and included in final data analysis. The study revealed, after controlling for gender effects, a significant long-term positive change, in physical functioning (PF, Mslope = 19.79, p < 0.001), social functioning (SF, Mslope = 17.27, p < 0.001), vitality (VT, Mslope = 6.309, p < 0.001) and mental health (MH, Mslope = 8.40, p < .001) in the total sample. Lower education was associated with an increase in PF (Mslope = 24.09, p < 0.001) and VT (Mslope = 8.39, p < 0.001), more complicated surgery (other than the coronary artery bypass graft (CABG) predicted increase in general health (GH, Mslope = 6.76, p = 0.005). Arrhythmia was a significant predictor for lower pre- and post-operative VT and SF. Conclusions Overall HRQOL in our sample improved from baseline to five years postoperatively. Further studies including larger patient groups are needed to confirm these findings.
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Katsi V, Georgiopoulos G, Mitropoulou P, Kontoangelos K, Kollia Z, Tzavara C, Soulis D, Toutouzas K, Oikonomou D, Aimo A, Tsioufis K. Exercise tolerance and quality of life in patients with known or suspected coronary artery disease. Qual Life Res 2021; 30:2541-2550. [PMID: 33893931 DOI: 10.1007/s11136-021-02844-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Coronary artery disease (CAD) is known to impact on patients' physical and mental health. The relationship between performance on treadmill exercise tolerance test (ETT) and health-related quality of life (HRQL)has never been specifically investigated in the setting of CAD. METHODS Consecutive patients undergoing an ETT with the Bruce protocol during a diagnostic workup for CAD (n = 1,631, age 55 ± 12 years) were evaluated. Exercise-related indices were recorded. Detailed information on cardiovascular risk factors and past medical history were obtained. HRQLwas assessed with the use of the validated 36-Item Short Form Survey (SF-36) questionnaire. RESULTS Increasing age and the presence of cardiovascular risk factors and comorbidities correlated with lower scores on the physical and mental health component of SF-36(all P < 0.05). Subjects with arrhythmias during exercise and slow recovery of systolic blood pressure had lower scores on the physical health indices or the Social Role Functioning component (P < 0.05). Achieved target heart rate and good exercise tolerance were independently associated with better scores of the physical and mental health domains of SF-36 and overall HRQLscores (β = 0.05 for target HR and PCS-36, β = 1.86 and β = 1.66 per increasing stage of exercise tolerance and PCS-36 and MCS-36, respectively, P < 0.001 for all associations). Ischemic ECG changes were associated with worse scores on Physical Functioning (β = - 3.2, P = 0.02) and Bodily Pain (β = - 4.55, P = 0.026). CONCLUSION ETT parameters are associated with HRQL indices in patients evaluated for possible CAD. Physical conditioning may increase patient well-being and could serve as a complementary target in conjunction with cardiovascular drug therapy.
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Affiliation(s)
- Vasiliki Katsi
- First Department of Cardiology, Hippocration Hospital, Athens, Greece
| | - Georgios Georgiopoulos
- First Department of Cardiology, Hippocration Hospital, Athens, Greece.
- Cardiovascular Imaging Department, School of Biomedical Engineering and Imaging Sciences, King's College London, St Thomas Hospital, Westminster Bridge Road, London, SE1 7EH, UK.
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, Athens, Greece.
| | - Panagiota Mitropoulou
- Department of Cardiology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Konstantinos Kontoangelos
- 1st Department of Psychiatry, Eginition Hospital, Medical School National and Kapodistrian University of Athens, Athens, Greece
| | - Zoi Kollia
- Emergency Department, Amalia Fleming' General Hospital, Athens, Greece
| | - Chara Tzavara
- Emergency Department, Amalia Fleming' General Hospital, Athens, Greece
| | - Dimitrios Soulis
- Emergency Department, Amalia Fleming' General Hospital, Athens, Greece
| | | | | | - Alberto Aimo
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
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17
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Thijssen CGE, Doze DE, Gökalp AL, Timmermans J, Peters JB, Elbers‐van de Ven LHC, van Royen N, Takkenberg JJM, Roos‐Hesselink JW, van Kimmenade RRJ. Male-female differences in quality of life and coping style in patients with Marfan syndrome and hereditary thoracic aortic diseases. J Genet Couns 2020; 29:1259-1269. [PMID: 32519797 PMCID: PMC7754440 DOI: 10.1002/jgc4.1288] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 04/09/2020] [Accepted: 04/20/2020] [Indexed: 12/12/2022]
Abstract
Hereditary thoracic aortic diseases (HTAD) such as Marfan syndrome (MFS) affect multiple organ systems and provide a risk of acute aortic dissection, which causes lifelong uncertainties. Although health-related quality of life (HRQOL) was found to be reduced in HTAD patients, no studies have evaluated male-female-specific aspects of HRQOL and coping in this population. This study aims to evaluate HRQOL in HTAD patients compared to the general population; assess male-female differences in HRQOL and factors associated with HRQOL; evaluate coping styles in male and female HTAD patients and identify factors associated with acceptance. All consecutive adult patients who visited the specialized HTAD outpatient clinic between 2013 and 2018 were asked to complete three HRQOL questionnaires: the Short Form 36 (SF-36), the Hospital Anxiety and Depression Scale (HADS), and the Nijmegen Clinical Screening Instrument (NCSI). In total, 142 patients were included (mean age 42.1 years, 65 females, 123 MFS). Compared to the general population, HTAD patients scored significantly lower on multiple SF-36 sub-domains (males: General Health 54.5 ± 18.8 vs. 71.6 ± 20.6, p < .001; Vitality 58.3 ± 20.4 vs. 71.9 ± 18.3, p < .001; females: Physical Functioning 67.5 ± 23.8 vs. 80.4 ± 24.2, p = .003; Role Physical 58.3 ± 45.1 vs. 73.8 ± 38.5, p = .047; General Health 49.4 ± 24.3 vs. 69.9 ± 20.6, p < .001; Social Functioning 73.5 ± 22.0 vs. 82.0 ± 23.5, p = .027). Females scored significantly lower than males on the SF-36 physical component score (41.6 [IQR 35.5-53.1] vs. 49.3 [IQR 42.3-54.6], p = .035). Males scored significantly higher on the coping style denial than females (2.75 [IQR 2.00-3.25] vs. 2.25 [IQR 1.75-3.25], p = .018). High scores on acceptance were found in 38 (26.8%) of HTAD patients, and these patients showed significantly better scores on the NCSI, SF-36, and HADS, except on NCSI Satisfaction Relationships and SF-36 Physical Functioning and Mental Health. Acceptance was associated with more medication use (beta blocker use, p = .008; angiotensin receptor blocker use, p = .003) and less hypertension (p = .001). In patients with MFS, employment was strongly associated with better scores on the NCSI. In conclusion, HTAD patients showed subnormal HRQOL, especially females. Interestingly, in both males and females factors such as employment, coping style, and disease acceptance seem more important for HRQOL than disease-related factors. This highlights the importance of genetic counseling and guidance for HTAD patients, and offers valuable leads for HRQOL improvement.
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Affiliation(s)
- Carlijn G. E. Thijssen
- Department of Congenital CardiologyErasmus MCRotterdamThe Netherlands
- Department of CardiologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Daphne E. Doze
- Department of CardiologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Arjen L. Gökalp
- Department of Cardiothoracic SurgeryErasmus MCRotterdamThe Netherlands
| | - Janneke Timmermans
- Department of CardiologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Jeannette B. Peters
- Department of Medical PsychologyRadboud University Medical CenterNijmegenThe Netherlands
| | | | - Niels van Royen
- Department of CardiologyRadboud University Medical CenterNijmegenThe Netherlands
| | | | | | - Roland R. J. van Kimmenade
- Department of Congenital CardiologyErasmus MCRotterdamThe Netherlands
- Department of CardiologyRadboud University Medical CenterNijmegenThe Netherlands
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18
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Garay A, Tapia J, Anguita M, Formiga F, Almenar L, Crespo-Leiro MG, Manzano L, Muñiz J, Chaves J, De Frutos T, Moliner P, Corbella X, Enjuanes-Grau C, Comín-Colet J. Gender Differences in Health-Related Quality of Life in Patients with Systolic Heart Failure: Results of the VIDA Multicenter Study. J Clin Med 2020; 9:jcm9092825. [PMID: 32878281 PMCID: PMC7563299 DOI: 10.3390/jcm9092825] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/27/2020] [Accepted: 08/29/2020] [Indexed: 12/30/2022] Open
Abstract
Previous studies have shown that heart failure is associated with worse health-related quality of life (HRQoL). The existence of differences according to gender remains controversial. We studied 1028 consecutive outpatients with heart failure and reduced ejection fraction (HFrEF) from a multicentre cross-sectional descriptive study across Spain that assessed HRQoL using two questionnaires (KCCQ, Kansas City Cardiomyopathy Questionnaire; and EQ-5D, EuroQoL 5 dimensions). The primary objective of the study was to describe differences in HRQoL between men and women in global scores and domains of health status of patients and explore gender differences and its interactions with heart failure related factors. In adjusted analysis women had lower scores in KCCQ overall summary scores when compared to men denoting worse HRQoL (54.7 ± 1.3 vs. 62.7 ± 0.8, p < 0.0001), and specifically got lower score in domains of symptom frequency, symptoms burden, physical limitation, quality of life and social limitation. No differences were found in domains of symptom stability and self-efficacy. Women also had lower scores on all items of EQ-5D (EQ-5D index 0.58 ± 0.01 vs. 0.67 ± 0.01, p < 0.0001). Finally, we analyzed interaction between gender and different clinical determinants regarding the presence of limitations in the 5Q-5D and overall summary score of KCCQ. Interestingly, there was no statistical significance for interaction for any variable. In conclusion, women with HFrEF have worse HRQoL compared to men. These differences do not appear to be mediated by clinical or biological factors classically associated with HRQoL nor with heart failure severity.
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Affiliation(s)
- Alberto Garay
- Unidad de Insuficiencia Cardiaca Comunitaria (UMICO), Servicio de Cardiología, Hospital Universitario de Bellvitge, L’ Hospitalet de Llobregat, 08907 Barcelona, Spain; (A.G.); (P.M.); (C.E.-G.)
