Schweikert Bernd, Hunger Matthias, Meisinger Christa, König Hans-Helmut, Gapp Oliver, Holle Rolf
Helmholtz Zentrum München-German Research Center for Environmental Health, Institute of Health Economics and Health Care Management, Neuherberg, Germany.
Eur Heart J. 2009 Feb;30(4):436-43. doi: 10.1093/eurheartj/ehn509. Epub 2008 Nov 19.
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.
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.
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.
本研究旨在评估心肌梗死（MI）对心肌梗死幸存者健康相关生活质量（HRQL）的影响，采用欧洲五维度健康量表（EQ-5D）进行测量，并与普通人群进行比较。
对MONICA/KORA注册登记中纳入的所有心肌梗死幸存者进行了随访研究。约2950名（67.1%）患者做出了回应。在EQ-5D维度中，中度或重度问题最常出现在疼痛/不适（55.0%）、焦虑/抑郁（29.2%）和活动能力（27.9%）方面。EQ视觉模拟量表（VAS）的平均得分为65.8（标准差18.5）。健康相关生活质量较低的主要预测因素包括年龄较大、糖尿病、体重指数增加、当前吸烟以及再次梗死经历。血运重建治疗类型对健康相关生活质量没有影响。与普通人群相比，45岁心肌梗死患者调整后的EQ VAS低6.2（95%置信区间3.4 - 8.9）分，随着年龄增长至80岁，差距逐渐缩小。在健康相关生活质量维度方面，心肌梗死幸存者在疼痛/不适、日常活动维度出现问题的风险显著更高，尤其是在焦虑/抑郁维度，且在较年轻患者中更为明显。活动能力是唯一一个心肌梗死显示出相反影响的维度。
与普通人群相比，心肌梗死与健康相关生活质量的显著降低相关。主要损害发生在疼痛/不适、日常活动维度，尤其是焦虑/抑郁维度。相对损害随着年龄增长而降低。
