Department of Public Health, Ghent University, Gent, Belgium.
Int J Cardiol. 2013 Sep 30;168(2):898-903. doi: 10.1016/j.ijcard.2012.10.053. Epub 2012 Nov 30.
Cardiovascular patients are likely to have an impaired health-related quality of life (HRQoL) due to functional and psycho-social limitations. The main objective of this study was to assess the distribution of HRQoL scores in coronary heart disease (CHD) patients across 22 European countries and to identify factors associated with the variation between patients.
Data from the EUROASPIRE III survey (European Action on Secondary and Primary Prevention by Intervention to Reduce Events), on 8734 patients, were used. Patients with a diagnosis of CHD (coronary artery bypass graft (CABG), percutaneous coronary intervention (PCI), acute myocardial infarction (AMI) or myocardial ischemia) were interviewed and examined at least 6 months after their acute coronary event. Quality of life of each patient was measured using 2 standardized questionnaires: the EuroQoL-5D (EQ-5D) and the 12-item short-form health survey (SF-12v2).
HRQoL values differed significantly across countries. Lower HRQoL estimates were found in women, older patients, less educated patients, patients with myocardial infarction or ischemia as recruiting diagnosis, patients with a history of stroke and patients who suffered from a recurring CHD event. In addition, HRQoL was significantly associated with current smoking, central obesity, lack of exercise and inappropriate HbA1c control in patients with diabetes. Furthermore the number of risk factors is inversely associated with HRQoL.
Overall, a large heterogeneity was observed in HRQoL values between countries and patient groups. There seems to be a significant association between quality of life and patient characteristics with lifestyle risk factors as important determinants of HRQoL.
心血管疾病患者由于功能和心理社会限制,其健康相关生活质量(HRQoL)可能受损。本研究的主要目的是评估 22 个欧洲国家冠心病(CHD)患者的 HRQoL 评分分布,并确定与患者间差异相关的因素。
使用 EUROASPIRE III 调查(通过干预减少事件的二级和一级预防的欧洲行动)的数据,对 8734 名患者进行了分析。在急性冠脉事件发生至少 6 个月后,对诊断为 CHD(冠状动脉旁路移植术(CABG)、经皮冠状动脉介入治疗(PCI)、急性心肌梗死(AMI)或心肌缺血)的患者进行访谈和检查。每位患者的生活质量均使用 2 个标准化问卷进行测量:EuroQoL-5D(EQ-5D)和 12 项简明健康调查量表(SF-12v2)。
各国之间 HRQoL 值存在显著差异。女性、年龄较大、受教育程度较低、以心肌梗死或缺血为招募诊断、有中风病史和发生复发性 CHD 事件的患者 HRQoL 估计值较低。此外,HRQoL 与当前吸烟、中心性肥胖、缺乏运动以及糖尿病患者 HbA1c 控制不当显著相关。此外,危险因素的数量与 HRQoL 呈负相关。
总体而言,国家和患者群体之间 HRQoL 值存在很大异质性。生活质量与患者特征之间似乎存在显著关联,生活方式危险因素是 HRQoL 的重要决定因素。