- Programa Territorial de Atención Integrada a la Insuficiencia Cardiaca Comunitaria de la Gerencia Metropolitana Sur del Instituto Catalán de la Salud, Hospital Universitario de Bellvitge, L’ Hospitalet de Llobregat, 08907 Barcelona, Spain
- Unidad de Cardio-Oncología Hospital de Bellvitge–Instituto Catalán de Oncología, L’Hospitalet del Llobregat, 08907 Barcelona, Spain
- Grupo de Investigación en Enfermedades Cardiovasculares, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L’ Hospitalet de Llobregat, 08907 Barcelona, Spain;
| | - Javier Tapia
- Grupo de Investigación en Enfermedades Cardiovasculares, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L’ Hospitalet de Llobregat, 08907 Barcelona, Spain;
- Departamento de Ciencias Clínicas, Universidad de Barcelona, 08907 Barcelona, Spain
| | - Manuel Anguita
- Unidad de Insuficiencia Cardíaca, Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba 14004, Argentina;
| | - Francesc Formiga
- Servicio de Medicina Interna, Hospital Universitario de Bellvitge, l’ Hospitalet de Llobregat, 08907 Barcelona, Spain; (F.F.); (X.C.)
| | - Luis Almenar
- Unidad de Insuficiencia Cardíaca y Trasplante, Servicio de Cardiología, Hospital Universitario La Fe, 46009 Valencia, Spain;
| | - María G. Crespo-Leiro
- Unidad de Insuficiencia Cardiaca Avanzada y Trasplante Cardiaco, Servicio de Cardiología, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña (UDC), 15006 A Coruña, Spain;
| | - Luis Manzano
- Servicio de Medicina Interna, Hospital Universitario Ramón y Cajal, Departamento de Medicina y Especialidades Médicas, Facultad de Medicina y Ciencias de la Salud, Universidad de Alcalá, IRYCIS, 28034 Madrid, Spain;
| | - Javier Muñiz
- Instituto Universitario de Ciencias de la Salud, Instituto de Investigación Biomédica de A Coruña (INIBIC), Universidade da Coruña, 15006 La Coruña, Spain;
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), 15705 Santiago de Compostela, Spain
| | - José Chaves
- Medical Department, Internal Medicine, Pfizer Biopharmaceuticals Group, 28108 Alcobendas, Spain; (J.C.); (T.D.F.)
| | - Trinidad De Frutos
- Medical Department, Internal Medicine, Pfizer Biopharmaceuticals Group, 28108 Alcobendas, Spain; (J.C.); (T.D.F.)
| | - Pedro Moliner
- Unidad de Insuficiencia Cardiaca Comunitaria (UMICO), Servicio de Cardiología, Hospital Universitario de Bellvitge, L’ Hospitalet de Llobregat, 08907 Barcelona, Spain; (A.G.); (P.M.); (C.E.-G.)
- Programa Territorial de Atención Integrada a la Insuficiencia Cardiaca Comunitaria de la Gerencia Metropolitana Sur del Instituto Catalán de la Salud, Hospital Universitario de Bellvitge, L’ Hospitalet de Llobregat, 08907 Barcelona, Spain
- Unidad de Cardio-Oncología Hospital de Bellvitge–Instituto Catalán de Oncología, L’Hospitalet del Llobregat, 08907 Barcelona, Spain
- Grupo de Investigación en Enfermedades Cardiovasculares, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L’ Hospitalet de Llobregat, 08907 Barcelona, Spain;
| | - Xavier Corbella
- Servicio de Medicina Interna, Hospital Universitario de Bellvitge, l’ Hospitalet de Llobregat, 08907 Barcelona, Spain; (F.F.); (X.C.)
- Cátedra HESTIA en Atención Integrada Social y Sanitaria, Facultad de Medicina y Ciencias de la Salud, Universitat Internacional de Catalunya, Sant Cugat del Vallès, 08017 Barcelona, Spain
| | - Cristina Enjuanes-Grau
- Unidad de Insuficiencia Cardiaca Comunitaria (UMICO), Servicio de Cardiología, Hospital Universitario de Bellvitge, L’ Hospitalet de Llobregat, 08907 Barcelona, Spain; (A.G.); (P.M.); (C.E.-G.)
- Programa Territorial de Atención Integrada a la Insuficiencia Cardiaca Comunitaria de la Gerencia Metropolitana Sur del Instituto Catalán de la Salud, Hospital Universitario de Bellvitge, L’ Hospitalet de Llobregat, 08907 Barcelona, Spain
- Grupo de Investigación en Enfermedades Cardiovasculares, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L’ Hospitalet de Llobregat, 08907 Barcelona, Spain;
| | - Josep Comín-Colet
- Unidad de Insuficiencia Cardiaca Comunitaria (UMICO), Servicio de Cardiología, Hospital Universitario de Bellvitge, L’ Hospitalet de Llobregat, 08907 Barcelona, Spain; (A.G.); (P.M.); (C.E.-G.)
- Programa Territorial de Atención Integrada a la Insuficiencia Cardiaca Comunitaria de la Gerencia Metropolitana Sur del Instituto Catalán de la Salud, Hospital Universitario de Bellvitge, L’ Hospitalet de Llobregat, 08907 Barcelona, Spain
- Grupo de Investigación en Enfermedades Cardiovasculares, Instituto de Investigación Biomédica de Bellvitge (IDIBELL), L’ Hospitalet de Llobregat, 08907 Barcelona, Spain;
- Servicio de Cardiologia, Hospital Universitario de Bellvitge, L’ Hospitalet de Llobregat, 08907 Barcelona, Spain
- Correspondence: ; Tel.: +34-932-607-078
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Asaithambi G, Tipps ME. Quality of life among ischemic stroke patients eligible for endovascular treatment: analysis of the DEFUSE 3 trial. J Neurointerv Surg 2020; 13:703-706. [PMID: 32753555 DOI: 10.1136/neurintsurg-2020-016399] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/07/2020] [Accepted: 07/13/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND The endovascular treatment (ET) for acute ischemic stroke is increasing among eligible patients. Assessing patients' perspectives on quality of life (QOL) can supplement the use of formal outcome scales and enable the assessment of outcomes across multiple domains affected by stroke. METHODS We analyzed publicly available data from the Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke (DEFUSE 3) trial. We evaluated patients who survived beyond the time of discharge from their acute hospitalizations and completed all Neuro-QOL short forms at 90-day follow-up. RESULTS Our final analysis included 128 patients (median age 67 [range 23-90] years, 50.8% men). As modified Rankin Scale (mRS) scores increased, there was a consistent increase in the severity of Neuro-QOL measures. T-scores for mobility, cognitive function, and the ability to participate in social roles declined significantly while depression T-scores increased significantly. We found that QOL T-scores for patients with mRS 3 did not differ significantly from T-scores for patients with mRS 2 in any domain. CONCLUSIONS Among ischemic stroke patients eligible for ET, QOL scores help validate and supplement quantitatively measured outcomes.
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Affiliation(s)
- Ganesh Asaithambi
- Neurosciences, Allina Health United Hospital, St. Paul, Minnesota, USA
| | - Megan E Tipps
- Neuroscience Research, Allina Health, Minneapolis, Minnesota, USA
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Oreel TH, Nieuwkerk PT, Hartog ID, Netjes JE, Vonk ABA, Lemkes J, van Laarhoven HWM, Scherer-Rath M, Sprangers MAG, Henriques JPS. Gender differences in quality of life in coronary artery disease patients with comorbidities undergoing coronary revascularization. PLoS One 2020; 15:e0234543. [PMID: 32555617 PMCID: PMC7299316 DOI: 10.1371/journal.pone.0234543] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 05/27/2020] [Indexed: 12/18/2022] Open
Abstract
In comparison to male patients with coronary artery disease, female patients suffer from more comorbidities, experience symptoms of coronary artery disease differently and report poorer health-related quality of life (HRQoL) after coronary revascularization. However, there is limited data on the impact of comorbidity burden on the recovery in HRQoL in female and male patients. We investigated the impact of comorbidity burden on the change in HRQoL following coronary revascularization in female patients versus male patients. 230 patients (60 female) with coronary artery disease were assessed before, and two weeks, three months and six months after coronary revascularization. Disease-specific HRQoL was measured with the Short-Form Seattle Angina Questionnaire. Physical and mental health was measured with the Short-Form Health Survey. Comorbidity burden was assessed by the total number of identified comorbidity conditions and by the Charlson comorbidity score. Linear mixed models were used to estimate the effects of time, gender and comorbidity burden on HRQoL. Whereas HRQoL improved after coronary revascularization in all patients, female patients reported poorer physical health and disease-specific HRQoL and their physical health improved more slowly than male patients. A higher comorbidity burden was related with poorer physical health and disease-specific HRQoL in male patients, but not in female patients. A higher comorbidity burden was associated with slower improvement in HRQoL for both female and male patients. Female patients reported poorer HRQoL and their physical health improved more slowly after coronary revascularization, irrespective of comorbidity burden. Higher comorbidity burden was associated with poorer physical health and disease-specific HRQoL in male patients only. Our results indicate that female and male patients recover differently after coronary revascularization. These findings highlight the importance of comorbidity- and gender-specific approaches for evaluating coronary artery disease and coronary revascularization procedures.
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Affiliation(s)
- Tom H. Oreel
- Department of Medical Psychology, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Pythia T. Nieuwkerk
- Department of Medical Psychology, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Iris D. Hartog
- Department of Medical Psychology, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
- Faculty of Philosophy, Theology and Religious Studies, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Justine E. Netjes
- Department of Medical Psychology, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Alexander B. A. Vonk
- Department of Cardio-thoracic Surgery, Amsterdam University Medical Centers, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jorrit Lemkes
- Department of Cardiology, Amsterdam University Medical Centers, Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hanneke W. M. van Laarhoven
- Department of Medical Oncology, Cancer Center Amsterdam, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Michael Scherer-Rath
- Faculty of Philosophy, Theology and Religious Studies, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Mirjam A. G. Sprangers
- Department of Medical Psychology, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - José P. S. Henriques
- Department of Cardiology, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Koh Y, Stehli J, Martin C, Brennan A, Dinh DT, Lefkovits J, Zaman S. Does sex predict quality of life after acute coronary syndromes: an Australian, state-wide, multicentre prospective cohort study. BMJ Open 2019; 9:e034034. [PMID: 31857318 PMCID: PMC6937071 DOI: 10.1136/bmjopen-2019-034034] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE Women have reported higher mortality and major adverse cardiovascular events (MACE) following acute coronary syndromes (ACSs) compared with men. With this in mind, we aimed to identify predictors of poor quality of life (QoL) post-ACS as our primary outcome. We examined predictors of MACE, major cerebrovascular events and major bleeding as our secondary outcome. DESIGN Prospective cohort study. SETTING 30 metropolitan centres across the Victorian Cardiac Outcomes Registry network. PARTICIPANTS 16 517 patients treated with percutaneous coronary intervention (PCI) for ACS (22.9% females). Selection/inclusion criteria: consecutive patients with successful or attempted PCI for ACS from 2013 to 2016, alive at 30 days post-PCI. EXCLUSION CRITERIA patients not fulfilling ACS criteria. At 30 days, 2497 (64.7% females) completed the QoL EQ-5D-3L instrument. PRIMARY AND SECONDARY OUTCOME MEASURES QoL, assessed using the EuroQo-5Dimensions (EQ-5D-3L) instrument by telephone at 30 days. Independent predictors of QoL were identified by univariate and multivariate logistic regression analyses. RESULTS Women were significantly older with more diabetes, cerebrovascular disease and renal failure. Regarding the primary outcome, female sex was independently associated with moderate/severe impairment in all EQ-5D-3L domains including mobility (OR 2.38, 95% CI 2.06 to 2.75, p<0.001), personal care (OR 2.14, 95% CI 1.73 to 2.66, p<0.001), activities of daily living (OR 1.84, 95% CI 1.63 to 2.08, p<0.001), pain/discomfort (OR 1.44, 95% CI 1.24 to 1.67, p<0.001) and anxiety/depression (OR 1.49, 95% CI 1.30 to 1.70, p<0.001). Women had significantly lower self-rated Visual Analogue Scale scores (80.0 for both groups, IQR 60-85 vs 70-90, p<0.001). There was no significant difference between the sexes in secondary outcomes. CONCLUSIONS Female sex was a predictor of poorer QoL following PCI for ACS including significantly higher pain, anxiety and depression. This was independent of age, comorbidities and ACS presentation. There is a clinical need for a tailored approach in female ACS management, for example, emphasis on management of depressive and anxiety symptoms.
