Positive Familienanamnese bezüglich eines Myokardinfarkts und ihr Effekt auf ausgewählte Faktoren der gesundheitsbezogenen Lebensqualität - Ergebnisse der Diast-CHF-Studie

Abstract

The purpose of the present study was to determine whether patients with a family history of premature myocardial infarction were more often affected by psychosocial risk factors and furthermore have lower health related quality of life. In addition, this dissertation investigated the impact of a family history of premature myocardial infarction on selected end points such as overall mortality and cardiovascular hospitalisation. Therefor, a community of patients of the Diast-CHF-study (n= 1470) was examined and separated into two groups: Patients with (n = 187) or without (n= 1283) a family history of premature myocardial infarction. Somatic and psychosocial risk factors were collected and included in the analysis. The study group with a family history of premature myocardial infarction was significantly more often affected by vital exhaustion, anxiety, type D personality, negative attachment patterns, lower social support, used depressive coping to handle diseases and had a significantly lower health related quality of life. During an observation period of five years, we found no significant difference between both groups as to the endpoints own myocardial infarction, cardiovascular and overall mortality and cardiovascular hospitalisation. A direct influence of a family history could not be demonstrated within the five year period. However, we demostrate that vital exhaustion as a factor of health related quality of life elevates cardiovascular mortality and hospitalisation amongst other factors. Our observations suggest that not the family history of myocardial infarction itself, but their significant effect on increase of psychosocial risk factors in persons concerned leads to higher risk of cardiovascular mortality and hospitalisation.