Department of Cardiology, Almazov National Medical Research Centre, Sankt-Peterburg, Russian Federation.
Leeds Institute of Cardiovascular and Metabolic Medicine/Leeds Institute of Data analytics, University of Leeds, Leeds, UK.
Open Heart. 2023 Oct;10(2). doi: 10.1136/openhrt-2023-002452.
To investigate the association between health-related quality of life (HRQoL) and major adverse cardiovascular and cerebrovascular events (MACCE) in individuals with ischaemic heart disease (IHD).
Medline(R), Embase, APA PsycINFO and CINAHL (EBSCO) from inception to 3 April 2023 were searched. Studies reporting association of HRQoL, using a generic or cardiac-specific tool, with MACCE or components of MACCE for individuals with IHD were eligible for inclusion. Risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Scale to assess the quality of the studies. Descriptive synthesis, evidence mapping and random-effects meta-analysis were performed stratified by HRQoL measures and effect estimates. Between-study heterogeneity was assessed using the Higgins I statistic.
Fifty-one articles were included with a total of 134 740 participants from 53 countries. Meta-analysis of 23 studies found that the risk of MACCE increased with lower baseline HeartQoL score (HR 1.49, 95% CI 1.16 to 1.93) and Short Form Survey (SF-12) physical component score (PCS) (HR 1.39, 95% CI 1.28 to 1.51). Risk of all-cause mortality increased with a lower HeartQoL (HR 1.64, 95% CI 1.34 to 2.01), EuroQol 5-dimension (HR 1.17, 95% CI 1.12 to 1.22), SF-36 PCS (HR 1.29, 95% CI 1.19 to 1.41), SF-36 mental component score (HR 1.18, 95% CI 1.08 to 1.30).
This study found an inverse association between baseline values or change in HRQoL and MACCE or components of MACCE in individuals with IHD, albeit with between-study heterogeneity. Standardisation and routine assessment of HRQoL in clinical practice may help risk stratify individuals with IHD for tailored interventions.
CRD42021234638.
探讨与缺血性心脏病（IHD）个体的健康相关生活质量（HRQoL）与主要不良心血管和脑血管事件（MACCE）之间的关联。
从建库至 2023 年 4 月 3 日，检索 Medline（R）、Embase、APA PsycINFO 和 CINAHL（EBSCO）数据库。纳入使用通用或心脏专用工具报告 HRQoL 与 MACCE 或 MACCE 各组分之间关联的研究。使用纽卡斯尔-渥太华质量评估量表评估研究质量以评估研究的偏倚风险。使用描述性综合、证据图谱和随机效应荟萃分析，按 HRQoL 测量和效应估计进行分层。使用 Higgins I 统计量评估研究间异质性。
共纳入 51 篇文章，来自 53 个国家的 134740 名参与者。对 23 项研究进行荟萃分析发现，基线 HeartQoL 评分较低（HR 1.49，95%CI 1.16 至 1.93）和短期健康调查（SF-12）生理成分评分（PCS）（HR 1.39，95%CI 1.28 至 1.51）与 MACCE 风险增加相关。全因死亡率风险随着 HeartQoL 评分降低而增加（HR 1.64，95%CI 1.34 至 2.01），欧洲五维健康量表（HR 1.17，95%CI 1.12 至 1.22），SF-36 PCS（HR 1.29，95%CI 1.19 至 1.41），SF-36 心理成分评分（HR 1.18，95%CI 1.08 至 1.30）。
本研究发现，IHD 个体的基线值或 HRQoL 变化与 MACCE 或 MACCE 各组分之间呈负相关，尽管存在研究间异质性。在临床实践中标准化和常规评估 HRQoL 可能有助于为 IHD 个体进行风险分层，以进行有针对性的干预。
PROSPERO 注册号：CRD42021234638。