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Affiliation(s)
- Youlin Koh
- Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia
| | - Julia Stehli
- Department of Cardiology, Alfred Hospital, Melbourne, Victoria, Australia
- Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
| | - Catherine Martin
- Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Victoria, Australia
| | - Angela Brennan
- Monash Cardiovascular Research Centre, Monash University, Clayton, Victoria, Australia
| | - Diem T Dinh
- Monash Cardiovascular Research Centre, Monash University, Clayton, Victoria, Australia
| | - Jeffrey Lefkovits
- Monash Cardiovascular Research Centre, Monash University, Clayton, Victoria, Australia
- Department of Cardiology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Sarah Zaman
- Monash Cardiovascular Research Centre, Monash University, Clayton, Victoria, Australia
- Monash Heart, Monash Health, Clayton, Victoria, Australia
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Khariton Y, Airhart S, Salisbury AC, Spertus JA, Gosch KL, Grantham JA, Karmpaliotis D, Moses JW, Nicholson WJ, Cohen DJ, Lombardi W, Sapontis J, McCabe JM. Health Status Benefits of Successful Chronic Total Occlusion Revascularization Across the Spectrum of Left Ventricular Function: Insights From the OPEN-CTO Registry. JACC Cardiovasc Interv 2019; 11:2276-2283. [PMID: 30466826 DOI: 10.1016/j.jcin.2018.07.058] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 07/02/2018] [Accepted: 07/24/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVES This study sought to describe the association between chronic total occlusion (CTO) revascularization (CTO percutaneous coronary intervention [PCI]) and health status in patients with and without cardiomyopathy. BACKGROUND Prior PCI trials for cardiomyopathy have excluded CTO patients. Whether patients with reduced left ventricular ejection fraction (LVEF) receive similar health status benefit from CTO-PCI compared with patients with normal LVEF is unclear. METHODS We assessed health status change, using the Seattle Angina Questionnaire (SAQ) Summary, SAQ Angina Frequency, and Rose Dyspnea Scale scores, among patients undergoing successful CTO PCI in the OPEN-CTO (Outcomes, Patient Health Status, and Efficiency in Chronic Total Occlusion) Registry. Participants were classified by LVEF (normal, ≥50%; mild-moderate, 30% to 49%; and severe, <30%), with higher SAQ and lower Rose Dyspnea Scale scores indicating better health status. Differences in 1-year outcomes were compared using hierarchical multivariable regression. RESULTS Of 762 patients, 506 (66.4%), 193 (25.3%), and 63 (8.3%) had normal, mild-moderate, and severely reduced LVEF. SAQ Summary score improvements were observed in each group (27.1 ± 20.4, 26.7 ± 21.2, and 20.3 ± 18.1, respectively). Compared with patients with LVEF ≥50%, those with LVEF <30% had less improvement in SAQ Summary Score (-5.2 points; 95% confidence interval: -9.0 to -1.5; p = 0.01) and Rose Dyspnea Scale (+0.5 points; 95% confidence interval: 0.1 to 0.8; p = 0.01), with no difference in odds of angina (odds ratio: 1.3; 95% confidence interval: 0.6 to 3.0; p = 0.48). Health status improvement was similar between patients with LVEF ≥50% and LVEF 30% to 49%. CONCLUSIONS Although health status improvement was less in patients with severely reduced LVEF compared with those with normal LVEF, each group experienced large health status improvements after CTO-PCI.
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Affiliation(s)
- Yevgeniy Khariton
- Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, Missouri
| | | | - Adam C Salisbury
- Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, Missouri
| | - John A Spertus
- Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, Missouri
| | - Kensey L Gosch
- Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, Missouri
| | - J Aaron Grantham
- Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, Missouri
| | | | - Jeffrey W Moses
- Columbia University Medical Center, New York Presbyterian Hospital, New York, New York
| | | | - David J Cohen
- Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, Missouri
| | | | - James Sapontis
- The Avenue Hospital and Monash Medical Center, Windsor, Victoria, Australia
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Sajobi TT, Wang M, Awosoga O, Santana M, Southern D, Liang Z, Galbraith D, Wilton SB, Quan H, Graham MM, James MT, Ghali WA, Knudtson ML, Norris C. Trajectories of Health-Related Quality of Life in Coronary Artery Disease. Circ Cardiovasc Qual Outcomes 2019; 11:e003661. [PMID: 29545392 DOI: 10.1161/circoutcomes.117.003661] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 01/10/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND Health-related quality of life (HRQOL) assessment is an important health outcome for measuring the efficacy of treatments and interventions for coronary artery disease (CAD). HRQOL is known to improve over the first year after interventions for CAD, but there is limited knowledge of the changes in HRQOL beyond 1 year. We investigated heterogeneity in long-term trajectories of HRQOL in patients with CAD. METHODS AND RESULTS Data were obtained from 6226 patients identified from the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease with at least 1-vessel CAD who underwent their first catheterization between 2006 and 2009. HRQOL was assessed using the Seattle Angina Questionnaire, a 19-item disease-specific measure of HRQOL for patients with CAD. Group-based trajectory analysis was used to identify various subgroups of Seattle Angina Questionnaire trajectories over time while adjusting for missing data through a longitudinal multiple imputation model. Multinomial logistic regression was used to identify the predictors of differences among the identified subgroups. Our analysis revealed significant improvements in HRQOL across all the 5 domains of Seattle Angina Questionnaire overtime for the whole data. Multitrajectory analyses revealed 4 HRQOL trajectory subgroups including high (25.1%), largely increased (32.3%), largely decreased (25.0%), and low (17.6%) trajectories. Age, sex, body mass index, diabetes mellitus, previous history of myocardial infarction, smoking, depression, anxiety, type of treatment received, and perceived social support were significant predictors of differences among these trajectory subgroups. CONCLUSIONS This study highlights variations in longitudinal trajectories of HRQOL in patients with CAD. Despite overall improvements in HRQOL, about a quarter of our cohort experienced a significant decline in their HRQOL over the 5-year period. Understanding these HRQOL trajectories may help personalize prognostic information, identify patients and HRQOL domains on which clinical interventions are most beneficial, and support treatment decisions for patients with CAD.
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Affiliation(s)
- Tolulope T Sajobi
- From the Department of Community Health Sciences, O'Brien Institute for Public Health (T.T.S., M.W., M.S., D.S., Z.L., D.G., H.Q., M.T.J., W.A.G.), Department of Cardiac Sciences (D.G., S.B.W., M.L.K.), and Department of Medicine (S.B.W., M.T.J., W.A.G., M.L.K.), University of Calgary, Canada; Faculty of Health Sciences, University of Lethbridge, Canada (O.A.); and Faculty of Medicine & Dentistry (M.M.G.) and Faculty of Nursing (C.N.), University of Alberta, Edmonton, Canada.
