European Heart Journal Advance Access published online on November 19, 2008
European Heart Journal, doi:10.1093/eurheartj/ehn509
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Quality of life several years after myocardial infarction: comparing the MONICA/KORA registry to the general population
1 Helmholtz Zentrum München—German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, Ingolstädter Landstr. 1, PO Box 1129, D-85758 Neuherberg, Germany
2 Ludwig-Maximilians University, Munich School of Management, Institute of Health Economics and Management, Munich, Germany
3 Helmholtz Zentrum München—German Research Center for Environmental Health, Institute of Epidemiology, Neuherberg, Germany
4 Central Hospital of Augsburg, MONICA/KORA Myocardial Infarction Registry, Augsburg, Germany
5 Health Economics Research Unit, Department of Psychiatry, University of Leipzig, Leipzig, Germany
Received 22 January 2008; revised 13 October 2008; accepted 21 October 2008.
* Corresponding author. Tel: +49 89 3187 4192, Fax: +49 89 3187 3375, Email: holle{at}helmholtz-muenchen.de
Aims: The aim of this study was to assess the impact of myocardial infarction (MI) on health-related quality of life (HRQL) in MI survivors measured by EuroQol (EQ-5D) and to compare it with the general population.
Methods and results: A follow-up study of all MI survivors included in the MONICA/KORA registry was performed. About 2950 (67.1%) patients responded. Moderate or severe problems were most frequent in EQ-5D dimension pain/discomfort (55.0%), anxiety/depression (29.2%), and mobility (27.9%). Mean EQ VAS score was 65.8 (SD 18.5). Main predictors of lower HRQL included older age, diabetes, increasing body mass index, current smoking, and experience of re-infarction. Type of revascularizational treatment showed no impact on HRQL. Compared with the general population, adjusted EQ VAS was 6.2 (95% confidence interval 3.4–8.9) points lower in 45-year-old MI patients converging with growing age up to the age of 80. With regard to HRQL dimensions, MI survivors had a significantly higher risk of incurring problems in the dimension pain/discomfort, usual activities, and especially in anxiety/depression which was more pronounced in younger age. Mobility was the single dimension, in which MI showed an inverse effect.
Conclusion: MI is combined with significant reduction in HRQL compared with the general population. The main impairments occur in the dimension pain/discomfort, usual activities, and particularly anxiety/depression. The relative impairment decreases with higher ages.
Key Words: Health-related quality of life • EQ-5D • Myocardial infarction • KORA • Health utilities • Germany
Analysis was performed at the Institute for Health Economics and Health Care Management, Helmholtz Zentrum München—German Research Center for Environmental Health, Neuherberg, Germany. Data were collected at the MONICA/KORA registry Augsburg, Germany.
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