Open Access

Health-related quality of life increases after first-time acute myocardial infarction: A population-based study

Aleksandra Gąsecka
Aleksandra Gąsecka
, 
Bartholomew Rzepa
Bartholomew Rzepa
, 
Aleksandra Skwarek
Aleksandra Skwarek
, 
Agata Ćwiek
Agata Ćwiek
, 
Kinga Pluta
Kinga Pluta
, 
Łukasz Szarpak
Łukasz Szarpak
, 
Miłosz J. Jaguszewski
Miłosz J. Jaguszewski
, 
Tomasz Mazurek
Tomasz Mazurek
, 
Janusz Kochman
Janusz Kochman
, 
Grzegorz Opolski
Grzegorz Opolski
, 
Krzysztof J. Filipiak
Krzysztof J. Filipiak
 and 
Krzysztof Gąsecki
Krzysztof Gąsecki
   | Jan 03, 2022
Slovenian Journal of Public Health's Cover Image
About this article
Previous Article
Next Article
Cite
Article Category: Original scientific article
Published Online: Jan 03, 2022
Page range: 24 - 31
Received: Jan 06, 2021
Accepted: Nov 04, 2021
DOI: https://doi.org/10.2478/sjph-2022-0005
Keywords
© 2022 National Institute of Public Health, Slovenia, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Study inclusion and exclusion chart. AMI – acute myocardial infarction.
Study inclusion and exclusion chart. AMI – acute myocardial infarction.

Figure 2

Changes in health-related quality of life from the index hospitalisation due to acute myocardial infarction up to a 6-month follow-up assessed with three questionnaires in 56 patients.
Changes in health-related quality of life from the index hospitalisation due to acute myocardial infarction up to a 6-month follow-up assessed with three questionnaires in 56 patients.

Results of univariable logistic regression analysis for prediction of improved quality of life, as assessed by Short Form-36 Health Survey. P-value<0.1 is considered significant.

Variable OR 95% CI
 p-value
Lower Upper
Baseline characteristics
    Age, years 0.978 0.925 1.033 0.424
    Gender 0.556 0.159 1.938 0.356
    BMI 1.119 0.987 1.269 0.080
    STEMI at admission 0.500 0.131 1.905 0.310
    LVEF<50% 5.863 1.441 23.851 0.013
CV risk factors
    Arterial hypertension 1.067 0.364 3.128 0.906
    Diabetes mellitus 1.474 0.424 5.121 0.542
    Dyslipidaemia 2.917 0.914 9.309 0.071
    Smoking 0.875 0.306 2.504 0.803
Laboratory parameters
    Creatinine 1.328 0.150 11.771 0.799
    Hb 1.221 0.799 1.865 0.356
    LDL-C 0.999 0.984 1.013 0.873
    NT-proBNP 1.000 1.000 1.000 0.976
    Plt count 0.996 0.988 1.005 0.389
    TnI 1.003 0.996 1.010 0.425
Pharmacotherapy at discharge
    Aspirin 0.959 0.867 1.014 0.593
    P2Y12 inhibitor 1.320 0.833 2.093 0.238
    Statin 0.998 0.990 1.006 0.551
    β-blocker 3.846 0.402 36.822 0.243
    ACE-inhibitor or ARB 0.862 0.051 14.506 0.918
    Diuretics 1.474 0.424 5.121 0.542
    Aldosterone antagonists 0.825 0.244 2.793 0.757
Cardiac rehabilitation – number (%) 1.010 0.986 1.034 0.432

Results of multivariable logistic regression analysis for prediction of improved quality of life (QOL) 6 months after AMI, as assessed by Short Form-36 Health Survey, including explanatory factors which significantly differed between patients with and without improved QOL and which were predictors of improved QOL in univariate analysis.

Variable OR 95% CI
 p-value
Lower Upper
BMI 1.096 0.958 1.255 0.180
Dyslipidaemia 1.921 0.544 6.786 0.310
EF<50% 4.463 1.045 19.059 0.043

Eligibility criteria for the study evaluating the health-related quality of life after first-time acute myocardial infarction in Poland.

Inclusion criteria Exclusion criteria
• Age ≥ 18 years • Cardiogenic shock
• Informed consent to participate in the study • Severe chronic renal failure
• First ST-elevation myocardial infarction (STEMI) or non-STEMI (eGFR<30 mL/min)
• PCI with stent implantation • Severe liver insufficiency (Child-Pugh C)
• Capability to fill-in the quality-of-life questionnaires alone or under supervision • Autoimmune disease
• Active neoplasm
• Known pregnancy, breast-feeding, or intention to
become pregnant during the study period

Comparison of baseline characteristics between patients with improved and without improved health-related quality of life, as assessed by Short Form-36 Health Survey. P-value<0.05 is considered significant.

Inclusion criteria All patients (n=56) QoL improved (n=26) QoL not improved (n=30) p
Characteristic
Age, years – mean (SD) 64.3 9.7 63.2 8.6 65.2 10.7 0.593
Male gender – n (%) 42 75% 21 80% 21 70% 0.353
BMI – n (range) 28.5 20.3-30.2 29.0 20.0-34.7 27.1 20.3-30.2 0.046
STEMI at admission – n (%) 44 79% 22 84% 22 73% 0.305
LVEF, % – median (range) 52 27-68 50 27-58 55 35-68 0.013
CV risk factors – n (%)
    Arterial hypertension 34 61% 16 0.62% 18 60% 0.906
    Diabetes mellitus 13 23% 7 27% 6 20% 0.541
    Dyslipidaemia 36 64% 20 76% 16 53% 0.046
    Smoking 29 52% 13 50% 16 53% 0.803
Laboratory parameters
    Creatinine, mg/dl – median (range) 0.95 0.33-1.65 0.94 0.55-1.51 0.95 0.33-1.65 0.966
    Hb, g/dl – median (range) 13.8 10.2-17.5 13.9 11.3-17.5 13.9 10.2-16.0 0.698
    LDL-C – median (range) 122 53-218 124 69-197 122 65-218 0.928
    NT-proBNP – median (range) 764 127-12708 962 146-4942 386 127-12708 0.153
    Plt count, 103/μl – median (range) 230 111-453 236 131-352 230 172-281 0.533
    TnI, ng/ml – median (range) 13.0 0.4-685 20.3 0.5-685 11.4 0.4-236 0.457
Pharmacotherapy at discharge – number (%)
    Aspirin 56 100% 26 100% 30 100% 1.000
    P2Y12 inhibitor 56 100% 26 100% 30 100% 1.000
    Statin 56 100% 26 100% 30 100% 1.000
    β-blocker 51 91% 25 96% 26 87% 0.214
    ACE-inhibitor or ARB 54 96% 25 96% 29 97% 0.918
    Diuretics 13 23% 7 27% 6 20% 0.541
    Aldosterone antagonists 14 25% 6 23% 8 27% 0.757
Cardiac rehabilitation – number (%) 44 79% 22 84% 22 73% 0.305
eISSN:
1854-2476
Language:
English
Publication timeframe:
4 times per year
Journal Subjects:
Medicine, Clinical Medicine, Hygiene and Environmental Medicine
Journal RSS Feed