| | - Meng Wang
- From the Department of Community Health Sciences, O'Brien Institute for Public Health (T.T.S., M.W., M.S., D.S., Z.L., D.G., H.Q., M.T.J., W.A.G.), Department of Cardiac Sciences (D.G., S.B.W., M.L.K.), and Department of Medicine (S.B.W., M.T.J., W.A.G., M.L.K.), University of Calgary, Canada; Faculty of Health Sciences, University of Lethbridge, Canada (O.A.); and Faculty of Medicine & Dentistry (M.M.G.) and Faculty of Nursing (C.N.), University of Alberta, Edmonton, Canada
| | - Oluwagbohunmi Awosoga
- From the Department of Community Health Sciences, O'Brien Institute for Public Health (T.T.S., M.W., M.S., D.S., Z.L., D.G., H.Q., M.T.J., W.A.G.), Department of Cardiac Sciences (D.G., S.B.W., M.L.K.), and Department of Medicine (S.B.W., M.T.J., W.A.G., M.L.K.), University of Calgary, Canada; Faculty of Health Sciences, University of Lethbridge, Canada (O.A.); and Faculty of Medicine & Dentistry (M.M.G.) and Faculty of Nursing (C.N.), University of Alberta, Edmonton, Canada
| | - Maria Santana
- From the Department of Community Health Sciences, O'Brien Institute for Public Health (T.T.S., M.W., M.S., D.S., Z.L., D.G., H.Q., M.T.J., W.A.G.), Department of Cardiac Sciences (D.G., S.B.W., M.L.K.), and Department of Medicine (S.B.W., M.T.J., W.A.G., M.L.K.), University of Calgary, Canada; Faculty of Health Sciences, University of Lethbridge, Canada (O.A.); and Faculty of Medicine & Dentistry (M.M.G.) and Faculty of Nursing (C.N.), University of Alberta, Edmonton, Canada
| | - Danielle Southern
- From the Department of Community Health Sciences, O'Brien Institute for Public Health (T.T.S., M.W., M.S., D.S., Z.L., D.G., H.Q., M.T.J., W.A.G.), Department of Cardiac Sciences (D.G., S.B.W., M.L.K.), and Department of Medicine (S.B.W., M.T.J., W.A.G., M.L.K.), University of Calgary, Canada; Faculty of Health Sciences, University of Lethbridge, Canada (O.A.); and Faculty of Medicine & Dentistry (M.M.G.) and Faculty of Nursing (C.N.), University of Alberta, Edmonton, Canada
| | - Zhiying Liang
- From the Department of Community Health Sciences, O'Brien Institute for Public Health (T.T.S., M.W., M.S., D.S., Z.L., D.G., H.Q., M.T.J., W.A.G.), Department of Cardiac Sciences (D.G., S.B.W., M.L.K.), and Department of Medicine (S.B.W., M.T.J., W.A.G., M.L.K.), University of Calgary, Canada; Faculty of Health Sciences, University of Lethbridge, Canada (O.A.); and Faculty of Medicine & Dentistry (M.M.G.) and Faculty of Nursing (C.N.), University of Alberta, Edmonton, Canada
| | - Diane Galbraith
- From the Department of Community Health Sciences, O'Brien Institute for Public Health (T.T.S., M.W., M.S., D.S., Z.L., D.G., H.Q., M.T.J., W.A.G.), Department of Cardiac Sciences (D.G., S.B.W., M.L.K.), and Department of Medicine (S.B.W., M.T.J., W.A.G., M.L.K.), University of Calgary, Canada; Faculty of Health Sciences, University of Lethbridge, Canada (O.A.); and Faculty of Medicine & Dentistry (M.M.G.) and Faculty of Nursing (C.N.), University of Alberta, Edmonton, Canada
| | - Stephen B Wilton
- From the Department of Community Health Sciences, O'Brien Institute for Public Health (T.T.S., M.W., M.S., D.S., Z.L., D.G., H.Q., M.T.J., W.A.G.), Department of Cardiac Sciences (D.G., S.B.W., M.L.K.), and Department of Medicine (S.B.W., M.T.J., W.A.G., M.L.K.), University of Calgary, Canada; Faculty of Health Sciences, University of Lethbridge, Canada (O.A.); and Faculty of Medicine & Dentistry (M.M.G.) and Faculty of Nursing (C.N.), University of Alberta, Edmonton, Canada
| | - Hude Quan
- From the Department of Community Health Sciences, O'Brien Institute for Public Health (T.T.S., M.W., M.S., D.S., Z.L., D.G., H.Q., M.T.J., W.A.G.), Department of Cardiac Sciences (D.G., S.B.W., M.L.K.), and Department of Medicine (S.B.W., M.T.J., W.A.G., M.L.K.), University of Calgary, Canada; Faculty of Health Sciences, University of Lethbridge, Canada (O.A.); and Faculty of Medicine & Dentistry (M.M.G.) and Faculty of Nursing (C.N.), University of Alberta, Edmonton, Canada
| | - Michelle M Graham
- From the Department of Community Health Sciences, O'Brien Institute for Public Health (T.T.S., M.W., M.S., D.S., Z.L., D.G., H.Q., M.T.J., W.A.G.), Department of Cardiac Sciences (D.G., S.B.W., M.L.K.), and Department of Medicine (S.B.W., M.T.J., W.A.G., M.L.K.), University of Calgary, Canada; Faculty of Health Sciences, University of Lethbridge, Canada (O.A.); and Faculty of Medicine & Dentistry (M.M.G.) and Faculty of Nursing (C.N.), University of Alberta, Edmonton, Canada
| | - Matthew T James
- From the Department of Community Health Sciences, O'Brien Institute for Public Health (T.T.S., M.W., M.S., D.S., Z.L., D.G., H.Q., M.T.J., W.A.G.), Department of Cardiac Sciences (D.G., S.B.W., M.L.K.), and Department of Medicine (S.B.W., M.T.J., W.A.G., M.L.K.), University of Calgary, Canada; Faculty of Health Sciences, University of Lethbridge, Canada (O.A.); and Faculty of Medicine & Dentistry (M.M.G.) and Faculty of Nursing (C.N.), University of Alberta, Edmonton, Canada
| | - William A Ghali
- From the Department of Community Health Sciences, O'Brien Institute for Public Health (T.T.S., M.W., M.S., D.S., Z.L., D.G., H.Q., M.T.J., W.A.G.), Department of Cardiac Sciences (D.G., S.B.W., M.L.K.), and Department of Medicine (S.B.W., M.T.J., W.A.G., M.L.K.), University of Calgary, Canada; Faculty of Health Sciences, University of Lethbridge, Canada (O.A.); and Faculty of Medicine & Dentistry (M.M.G.) and Faculty of Nursing (C.N.), University of Alberta, Edmonton, Canada
| | - Merrill L Knudtson
- From the Department of Community Health Sciences, O'Brien Institute for Public Health (T.T.S., M.W., M.S., D.S., Z.L., D.G., H.Q., M.T.J., W.A.G.), Department of Cardiac Sciences (D.G., S.B.W., M.L.K.), and Department of Medicine (S.B.W., M.T.J., W.A.G., M.L.K.), University of Calgary, Canada; Faculty of Health Sciences, University of Lethbridge, Canada (O.A.); and Faculty of Medicine & Dentistry (M.M.G.) and Faculty of Nursing (C.N.), University of Alberta, Edmonton, Canada
| | - Colleen Norris
- From the Department of Community Health Sciences, O'Brien Institute for Public Health (T.T.S., M.W., M.S., D.S., Z.L., D.G., H.Q., M.T.J., W.A.G.), Department of Cardiac Sciences (D.G., S.B.W., M.L.K.), and Department of Medicine (S.B.W., M.T.J., W.A.G., M.L.K.), University of Calgary, Canada; Faculty of Health Sciences, University of Lethbridge, Canada (O.A.); and Faculty of Medicine & Dentistry (M.M.G.) and Faculty of Nursing (C.N.), University of Alberta, Edmonton, Canada
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Trajectories of perceived social support in acute coronary syndrome. Qual Life Res 2019; 28:1365-1376. [DOI: 10.1007/s11136-018-02095-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2018] [Indexed: 01/14/2023]
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Park EY, Won-Ho K. Participation restriction of stroke survivors: Verification of the moderating effects of demographic characteristics. COGENT PSYCHOLOGY 2019. [DOI: 10.1080/23311908.2019.1674090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- Eun-Young Park
- Professor of the Department of Secondary Special Education, College of Education, Jeonju University, 303 Cheonjam-ro, Wansan-gu 55069, South Korea
| | - Kim Won-Ho
- Professor of the Department of Physical Therapy, Ulsan College, 101 Bong su-ro, Dong-gu 44022, South Korea
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Bohm M, Lilja G, Finnbogadóttir H, Cronberg T, Undén J, Friberg H, Kjærgaard J, Nielsen N, Wise MP, Åkerman E. Detailed analysis of health-related quality of life after out-of-hospital cardiac arrest. Resuscitation 2018; 135:197-204. [PMID: 30385386 DOI: 10.1016/j.resuscitation.2018.10.028] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 10/18/2018] [Accepted: 10/28/2018] [Indexed: 11/18/2022]
Abstract
AIM To describe the detailed health-related quality of life (HRQoL) in survivors from the TTM-trial and to investigate potential differences related to sex and age. METHODS This is a cross-sectional study originating from a large prospective international, multicentre trial, including 442 respondents who answered the Short Form-36 item Questionnaire Health Survey version 2® (SF-36v2®) at a structured follow-up 6 months after out-of-hospital cardiac arrest (OHCA). Statistical analysis between independent groups were performed with Mann-Whitney U or Chi-square. Age was analysed primarily as a dichotomised variable. RESULTS Although overall physical and mental health were within the normal range, a substantial proportion of respondents had impaired function at domain-specific levels, particularly in Role-Physical (50%) and Role-Emotional (35%). Females scored significantly lower than males in; Physical Functioning (41.7 vs. 47.9, p < 0.001), Role-Physical (40.4 vs. 44.3, p = 0.02), General Health (47.0 vs. 50.5, p = 0.02), Vitality (47.2 vs. 52.7, p < 0.001), and Role-Emotional (41.5 vs. 46.2, p = 0.009). Those ≤65 years scored significantly better in Physical Functioning (47.9 vs. 44.1 p < 0.001), while those >65 years scored significantly better in Vitality (50.8 vs. 53.7, p = 0.006) and Mental Health (50.3 vs. 52.6, p = 0.04). CONCLUSIONS Many OHCA survivors demonstrated impaired function in HRQoL at a domain level, despite most patients reporting an acceptable general HRQoL. Females reported worse HRQoL than males. Older age was associated with a worse Physical Functioning but better Vitality and Mental Health. Role-Physical and Role-Emotional aspects of health were especially affected, even when effects of age and sex where accounted for.
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Affiliation(s)
- Mattias Bohm
- Department of Intensive and Perioperative Care, Skåne University Hospital, Malmö, Sweden.
| | - Gisela Lilja
- Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Neurology, Lund, Sweden
| | - Hafrún Finnbogadóttir
- Department of Care Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
| | - Tobias Cronberg
- Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Neurology, Lund, Sweden
| | - Johan Undén
- Lund University, Hallands Hospital Halmstad, Department of Operation and Intensive Care, Halmstad, Sweden
| | - Hans Friberg
- Lund University, Skåne University Hospital, Department of Clinical Sciences Lund, Department of Intensive and Perioperative Care, Malmö, Sweden
| | - Jesper Kjærgaard
- Department of Cardiology, The Heart Center, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Niklas Nielsen
- Lund University, Helsingborg Hospital, Department of Anesthesiology and Intensive Care, Helsingborg, Sweden
| | - Matt P Wise
- Adult Critical Care, University Hospital of Wales, Cardiff, United Kingdom
| | - Eva Åkerman
- Department of Perioperative Medicine and Intensive Care, Karolinska University Hospital, Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
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Affiliation(s)
- Ellen K Brinza
- Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA
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Mommersteeg PMC, Arts L, Zijlstra W, Widdershoven JW, Aarnoudse W, Denollet J. Impaired Health Status, Psychological Distress, and Personality in Women and Men With Nonobstructive Coronary Artery Disease: Sex and Gender Differences: The TWIST (Tweesteden Mild Stenosis) Study. Circ Cardiovasc Qual Outcomes 2017; 10:e003387. [PMID: 28228453 PMCID: PMC5333724 DOI: 10.1161/circoutcomes.116.003387] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 01/20/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Patients with nonobstructive coronary artery disease (NOCAD; wall irregularities, stenosis <60%), and women with NOCAD in particular, remain underinvestigated. We examined sex and gender (S&G) differences in health status, psychological distress, and personality between patients with NOCAD and the general population, as well as S&G differences within the NOCAD population. METHODS AND RESULTS In total, 523 patients with NOCAD (61±9 years, 52% women) were included via coronary angiography and computed tomography as part of the TWIST (Tweesteden Mild Stenosis) study. Generic health status (12-item Short Form physical and mental scales and fatigue), psychological distress (Hospital Anxiety and Depression Scale anxiety and depressive symptoms and Global Mood Scale negative and positive affect), and personality (Type D personality) were compared between patients with NOCAD and an age- and sex-matched group of 1347 people from the general population. Frequency matching was performed to obtain a similar sex distribution in each age-decile group. Both men and women with NOCAD reported impaired health status, more psychological distress, and Type D personality compared with men and women in the reference group. Women reported more psychosocial distress compared with men, but no significant sex-by-group interaction effects were observed. Women with NOCAD reported impaired health status, more anxiety, and less positive affect, but no differences in depressive symptoms, angina, or Type D personality when compared with men with NOCAD. Age, education, employment, partner, and alcohol use explained these S&G differences within the NOCAD group. CONCLUSIONS In both men and women, NOCAD was associated with impaired health status, more psychological distress, and Type D personality when compared with a reference population. Factors reflecting S&G differences explained these S&G findings in patient-reported outcomes. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT01788241.
