Quality of life in patients with ischaemic heart disease: a prospective controlled study

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Abstract
Westin L, Carlsson R, Israelsson B, Willenheimer R, Cline C, McNeil TF (University of Lund, University Hospital, Malmö, Sweden). Quality of life in patients with ischaemic heart disease: a prospective controlled study. J Intern Med 1997; 242: 239–47. Objectives To assess quality of life in patients after acute myocardial infarction (AMI), coronary artery by‐pass grafting surgery (CABG) and percutaneous transluminal coronary angioplasty (PTCA) as compared with healthy controls. Design Self‐administered questionnaires were completed 1 month and 1 year after the event. Setting Department of Cardiology, University Hospital, Malmö, Sweden; 1989–1992. Subjects 296 AMI, 99 CABG, 18 PTCA patients and 88 randomly selected healthy controls were included; 349 patients completed the entire programme. Main outcome measures Quality of life in the dimensions of perceived general health, thoracic pain, breathlessness, feeling of arrhythmia, anxiety, depression, self‐esteem, experience of social life and sex life. Results Patients differed from controls in both psychological and somatic aspects of QL after 1 month. Furthermore, 1 month after the event AMI patients experienced more anxiety (P= 0.001) than CABG patients, whilst CABG patients experienced a poorer sex life (P < 0.001) than AMI patients. One year after the event patients differed from controls primarily in somatic symptoms; no significant differences were found across patient groups. Patients who sought emergency out‐patient care during the follow‐up year for clinically diagnosed angina pectoris or cardiac incompensation had reported higher levels of thoracic pain (P < 0.001) and breathlessness (P < 0.001) at 1 month follow‐up than patients who did not seek such care. Conclusions Quality of life is considerably affected in patients following a cardiac event, especially during the initial recovery phase. Although substantial improvement in quality of life occurs over time, the persistence of residual distress at 1‐year follow‐up is a challenge for clinicians concerned with the full rehabilitation of the cardiac patient.

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