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      Quality of life trajectories in survivors of acute myocardial infarction: a national longitudinal study

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          Abstract

          Aim

          To define trajectories of perceived health-related quality of life (HRQoL) among survivors of acute myocardial infarction (AMI) and identify factors associated with trajectories.

          Methods

          Data on HRQoL among 9566 survivors of AMI were collected from 77 National Health Service hospitals in England between 1 November 2011 and 24 June 2015. Longitudinal HRQoL was collected using the EuroQol five-dimension questionnaire measured at hospitalisation, 1, 6 and 12 months post-AMI. Trajectories of perceived HRQoL post-MI were determined using multilevel regression analysis and latent class growth analysis (LCGA).

          Results

          One or more percieved health problems in mobility, self-care, usual activities, pain/discomfort and anxiety/depression was reported by 69.1% (6607/9566) at hospitalisation and 59.7% (3011/5047) at 12 months. Reduced HRQoL was associated with women (−4.07, 95% CI −4.88 to −3.25), diabetes (−2.87, 95% CI −3.87 to −1.88), previous AMI (−1.60, 95% CI −2.72 to −0.48), previous angina (−1.72, 95% CI −2.77 to −0.67), chronic renal failure (−2.96, 95% CI −5.08 to −0.84; −3.10, 95% CI −5.72 to −0.49), chronic obstructive pulmonary disease (−3.89, 95% CI −5.07 to −2.72) and cerebrovascular disease (−2.60, 95% CI −4.24 to −0.96). LCGA identified three subgroups of HRQoL which we labelled: improvers (68.1%), non-improvers (22.1%) and dis-improvers (9.8%). Non-improvers and dis-improvers were more likely to be women, non-ST-elevation myocardial infarction (NSTEMI) and have long-term health conditions, compared with improvers.

          Conclusions

          Quality of life improves for the majority of survivors of AMI but is significantly worse and more likely to decline for women, NSTEMI and those with long-term health conditions. Assessing HRQoL both in hospital and postdischarge may be important in determining which patients could benefit from tailored interventions.

          Trial registration

          NCT01808027 and NCT01819103

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          Author and article information

          Journal
          Heart
          Heart
          BMJ
          1355-6037
          1468-201X
          November 07 2019
          : heartjnl-2019-315510
          Article
          10.1136/heartjnl-2019-315510
          © 2019

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