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Affiliation(s)
- Paula M C Mommersteeg
- From the Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, The Netherlands (P.M.C.M., L.A, W.Z., J.W., J.D.); and Department of Cardiology, Elisabeth-Tweesteden Hospital, The Netherlands (J.W., W.A.).
| | - Lindy Arts
- From the Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, The Netherlands (P.M.C.M., L.A, W.Z., J.W., J.D.); and Department of Cardiology, Elisabeth-Tweesteden Hospital, The Netherlands (J.W., W.A.)
| | - Wobbe Zijlstra
- From the Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, The Netherlands (P.M.C.M., L.A, W.Z., J.W., J.D.); and Department of Cardiology, Elisabeth-Tweesteden Hospital, The Netherlands (J.W., W.A.)
| | - Jos W Widdershoven
- From the Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, The Netherlands (P.M.C.M., L.A, W.Z., J.W., J.D.); and Department of Cardiology, Elisabeth-Tweesteden Hospital, The Netherlands (J.W., W.A.)
| | - Wilbert Aarnoudse
- From the Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, The Netherlands (P.M.C.M., L.A, W.Z., J.W., J.D.); and Department of Cardiology, Elisabeth-Tweesteden Hospital, The Netherlands (J.W., W.A.)
| | - Johan Denollet
- From the Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, The Netherlands (P.M.C.M., L.A, W.Z., J.W., J.D.); and Department of Cardiology, Elisabeth-Tweesteden Hospital, The Netherlands (J.W., W.A.)
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Wasiak J, Lee SJ, Paul E, Shen A, Tan H, Cleland H, Gabbe B. Female patients display poorer burn-specific quality of life 12 months after a burn injury. Injury 2017; 48:87-93. [PMID: 27476885 DOI: 10.1016/j.injury.2016.07.032] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 07/11/2016] [Accepted: 07/20/2016] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Although gender differences in morbidity and mortality have been measured in patients with moderate to severe burn injury, little attention has been directed at gender effects on health-related quality of life (HRQoL) following burn injury. The current study was therefore conducted to prospectively measure changes in HRQoL for males and females in a sample of burn patients. METHODS A total of 114 adults who received treatment at a statewide burns service for a sustained burns injury participated in this study. Instruments measuring generic health status (Short Form 36 Medical Outcomes Survey version 2), burn-specific HRQoL (Burns Specific Health Scale-Brief), psychological distress (Kessler Psychological Distress Scale) and alcohol use (Alcohol Use Disorders Identification Tool) were prospectively measured at 3, 6 and 12 months post-burn. RESULTS In the 12 months post-injury, female patients showed overall poorer physical (p=0.01) and mental health status (p<0.001), greater psychological distress (p<0.001), and greater difficulty with aspects of burn-specific HRQoL: body image (p<0.001), affect (p<0.001), interpersonal functioning (p=0.005), heat sensitivity (p=0.01) and treatment regime (p=0.01). While significant interaction effects suggested that female patients had more improvement in difficulties with treatment regime (p=0.007), female patients continued to report greater difficulty with multiple aspects of physical and psychosocial health status 12 months post-injury. CONCLUSION Even though demographic variables, injury characteristics and burn care interventions were similar across genders, following burn injury female patients reported greater impairments in generic and burn-specific HRQoL along with psychological morbidity, when compared to male patients. Urgent clinical and research attention utilising an evidence-based research framework, which incorporates the use of larger sample sizes, the use of validated instruments to measure appropriate outcomes, and a commitment to monitoring long-term care, can only improve burn-care.
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Affiliation(s)
- J Wasiak
- Victorian Adult Burns Service, The Alfred, Melbourne, Australia; Epworth Hospital, Richmond, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - S J Lee
- Monash Alfred Psychiatry Research Centre, The Alfred and Central Clinical School Monash University, Melbourne, Australia
| | - E Paul
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia; Clinical Haematology Department, The Alfred, Melbourne, Australia
| | - A Shen
- Victorian Adult Burns Service, The Alfred, Melbourne, Australia
| | - H Tan
- Victorian Adult Burns Service, The Alfred, Melbourne, Australia
| | - H Cleland
- Victorian Adult Burns Service, The Alfred, Melbourne, Australia
| | - B Gabbe
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Predictors of Health-Related Quality of Life in Patients with Co-Morbid Diabetes and Chronic Kidney Disease. PLoS One 2016; 11:e0168491. [PMID: 27992595 PMCID: PMC5167387 DOI: 10.1371/journal.pone.0168491] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Accepted: 12/01/2016] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND People living with diabetes and chronic kidney disease (CKD) experience compromised quality of life. Consequently, it is critical to identify and understand factors influencing their health-related quality of life (HRQoL). This study examined factors associated with HRQoL among patients with diabetes and CKD. METHODS A cross sectional study among adults with comorbid diabetes and CKD (eGFR <60 mL/min/1.73m2) recruited from renal and diabetes clinics of four large tertiary referral hospitals in Australia was performed. Each participant completed the Kidney Disease Quality of Life (KDQoL ™ -36) questionnaire, which is comprised of two composite measures of physical and mental health and 3 kidney disease specific subscales with possible scores ranging from 0 to 100 with higher values indicating better HRQoL. Demographic and clinical data were also collected. Regression analyses were performed to determine the relationship between HRQoL and potential predictor factors. RESULTS A total of 308 patients were studied with a mean age of 66.9 (SD = 11.0) years and 70% were males. Mean scores for the physical composite summary, mental composite summary, symptom/problem list, effects of kidney disease and burden of kidney disease scales were 35.2, 47.0, 73.8, 72.5 and 59.8 respectively. Younger age was associated with lower scores in all subscales except for the physical composite summary. Female gender, obese or normal weight rather than overweight, and smoking were all associated with lower scores in one or more subscales. Scores were progressively lower with more advanced stage of CKD (p<0.05) in all subscales except for the mental composite summary. CONCLUSION In patients with diabetes and CKD, younger age was associated with lower scores in all HRQoL subscales except the physical composite summary and female gender, obese or normal weight and more advanced stages of CKD were associated with lower scores in one or more subscales. Identifying these factors will inform the timely implementation of interventions to improve the quality of life of these patients.
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Tchicaya A, Lorentz N. Socioeconomic inequalities in health-related quality of life between men and women, 5 years after a coronary angiography. Health Qual Life Outcomes 2016; 14:165. [PMID: 27912774 PMCID: PMC5135793 DOI: 10.1186/s12955-016-0570-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 11/29/2016] [Indexed: 11/25/2022] Open
Abstract
Background The aim of this study is to measure gender differences in health-related quality of life (HRQOL) among men and women patients with cardiovascular diseases (CVD), and to assess the impact of socioeconomic factors on HRQOL between men and women, 5 years after a coronary angiography. Methods The study included 1,289 out of 4,391 patients who had undergone an angiography in the National Institute for Cardiac Surgery and Interventional Cardiology, Luxembourg in 2008/2009. Four indicators of the WHOQOL-BREF questionnaire (Self-rated health, Quality of life, Physical health, and Psychological health) were used in this study as interest variables. To assess the socioeconomic inequalities in HRQOL between men and women, general linear models were constructed for every indicator, with educational level and living conditions as predictors, and demographic variables, cardiovascular risk factors, and cardiovascular events as covariates. Results Women were older than men (71.5 versus 68.1, p <0.0001) and less likely to be married. HRQOL was significantly different between men and women despite the fact they had the same socioeconomic status. The average score for overall health was 3.7/5 for men versus 3.5/5 for women; similarly, the life quality score was 3.8/5 for men versus 3.6/5 for women. Education level and living conditions were associated with lower HRQOL scores in men and women. Conclusion The findings showed that women have lower HRQOL than men regarding self-rated health, quality of life, and the WHOQOL-BREF physical and psychological domains 5 years after a coronary angiography. Socioeconomic inequalities affect HRQOL, and their influence was similar in both men and women. Socioeconomic inequalities in HRQOL in women and men with CVD are strong 5 years after a coronary angiography. Taking into account differences in gender and socioeconomic status in intervention strategies to substantially reduce the differences observed between women and men could help improve the effectiveness of secondary prevention.
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Affiliation(s)
- Anastase Tchicaya
- LISER- Luxembourg Institute of Socio-Economic Research, LISER, 11 Porte des Sciences, L4366, Esch-Sur-Alzette, Luxembourg.
| | - Nathalie Lorentz
- LISER- Luxembourg Institute of Socio-Economic Research, LISER, 11 Porte des Sciences, L4366, Esch-Sur-Alzette, Luxembourg
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Chai W, Fan JX, Wen M. Association of individual and community factors with C-reactive protein and 25-hydroxyvitamin D: Evidence from the National Health and Nutrition Examination Survey (NHANES). SSM Popul Health 2016; 2:889-896. [PMID: 27995178 PMCID: PMC5161036 DOI: 10.1016/j.ssmph.2016.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Revised: 10/21/2016] [Accepted: 11/14/2016] [Indexed: 01/09/2023] Open
Abstract
Many individual and community/neighborhood factors may contribute to inflammation and vitamin D deficiency leading to the development of chronic diseases. This study examined the associations of serum C-reactive protein (CRP) and 25-hydroxyvitamin D [25(OH)D] levels with individual and community/neighborhood (tract-level or county-level) factors using a nationally representative sample from 2001-2006 National Health and Nutrition Examination Survey (NHANES). Data from the 2001-2006 waves of the continuous NHANES was merged with the 2000 census and other neighborhood data sources constructed using geographic information system. Associations between multilevel factors and biomarker levels were assessed using multilevel random-intercept regression models. 6643 participants aged 19-65 (3402 men and 3241 women) were included in the analysis. Family income-to-needs ratio was inversely associated with CRP (P=0.002) and positively associated with 25(OH)D levels (P=0.0003). County crime rates were positively associated with CRP (P=0.007) and inversely associated with 25(OH)D levels (P=0.0002). The associations with income-to-needs ratio were significant in men [CRP; P=0.005; 25(OH)D, P=0.005] but not in women. For county crime rates, the association was only significant in women for CRP (P=0.004) and was significant in both men (P=0.01) and women (P=0.001) for 25(OH)D. Additionally, overall CRP was positively associated with age (P<0.0001), female sex (P<0.0001), Hispanic race/ethnicity (P=0.0001), current smokers (P<0.0001), body mass index (BMI, P<0.0001), and participants who were US-born (P=0.02). Non-Hispanic black (P<0.0001) and Hispanic race/ethnicity (P<0.0001), current smoker (P=0.047), and higher BMI (P<0.0001) were associated with lower serum 25(OH)D levels. No significant associations were observed between other community/neighborhood variables and serum CRP and 25(OH)D levels. The current results suggest that family income-to-needs ratio and county crime rate may be important contributors to chronic inflammation and vitamin D status.
