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Heart failure-related quality-of-life impairment after myocardial infarction

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Abstract

Aims

Recent advances in therapy led to a significant decrease in mortality and morbidity after myocardial infarction (MI). However, little is known about quality of life (QoL) after MI. We examined heart failure (HF)-related quality-of-life (QoL) impairment, its trajectories, and determinants after MI.

Methods

Data from a single-center prospectively designed registry of consecutive patients hospitalized for MI at a large tertiary cardiology center were utilized. At 1 month and 1 year after hospital discharge, patients completed the Kansas City Cardiomyopathy Questionnaire (KCCQ).

Results

In total, 850 patients (aged 65 ± 12 years, 27% female) hospitalized between June 2017 and October 2020 completed KCCQ at 1 month after discharge. Of these, 38.7% showed HF-related QoL impairment (KCCQ ≤ 75). In addition to characteristics of MI (MI size, diuretics need, heart rate), comorbidities as renal dysfunction and anemia were associated with QoL impairment. Of the 673 eligible, 500 patients (74.3%) completed KCCQ at 1 year after MI. On average, QoL improved by 5.9 ± 16.8 points during the first year after MI (p < 0.001); but, in 18% of patients QoL worsened. Diabetes control and hemoglobin level at the time of hospitalization were associated with QoL worsening.

Conclusion

Two out of 5 patients after MI present with HF-related QoL impairment. In addition to guideline-directed MI management, careful attention to key non-cardiac comorbidities as chronic kidney disease, anemia and diabetes may lead to further augmentation of the benefit of modern therapies in terms of QoL.

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Abbreviations

CAD:

Coronary artery disease

HF:

Heart failure

KCCQ:

Kansas City Cardiomyopathy Questionnaire

MI:

Myocardial infarction

PCI:

Percutaneous coronary intervention

PRO:

Patient-reported outcomes

QoL:

Quality of life

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Funding

Supported by Ministry of Health of the Czech Republic, grant nr. NV 19–09-00125.

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Correspondence to Peter Wohlfahrt.

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Conflict of interest

Dr. Wohlfahrt has received consulting fees or honoraria from Servier. Dr. Kautzner reports grants and personal fees from Biosense Webster, Biotronik, Boston Scientific, Medtronic, grants and personal fees from Abbott (SJM), personal fees from Merit Medical, Daiichi Sankyo, Boehringer Ingelheim, BMS, Bayer, Merck, MSD, Pfizer, all outside the submitted work. The other authors have nothing to disclose.

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Wohlfahrt, P., Jenča, D., Stehlik, J. et al. Heart failure-related quality-of-life impairment after myocardial infarction. Clin Res Cardiol 112, 39–48 (2023). https://doi.org/10.1007/s00392-022-02008-z

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  • DOI: https://doi.org/10.1007/s00392-022-02008-z

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