Abstract

BackgroundLittle is known regarding the health-related quality of life among myocardial infarction (MI) survivors in the United States. The purpose of this population-based study was to identify differences in health-related quality of life domains between MI survivors and propensity score matched controls.MethodsThis retrospective, cross-sectional matched case-control study examined differences in health-related quality of life (HRQoL) among MI survivors of myocardial infarction compared to propensity score matched controls using data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS) survey. Propensity scores were generated via logistic regression for MI survivors and controls based on gender, race/ethnicity, age, body mass index (BMI), smoking status, and comorbidities. Chi-square tests were used to compare differences between MI survivors to controls for demographic variables. A multivariate analysis of HRQoL domains estimated odds ratios. Life satisfaction, sleep quality, and activity limitations were estimated using binary logistic regression. Social support, perceived general health, perceived physical health, and perceived mental health were estimated using multinomial logistic regression. Significance was set at p < 0.05.ResultsThe final sample consisted of 16,729 MI survivors matched to 50,187 controls (n = 66,916). Survivors were approximately 2.7 times more likely to report fair/poor general health compared to control (AOR = 2.72, 95% CI: 2.43–3.05) and 1.5 times more likely to report limitations to daily activities (AOR = 1.46, 95% CI: 1.34–1.59). Survivors were more likely to report poor physical health >15 days in the month (AOR = 1.63, 95% CI: 1.46–1.83) and poor mental health >15 days in the month (AOR = 1.25, 95% CI: 1.07–1.46) compared to matched controls. There was no difference in survivors compared to controls in level of emotional support (rarely/never: AOR = 0.75, 95% CI: 0.48–1.18; sometimes: AOR = 0.73, 95% CI: 0.41–1.28), hours of recommended sleep (AOR = 1.14, 95% CI: 0.94–1.38), or life satisfaction (AOR = 1.62, 95% CI: 0.99–2.63).ConclusionMI survivors experienced lower HRQoL on domains of general health, physical health, daily activity, and mental health compared to the general population.

Highlights

  • Little is known regarding the health-related quality of life among myocardial infarction (MI) survivors in the United States

  • Findings from this study demonstrate that MI survivors experience worse health-related quality of life (HRQoL) compared to the general population on domains of general health, daily activity, physical health, and mental health in the U.S This disparity remained after controlling for patient characteristics that are known predictors of reduced HRQoL after MI

  • By utilizing national survey data obtained from a U.S sample, our study provides data that is more representative of MI survivors within the U.S Since this study relied on selfreported data, it is subject to response bias

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Summary

Introduction

Little is known regarding the health-related quality of life among myocardial infarction (MI) survivors in the United States. The purpose of this population-based study was to identify differences in health-related quality of life domains between MI survivors and propensity score matched controls. An existing study conducted in Germany demonstrated that health-related quality of life (HRQoL) is significantly decreased in MI survivors compared to the general population [3]. With an aging population in the U.S and people living longer, even after experiencing MI, HRQoL has become an important measure related to short- and long-term recovery and has prognostic value [9]. Assessing HRQoL has value in determining which individual characteristics are related to reduced HRQoL so that clinicians can identify possible interventions to relieve symptoms, prolong life, improve functionality, and increase participation in activities of daily living [10]

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