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Affiliation(s)
- Weiwen Chai
- Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Jessie X. Fan
- Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT, USA
| | - Ming Wen
- Department of Sociology, University of Utah, Salt Lake City, UT, USA
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Randolph TC, Simon DN, Thomas L, Allen LA, Fonarow GC, Gersh BJ, Kowey PR, Reiffel JA, Naccarelli GV, Chan PS, Spertus JA, Peterson ED, Piccini JP. Patient factors associated with quality of life in atrial fibrillation. Am Heart J 2016; 182:135-143. [PMID: 27914493 DOI: 10.1016/j.ahj.2016.08.003] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 08/12/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND As treatment options for atrial fibrillation (AF) increase, more attention is focused on patients' experiences and quality of life (QoL). However, little is known about the factors associated with these outcomes. METHODS The Atrial Fibrillation Effect on QualiTy-of-life (AFEQT) is a disease-specific QoL tool for AF, with domain and summary scores ranging from 0 (the worst QoL) to 100. Using multivariable linear regression, we evaluated factors associated with baseline AFEQT Summary and Subscale Scores in ORBIT AF, a large, community-based AF registry. Independent associations were reported as coefficient estimates in scores and 95% confidence intervals (CI). RESULTS Overall, AFEQT was assessed in 2007 AF outpatients from 99 sites. Median age (IQR) was 76 years (67-82) and 43% were female. The median AFEQT summary score was 82 (67-94). Female sex, younger age, new onset AF, higher heart rate, obstructive sleep apnea, symptomatic heart failure (HF), chronic obstructive pulmonary disease and coronary artery disease were all independently associated with reduced QoL. Female sex [Estimate -7.03, 95% CI (-9.31, -4.75)] and new onset versus permanent AF [Estimate -7.44, 95% CI (-11.03, -3.84)] were independently associated with increased symptoms. NYHA Class III or IV HF [Estimate -14.44, 95% CI (-19.46, -8.76)] and female sex [Estimate -7.91, 95% CI (-9.95, -5.88)] were most independently associated with impaired daily activities. CONCLUSIONS QoL in patients with AF varies widely and is associated with several patient factors. Understanding patient factors independently associated with worse QoL can be a foundation for tailoring treatment.
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Norris CM, Johnson NL, Hardwicke-Brown E, McEwan M, Pelletier R, Pilote L. The Contribution of Gender to Apparent Sex Differences in Health Status Among Patients with Coronary Artery Disease. J Womens Health (Larchmt) 2016; 26:50-57. [PMID: 27400270 DOI: 10.1089/jwh.2016.5744] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND While it has been identified that gender (socially manufactured roles, behaviors, expressions, and identities) plays a central role in men's and women's health, the distinction between gender and sex (biological attributes) has largely been ignored in health science research. The purpose of this study was to look at the unique contributions of sex, age, and the Gender Index (GI) to baseline health status in a cohort of patients with coronary artery disease (CAD). PARTICIPANTS AND METHODS Questions that comprised the GI were included in the follow-up questionnaire sent to patients in the APPROACH registry. To examine the relationship between sex, gender, and health status, a sequential linear regression modeling approach was used. RESULTS A total of 632 patients completed the GI between July and August 2015. The women were significantly older (68 years vs. 66 years, p = 0.02) and significantly more likely to have hypertension (50.8% vs. 38.8%, p = 0.02) compared to the men. Women reported significantly lower mean Seattle Angina Questionnaire (SAQ) scores compared to men. The inclusion of age into the models did not change the relationship between sex and the SAQ scales. However, the inclusion of the GI attenuated the relationship between sex and the SAQ scale scores. CONCLUSIONS Our results support the concept that sex differences in health status outcomes may be better explained by patient's gender-related characteristics, than biological sex characteristics. More importantly, the GI offers a pragmatic composite score to assess the effects of psychosocial factors that researchers interested in measuring gender could use in studies of subjects with CAD.
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Affiliation(s)
- Colleen M Norris
- 1 Faculty of Nursing, University of Alberta , Edmonton, Alberta.,2 Heart Health and Stroke Strategic Clinical Network, Alberta Health Services , Edmonton, Alberta.,3 Division of CV Surgery, Faculty of Medicine, University of Alberta , Edmonton, Alberta
| | | | | | - Matthew McEwan
- 2 Heart Health and Stroke Strategic Clinical Network, Alberta Health Services , Edmonton, Alberta
| | - Roxanne Pelletier
- 5 Division of Clinical Epidemiology, Research Institute of the McGill University , Montreal, Québec
| | - Louise Pilote
- 5 Division of Clinical Epidemiology, Research Institute of the McGill University , Montreal, Québec.,6 Division of General Internal Medicine, McGill University , Montreal, Québec
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Brewer LC, Svatikova A, Mulvagh SL. The Challenges of Prevention, Diagnosis and Treatment of Ischemic Heart Disease in Women. Cardiovasc Drugs Ther 2016. [PMID: 26210899 DOI: 10.1007/s10557-015-6607-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Increasing evidence suggests that there are significant differences in the presentation, diagnosis and treatment of ischemic heart disease in women compared to men. Women often present with atypical symptoms, and this, in association with a consistent underestimation of their risk for ischemic heart disease, leads to underdiagnosis and undertreatment in women. Cardiovascular risk factors unique to women have only recently been recognized, and moreover, traditional risk factors have recently been shown to have greater impacts on women. Consequently, women suffer more disability and poorer clinical outcomes, with higher cardiovascular morbidity and mortality. These discrepancies may in part be secondary to the higher prevalence of nonobstructive coronary artery disease in women with persistent chest pain symptoms as compared to men when evaluated invasively. Focused diagnostic and therapeutic strategies unique to women are thus needed, but unfortunately, such sex-specific guidelines do not yet exist, largely due to lack of awareness, both on the part of providers and patients, as well as a paucity of evidence-based research specific to women. Although underutilized in women, diagnostic modalities, including functional and anatomic cardiac tests as well as physiologic assessments of endothelial and microvascular function, are useful for establishing the diagnosis and prognosis of suspected ischemic heart disease in women. This review discusses the current challenges of prevention, diagnosis and treatment of ischemic heart disease in women.
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McSweeney JC, Rosenfeld AG, Abel WM, Braun LT, Burke LE, Daugherty SL, Fletcher GF, Gulati M, Mehta LS, Pettey C, Reckelhoff JF. Preventing and Experiencing Ischemic Heart Disease as a Woman: State of the Science: A Scientific Statement From the American Heart Association. Circulation 2016; 133:1302-31. [PMID: 26927362 PMCID: PMC5154387 DOI: 10.1161/cir.0000000000000381] [Citation(s) in RCA: 176] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Stevanović J, Pechlivanoglou P, Kampinga MA, Krabbe PFM, Postma MJ. Multivariate Meta-Analysis of Preference-Based Quality of Life Values in Coronary Heart Disease. PLoS One 2016; 11:e0152030. [PMID: 27011260 PMCID: PMC4806923 DOI: 10.1371/journal.pone.0152030] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 03/08/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND There are numerous health-related quality of life (HRQol) measurements used in coronary heart disease (CHD) in the literature. However, only values assessed with preference-based instruments can be directly applied in a cost-utility analysis (CUA). OBJECTIVE To summarize and synthesize instrument-specific preference-based values in CHD and the underlying disease-subgroups, stable angina and post-acute coronary syndrome (post-ACS), for developed countries, while accounting for study-level characteristics, and within- and between-study correlation. METHODS A systematic review was conducted to identify studies reporting preference-based values in CHD. A multivariate meta-analysis was applied to synthesize the HRQoL values. Meta-regression analyses examined the effect of study level covariates age, publication year, prevalence of diabetes and gender. RESULTS A total of 40 studies providing preference-based values were detected. Synthesized estimates of HRQoL in post-ACS ranged from 0.64 (Quality of Well-Being) to 0.92 (EuroQol European"tariff"), while in stable angina they ranged from 0.64 (Short form 6D) to 0.89 (Standard Gamble). Similar findings were observed in estimates applying to general CHD. No significant improvement in model fit was found after adjusting for study-level covariates. Large between-study heterogeneity was observed in all the models investigated. CONCLUSIONS The main finding of our study is the presence of large heterogeneity both within and between instrument-specific HRQoL values. Current economic models in CHD ignore this between-study heterogeneity. Multivariate meta-analysis can quantify this heterogeneity and offers the means for uncertainty around HRQoL values to be translated to uncertainty in CUAs.
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Affiliation(s)
- Jelena Stevanović
- University of Groningen, Department of Pharmacy, Unit of Pharmacoepidemiology and Pharmacoeconomics (PE2), Groningen, The Netherlands
| | - Petros Pechlivanoglou
- Toronto Health Economics and Technology Assessment (THETA), Toronto, Canada.,University of Toronto, Faculty of Medicine, Institute of Health Policy, Management and Evaluation, Toronto, Canada
| | - Marthe A Kampinga
- University of Groningen, University Medical Center Groningen, Department of Cardiology, Thorax Center, Groningen, The Netherlands
| | - Paul F M Krabbe
- University of Groningen, University Medical Centre Groningen, Department of Epidemiology, Groningen, The Netherlands
| | - Maarten J Postma
- University of Groningen, Department of Pharmacy, Unit of Pharmacoepidemiology and Pharmacoeconomics (PE2), Groningen, The Netherlands
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Wang L, Wu YQ, Tang X, Li N, He L, Cao Y, Chen DF, Hu YH. Profile and Correlates of Health-related Quality of Life in Chinese Patients with Coronary Heart Disease. Chin Med J (Engl) 2016; 128:1853-61. [PMID: 26168822 PMCID: PMC4717935 DOI: 10.4103/0366-6999.160486] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Although coronary heart disease (CHD) is one of the major cardiovascular diseases, risk factors associated with the health-related quality of life (HRQoL) of CHD patients remain unclear. The present study was designed to determine the profile and significant factors of the HRQoL in CHD patients. METHODS A cross-sectional study was conducted in rural communities of Fangshan District, Beijing, China. Socio-demographic, lifestyle, and comorbidity information of CHD patients were collected by a structured questionnaire and medical records. HRQoL was measured using European Quality of Life 5-dimensions (EQ-5D) scale and EQ Visual Analog Scale (EQ-VAS). Multiple linear and logistic regressions were performed to explore the association of potential risk factors with HRQoL scores and each EQ-5D, respectively. RESULTS Totally, 1928 CHD patients (mean age 61.64 ± 9.24 years; female:male = 2.4:1) were enrolled in the study. The mean score of EQ-5D index and EQ-VAS were 0.889 ± 0.172 and 71.56 ± 17.65, respectively. Multiple linear regression revealed that marital status, physical activity, moderate alcohol drinking, and family's population were positive independent correlates of EQ-VAS, whereas diabetes mellitus and stroke were negative independent correlates (all P < 0.05). Age and stroke were negatively while physical activity, moderate alcohol drinking, family's population and household income were positively correlated with EQ-5D index (all P < 0.05) independently. In addition, each of the five HRQoL dimensions had various specific determinants, including obesity, underweight, smoking or education. CONCLUSIONS Findings of the study highlight certain socio-demographic, lifestyle factors, and comorbid stroke or diabetes mellitus as correlates of HRQoL in Chinese CHD patients. Large-scale cohort studies should be carried out to confirm our results in the future.
