[Characteristics and predictive value of quality of life in a French cohort of angina patients].
The study of quality of life (QoL) in a French cohort of patients suffering from angina pectoris was one of the objectives of the ELAN longitudinal study. It concerned 3,954 subjects (76% males) mean age: 67 +/- 11 years, followed up by 613 cardiologists which were invited to complete a series of baseline sociodemographic and clinical data and to answer a series of questions upon one year outcome (3,261 medical records available). QoL was assessed at baseline via a self-administered 12-item general questionnaire, the Short-Form 12 (SF-12), enabling to compute a mental component summary (CS-12) and a physical component summary (PCS-12) score. Mean MCS-12 in the ELAN cohort (49 +/- 7.5) was very close to the standards derived from general American population (50 +/- 10) or to the data available in a general French population (51.2 +/- 7.4). Whereas mean PCS-12 was hardly lower (about one standard deviation) in comparison with general American population (50 +/- 10) or with a general French population (48.4 +/- 9.4). QoL was higher in males and linked to age in a contrasted way (higher MCS-12 and lower PCS-12 in elderly; p < 0.0001). It depended on the clinical condition (lower MCS-12 associated with mixed-type angina pectoris or with more severe angina and with persistent smoking; lower PCS-12 associated with mixed type or more severe angina, with cardiac failure episodes, arteritis obliterans, stroke antecedents or left ventricular hypertrophy). Both scores were negatively correlated, in multivariate regression analysis, with the severity of persisting angina at one year, after controlling for the severity of baseline angina and the other confounding variables. Above all, MCS-12 and especially PCS-12, predicted major coronary events at one year (death, myocardial infarction, angioplasty, coronary by-pass surgery). In a multivariate logistic regression analysis, low baseline PCS-12 was associated with higher risk for cardiovascular death at one year (OR = 2.44; 95% CI = 1.25-4.74; p < 0.01). These results confirm the clinical validity of SF-12 (cross sectional stage of the study) and stress its prognostic value independent from the other risk factors (longitudinal stage of the study).
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Service de psychologie clinique et psychiatrie de liaison, Hôpital européen Georges Pompidou, 75015 Paris.
Guize
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Ducimetière
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Duprat-Lomon
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Girod
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D000367:Age Factors; D000368:Aged; D000787:Angina Pectoris / Q000523:psychology* / Q000628:therapy*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain; D011237:Predictive Value of Tests; D011379:Prognosis; D011788:Quality of Life; D012044:Regression Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects