QUALITY-OF-LIFE IN PATIENTS WITH ISCHEMIC-HEART-DISEASE - A PROSPECTIVE CONTROLLED-STUDY

Objectives. To assess quality of life in patients after acute myocardi al infarction (AMI), coronary artery by-pass grafting surgery (CABG) a nd percutaneous transluminal coronary angioplasty (PTCA) as compared w ith healthy controls. Design. Self-administered questionnaires were co mpleted 1 month and 1 year after the event. Setting. Department of Car diology, University Hospital, Malmo, Sweden; 1989-1992. Subjects. 296 AMI, 99 CABG, 18 PTCA patients and 88 randomly selected healthy contro ls were included; 349 patients completed the entire programme. Main ou tcome 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. Res ults. Patients differed from controls in both psychological and somati c aspects of QL after 1 month. Furthermore, 1 month after the event AM I patients experienced more anxiety (P = 0.001) than CABG patients, wh ilst CABG patients experienced a poorer sex life (P < 0.001) than AMI patients. One year after the event patients differed from controls pri marily in somatic symptoms; no significant differences were found acro ss patient groups. Patients who sought emergency out-patient care duri ng the follow-up year for clinically diagnosed angina pectoris or card iac 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 considera bly affected in patients following a cardiac event, especially during the initial recovery phase. Although substantial improvement in qualit y of life occurs over time, the persistence of residual distress at 1- year follow-up is a challenge for clinicians concerned with the full r ehabilitation of the cardiac patient.