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Affiliation(s)
| | | | | | | | | | | | | | - Yong-Hua Hu
- Department of Epidemiology and Biostatistics, Peking University Health Science Center, Beijing 100191, China
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De Smedt D, Clays E, Höfer S, Oldridge N, Kotseva K, Maggioni AP, Pogosova N, Dolzhenko M, De Bacquer D. The use of HeartQoL in patients with coronary heart disease: Association with risk factors and European reference values. The EUROASPIRE IV study of the European Society of Cardiology. Eur J Prev Cardiol 2016; 23:1174-86. [PMID: 26862122 DOI: 10.1177/2047487316631400] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 01/19/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND HeartQoL is a recently developed core health-related quality of life instrument for patients with coronary heart disease. The current study aims to investigate its association with patients' coronary risk profile and to provide reference values for patients with coronary heart disease across Europe. DESIGN Analyses are based on the EUROASPIRE IV (EUROpean Action on Secondary and Primary prevention through Intervention to Reduce Events) cross-sectional survey. METHODS Patients with a diagnosis of coronary heart disease were examined and interviewed six months to three years after their coronary event. The HeartQoL questionnaire was completed by 7261 coronary heart disease patients. Reference values were calculated and the association with the coronary risk profile was assessed. RESULTS Significantly worse outcomes were observed in higher-risk patient groups. Both metabolic and behavioural risk factors were associated with worse HeartQoL outcomes. Further, the HeartQoL scores decreased as the number of risk factors increased. The mean global reference values in males were 2.27 ± 0.65 (<60 years), 2.30 ± 0.61 (between 60 and 69 years) and 2.19 ± 0.64 (≥70 years). Likewise, in females, the respective global HeartQoL reference values were 2.02 ± 0.67, 2.01 ± 0.66 and 1.83 ± 0.70. The ceiling effect in males was 11.4%, 10.4% and 7.4% for the three age classes respectively, whereas in females the ceiling effect was 5.2%, 3.5% and 1.9%, respectively. CONCLUSION HeartQoL scores were associated with patients' coronary risk profile. The reference values may help other researchers to interpret HeartQoL scores. Further research should focus on the minimal important difference needed to evaluate the effect of therapies and lifestyle changes.
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Affiliation(s)
| | - Els Clays
- Department of Public Health, Ghent University, Belgium
| | - Stefan Höfer
- Department of Medical Psychology, Innsbruck Medical University, Austria
| | - Neil Oldridge
- College of Health Sciences, University of Wisconsin-Milwaukee, USA
| | - Kornelia Kotseva
- Department of Public Health, Ghent University, Belgium Department of Cardiovascular Medicine, National Heart and Lung Institute, Imperial College London, UK
| | - Aldo Pietro Maggioni
- EURObservational Research Programme Department, European Society of Cardiology, Sophia Antipolis, France
| | - Nana Pogosova
- National Research Centre for Preventive Medicine, Moscow, Russian Federation
| | - Maryna Dolzhenko
- Shupik's National Medical Academy of Postgraduation Education, Kiev, Ukraine
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Gijsberts CM, den Ruijter HM. Non-response to questionnaires independently predicts mortality of coronary angiography patients. Int J Cardiol 2015; 201:168-70. [PMID: 26298369 DOI: 10.1016/j.ijcard.2015.06.150] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 06/26/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Crystel M Gijsberts
- Experimental Cardiology, Department Heart and Lungs, University Medical Center Utrecht, The Netherlands; Netherlands Heart Institute - ICIN, Utrecht, The Netherlands
| | - Hester M den Ruijter
- Experimental Cardiology, Department Heart and Lungs, University Medical Center Utrecht, The Netherlands.
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Factorial Validity and Gender Invariance of the Center for Epidemiological Studies Depression in Cardiac Rehabilitation Patients. J Cardiopulm Rehabil Prev 2015; 35:320-7. [DOI: 10.1097/hcr.0000000000000127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Gijsberts CM, Agostoni P, Hoefer IE, Asselbergs FW, Pasterkamp G, Nathoe H, Appelman YE, de Kleijn DPV, den Ruijter HM. Gender differences in health-related quality of life in patients undergoing coronary angiography. Open Heart 2015; 2:e000231. [PMID: 26339493 PMCID: PMC4555073 DOI: 10.1136/openhrt-2014-000231] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 06/08/2015] [Accepted: 06/09/2015] [Indexed: 01/24/2023] Open
Abstract
Background Health-related quality of life (HRQOL) reflects the general well-being of individuals. In patients with coronary artery disease (CAD), HRQOL is compromised. Female patients with CAD have been reported to have lower HRQOL. In this study, we investigate gender differences in HRQOL and in associations of patient characteristics with HRQOL in patients with coronary angiography (CAG). Methods We cross-sectionally analysed patients from the Utrecht Coronary Biobank undergoing CAG. All patients filled in an HRQOL questionnaire (RAND-36 and EuroQoL) on inclusion. RAND-36 and EuroQoL HRQOL measures were compared between the genders across indications for CAG, CAD severity and treatment of CAD. RAND-36 HRQOL measures were compared with the general Dutch population. Additionally, we assessed interactions of gender with patient characteristics in their association with HRQOL (EuroQoL). Results We included 1421 patients (1020 men and 401 women) with a mean age of 65 in our analysis. Women reported lower HRQOL measures than men (mean EuroQoL self-rated health grade 6.84±1.49 in men, 6.46±1.40 in women, p<0.001). The reduction in RAND-36 HRQOL as compared with the general Dutch population was larger in women than in men. From regression analysis, we found that diabetes, a history of cardiovascular disease and symptoms of shortness of breath determined HRQOL (EuroQoL) more strongly in men than in women. Conclusions Women reported lower HRQOL than men throughout all indications for CAG and regardless of CAD severity or treatment. As compared with the general population, the reduction in HRQOL was more extreme in women than in men. Evident gender differences were found in determinants of HRQOL in patients undergoing CAG, which deserve attention in future research. Trial registration NCT02304744 (clinicaltrials.gov).
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Affiliation(s)
- Crystel M Gijsberts
- Laboratory of Experimental Cardiology, Division Heart and Lungs , University Medical Centre Utrecht , Utrecht , The Netherlands ; ICIN-Netherlands Heart Institute , Utrecht , The Netherlands
| | - Pierfrancesco Agostoni
- Department of Cardiology, Division Heart and Lungs , University Medical Centre Utrecht , Utrecht , The Netherlands
| | - Imo E Hoefer
- Laboratory of Experimental Cardiology, Division Heart and Lungs , University Medical Centre Utrecht , Utrecht , The Netherlands
| | - Folkert W Asselbergs
- Department of Cardiology, Division Heart and Lungs , University Medical Centre Utrecht , Utrecht , The Netherlands ; Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute , Utrecht , The Netherlands ; Faculty of Population Health Sciences , Institute of Cardiovascular Science, University College London , London , UK
| | - Gerard Pasterkamp
- Laboratory of Experimental Cardiology, Division Heart and Lungs , University Medical Centre Utrecht , Utrecht , The Netherlands
| | - Hendrik Nathoe
- Department of Cardiology, Division Heart and Lungs , University Medical Centre Utrecht , Utrecht , The Netherlands
| | - Yolande E Appelman
- Department of Cardiology , VU University Medical Center , Amsterdam , The Netherlands
| | - Dominique P V de Kleijn
- Laboratory of Experimental Cardiology, Division Heart and Lungs , University Medical Centre Utrecht , Utrecht , The Netherlands ; ICIN-Netherlands Heart Institute , Utrecht , The Netherlands ; Department of Surgery , Yong Loo Lin School of Medicine, National University of Singapore , Singapore , Singapore ; Cardiovascular Research Institute, National University Heart Centre, National University Health System , Singapore , Singapore
| | - Hester M den Ruijter
- Laboratory of Experimental Cardiology, Division Heart and Lungs , University Medical Centre Utrecht , Utrecht , The Netherlands
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Olson KL, Stiefel M, Ross C, Stadler S, Hornak R, Sandhoff B, Merenich JA. Self-Rated Health Among Patients with Coronary Artery Disease Enrolled in a Cardiovascular Risk Reduction Service. Popul Health Manag 2015; 19:24-30. [PMID: 26237495 DOI: 10.1089/pop.2014.0178] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Little is known about the use of the single self-rated health (SRH) status item measuring health-related quality of life among people with coronary artery disease (CAD). The objective of this study was to assess relationships between SRH and recurrent coronary events, mortality, health care utilization, and intermediate clinical outcomes and to assess predictors of fair/poor SRH. A total of 5573 patients enrolled in a comprehensive cardiac risk reduction service managed by clinical pharmacy specialists were evaluated over a 2-year period. Regression modeling explored relationships among variables, modeling SRH separately as an independent and a dependent variable. The 1374 (24.7%) respondents reporting fair/poor SRH differed statistically from 4199 (75.3%) respondents reporting good/very good/excellent SRH in terms of age, sex, ethnicity, number of comorbid conditions, DxCG scores, lifestyle behaviors, blood pressure control, and inpatient and emergency department (ED) utilization. Respondents reporting fair/poor health were more likely to have recurrent major coronary events (MCE), including death. Fair/poor SRH was consistently statistically significant when it was included as a predictor in regression modeling for poor blood pressure control, health care utilization, MCE, and all-cause mortality. Variables associated with fair/poor SRH in regression modeling included females, Hispanic ethnicity, ≥1 baseline ED visit, and DxCG score. Exercising <30 minutes per week was strongly associated with fair/poor SRH. Single-item SRH status may help identify patients with CAD at higher risk of poor blood pressure control, recurrent MCE, and death and those who may benefit from interventions to increase physical activity.
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Affiliation(s)
- Kari L Olson
- 1 Kaiser Permanente Colorado , Pharmacy Department, Aurora, Colorado
| | - Matt Stiefel
- 2 Center for Population Health, Care Management Institute , Kaiser Permanente, Oakland, California
| | - Colleen Ross
- 3 Institute for Health Research , Kaiser Permanente Colorado, Denver, Colorado
| | - Sheila Stadler
- 1 Kaiser Permanente Colorado , Pharmacy Department, Aurora, Colorado
| | - Roseanne Hornak
- 1 Kaiser Permanente Colorado , Pharmacy Department, Aurora, Colorado
| | - Brian Sandhoff
- 1 Kaiser Permanente Colorado , Pharmacy Department, Aurora, Colorado
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Dreyer RP, van Zitteren M, Beltrame JF, Fitridge R, Denollet J, Vriens PW, Spertus JA, Smolderen KG. Gender differences in health status and adverse outcomes among patients with peripheral arterial disease. J Am Heart Assoc 2014; 4:e000863. [PMID: 25537275 PMCID: PMC4330046 DOI: 10.1161/jaha.114.000863] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Few studies have examined gender differences in health status and cardiovascular outcomes in patients with peripheral artery disease (PAD). This study assessed (1) self-reported health status at PAD diagnosis and 12-months later, and explored (2) whether outcomes in women with PAD differ with regard to long-term major adverse events. METHODS AND RESULTS A total of 816 patients (285 women) with PAD were enrolled from 2 vascular clinics in the Netherlands. Baseline clinical data and subsequent adverse events were recorded and patients completed the Short Form-12 (SF-12, Physical Component Score [PCS] and Mental Component Score [MCS]) upon PAD diagnosis and 12-months later. Women had similar ages and clinical characteristics, but poorer socio-economic status and more depressive symptoms at initial diagnosis, as compared with men. Women also had poorer physical (PCS: 37±10 versus 40±10, P=0.004) and mental ( MCS 47±12 versus 49±11, P=0.005) health status at the time of presentation. At 12-months, women still reported a poorer overall PCS score (41±12 versus 46±11, P=0.006) and MCS score (42±14 versus 49±12, P=0.002). Female gender was an independent determinant of a poorer baseline and 12-month PCS and MCS scores. However, there were no significant differences by gender on either mortality (unadjusted hazard ratio [HR]=0.93, 95% CI 0.60;1.44, P=0.74) or major adverse events (unadjusted HR=0.90, 95% CI 0.63;1.29, P=0.57), after a median follow-up of 3.2 years. CONCLUSIONS Women's physical and mental health status is compromised both at initial PAD diagnosis and at 12-month follow-up, despite experiencing a similar magnitude of change in their health scores throughout the first 12-months after diagnosis.
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Affiliation(s)
- Rachel P Dreyer
- Center for Outcomes Research and Evaluation (CORE), New Haven, CT (R.P.D.) Department of Internal Medicine, Yale School of Medicine, New Haven, CT (R.P.D.)
| | - Moniek van Zitteren
- CoRPS-Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands (M.Z., J.D.) Department of Vascular Surgery, St. Elisabeth Hospital, Tilburg, The Netherlands (M.Z., P.W.V.)
| | - John F Beltrame
- Discipline of Medicine, The Queen Elizabeth Hospital, University of Adelaide, Adelaide, South Australia (J.F.B.)
| | - Robert Fitridge
- Discipline of Surgery, The Queen Elizabeth Hospital, University of Adelaide, Adelaide, South Australia (R.F.)
| | - Johan Denollet
- CoRPS-Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands (M.Z., J.D.)
| | - Patrick W Vriens
- Department of Vascular Surgery, St. Elisabeth Hospital, Tilburg, The Netherlands (M.Z., P.W.V.)
| | - John A Spertus
- Saint Luke's Mid America Heart Institute, Kansas City, MO (J.A.S., K.G.S.) UMKC-University of Missouri-Kansas City, Kansas City, MO (J.A.S., K.G.S.)
| | - Kim G Smolderen
- Saint Luke's Mid America Heart Institute, Kansas City, MO (J.A.S., K.G.S.) UMKC-University of Missouri-Kansas City, Kansas City, MO (J.A.S., K.G.S.)
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Leung Yinko SSL, Pelletier R, Behlouli H, Norris CM, Humphries KH, Pilote L. Health-related quality of life in premature acute coronary syndrome: does patient sex or gender really matter? J Am Heart Assoc 2014; 3:jah3598. [PMID: 25074696 PMCID: PMC4310372 DOI: 10.1161/jaha.114.000901] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background Limited data exist as to the relative contribution of sex and gender on health‐related quality of life (HRQL) among patients with acute coronary syndrome (ACS). This study aims to evaluate the effect of sex and gender‐related variables on long‐term HRQL among young adults with ACS. Methods and Results GENESIS‐PRAXY (GENdEr and Sex determInantS of cardiovascular disease: from bench to beyond‐Premature Acute Coronary SYndrome) is a multicenter, prospective cohort study (January 2009 to August 2013) of adults aged 18 to 55 years, hospitalized with ACS. HRQL was measured at baseline, 1, 6, and 12 months using the Short Form‐12 and Seattle Angina Questionnaire (SAQ) among 1213 patients. Median age was 49 years. Women reported worse HRQL than men over time post‐ACS, both in terms of physical and mental functioning. Gender‐related factors were more likely to be predictors of HRQL than sex. Femininity score, social support, and housework responsibility were the most common gender‐related predictors of HRQL at 12 months. We observed an interaction between female sex and social support (β=0.44 [95% confidence interval, 0.01, 0.88]; P=0.047) for the physical limitation subscale of the SAQ. Conclusions Young women with ACS report significantly poorer HRQL than young men. Gender appears to be more important than sex in predicting long‐term HRQL post‐ACS. Specific gender‐related factors, such as social support, may be amenable to interventions and could improve the HRQL of patients with premature ACS.
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Affiliation(s)
- Sylvie S L Leung Yinko
- Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada (S.L.L.Y., R.P., H.B., L.P.)
| | - Roxanne Pelletier
- Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada (S.L.L.Y., R.P., H.B., L.P.)
| | - Hassan Behlouli
- Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada (S.L.L.Y., R.P., H.B., L.P.)
| | - Colleen M Norris
- Faculties of Nursing, Medicine and School of Public Health, University of Alberta, Edmonton, Alberta, Canada (C.M.N.)
| | - Karin H Humphries
- Division of Cardiology, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (K.H.H.) Providence Health Care Research Institute, St. Paul's Hospital, Vancouver British, Columbia, Canada (K.H.H.)
| | - Louise Pilote
- Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada (S.L.L.Y., R.P., H.B., L.P.) Division of General Internal Medicine, McGill University Health Centre, Montreal, Quebec, Canada (L.P.)
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Furuya RK, Costa EDCA, Coelho M, Richter VC, Dessotte CAM, Schmidt A, Dantas RAS, Rossi LA. [Anxiety and depression among men and women who underwent percutaneous coronary intervention]. Rev Esc Enferm USP 2014; 47:1333-7. [PMID: 24626358 DOI: 10.1590/s0080-623420130000600012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 09/27/2013] [Indexed: 11/22/2022] Open
Abstract
A descriptive, cross-sectional, correlational study aimed to investigate the association of sex and the presence of anxiety and depression after hospital discharge in patients who underwent percutaneous coronary intervention (PCI). Fifty-nine patients undergoing PCI and receiving outpatient treatment in the first seven months after hospital discharge were evaluated. To assess the symptoms of anxiety and depression the Hospital Anxiety and Depression Scale (HADS) was used. To test the possible associations between the variables anxiety, depression and sex the Chi-square test was used with a significance level of 5%. The results indicated a greater number of women with depression and the association between the variables sex and depression was statistically significant. In relation to anxiety, cases were more frequent in males and the association between the variables sex and anxiety was not statistically significant.
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Affiliation(s)
- Rejane Kiyomi Furuya
- Escola de Enfermagem, Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Brasil, Ribeirão PretoSP, Enfermeira. Doutoranda, Programa Interunidades, Escola de Enfermagem , Escola de Enfermagem de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto , SP , Brasil
| | - Eliana de Cássia Arantes Costa
- Universidade de Franca, Brasil, SP, Terapeuta Ocupacional. Especialista em Saúde Pública, Universidade de Franca , SP , Brasil
| | - Mariana Coelho
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Brasil, Ribeirão PretoSP, Graduanda em Enfermagem, Escola de Enfermagem de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto , SP , Brasil
| | - Vitor César Richter
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Brasil, Ribeirão PretoSP, Graduando em Enfermagem, Escola de Enfermagem de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto , SP , Brasil
| | - Carina Aparecida Marosti Dessotte
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Brasil, Ribeirão PretoSP, Enfermeira. Doutora em Enfermagem, Escola de Enfermagem de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto , SP , Brasil
| | - André Schmidt
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Brasil, Ribeirão PretoSP, Médico. Professor Doutor, Faculdade de Medicina de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto , SP , Brasil
| | - Rosana Aparecida Spadoti Dantas
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Brasil, Ribeirão PretoSP, Enfermeira. Professora Associada, Escola de Enfermagem de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto , SP , Brasil
| | - Lídia Aparecida Rossi
- Escola de Enfermagem de Ribeirão Preto, Universidade de São Paulo, Brasil, Ribeirão PretoSP, Enfermeira. Professora Titular, Escola de Enfermagem de Ribeirão Preto , Universidade de São Paulo , Ribeirão Preto , SP , Brasil
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Muhammad I, He HG, Kowitlawakul Y, Wang W. Narrative review of health-related quality of life and its predictors among patients with coronary heart disease. Int J Nurs Pract 2014; 22:4-14. [DOI: 10.1111/ijn.12356] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Imran Muhammad
- Ward B65 (General Medicine/Cardiology); Khoo Teck Phuat Hospital; Singapore
| | - Hong-Gu He
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore
| | - Yanika Kowitlawakul
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies; Yong Loo Lin School of Medicine; National University of Singapore; Singapore
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Basis for Sex-Dependent Outcomes in Acute Coronary Syndrome. Can J Cardiol 2014; 30:713-20. [DOI: 10.1016/j.cjca.2013.08.020] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 08/28/2013] [Accepted: 08/29/2013] [Indexed: 11/20/2022] Open
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Biopsychosocial Determinants of Health and Quality of life Among Young Women with Coronary Heart Disease. CURRENT CARDIOVASCULAR RISK REPORTS 2013. [DOI: 10.1007/s12170-013-0366-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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50
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Health-related quality of life and its predictors among outpatients with coronary heart disease in Singapore. Appl Nurs Res 2013; 27:175-80. [PMID: 25052181 DOI: 10.1016/j.apnr.2013.11.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Revised: 11/04/2013] [Accepted: 11/04/2013] [Indexed: 12/15/2022]
Abstract
AIMS AND BACKGROUND Coronary heart disease (CHD) is a major cause of death and disability and negatively impacts on patients' health-related quality of life (HRQoL). This study aimed to explore HRQoL and identify its predictors among outpatients with CHD in Singapore. METHODS A correlational study was conducted with a convenience sample of 106 outpatients with CHD recruited from a public hospital. HRQoL outcomes were measured using the Short Form-12 Health Survey (SF-12), Medical Outcomes Study Social Support Survey (MOS-SSS) and Hospital Anxiety and Depression Scale (HADS). RESULTS Patients reported a generally high level of HRQoL as assessed by SF-12. Those aged over 65years reported significantly higher mental health and those who were married had higher levels of education or income reported significantly higher physical health. There were significant negative correlations between physical and mental health and anxiety and depression (p<.05). Perceived social support was negatively correlated with anxiety and depression and positively correlated with mental health. Education level and depression significantly predicted physical health, while age, anxiety and depression predicted mental health. CONCLUSION Anxiety, depression, age and education are significant predictors of HRQoL in this patient population and should be assessed routinely and, where appropriate, addressed through individually-tailored interventions.
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