Quality of life after acute myocardial infarction among patients treated at sites with and without on-site availability of angiography.
BACKGROUND
Previous studies have compared the treatment and outcome of patients with acute myocardial infarction (AMI) admitted at sites with and without availability of angiography. Although mortality rates do not differ, it is unknown if quality of life (QOL) and functional status differ.


METHODS
We measured QOL and functional status in patients with AMI treated within Québec at 5 sites with (n = 253) and 5 sites without (n = 334) angiography.


RESULTS
At admission, clinical characteristics, complication rates, and baseline measures of QOL and functional status were similar at sites with and without angiography. During hospitalization, patients treated at sites with angiography were more likely to undergo an invasive cardiac procedure than patients admitted at sites without angiography (angiography, 63% vs 26%; percutaneous transluminal coronary angioplasty, 33% vs 13%; and coronary artery bypass graft, 12% vs 5%). At 30 days and 6 months after AMI, QOL was slightly superior at sites with angiography, but by 1 year, most measures of QOL were back to baseline at both types of sites and were similar between the 2 groups. At 6 months, most standard health-related QOL components were similar; only physical and emotional role limitations were higher at sites with angiography. Return to work occurred earlier (at 30 days, 23% vs 12%), and a lower proportion of patients was readmitted for angina (within 1 year after AMI, 12% vs 18%) at sites with angiography.


CONCLUSIONS
In the early post-AMI period, the QOL of patients admitted at sites with angiography was higher than that of patients admitted at sites without angiography. However, by 1 year, the QOL and functional status of patients was similar in both groups. Differences in QOL were greatest when differences in treatment were greatest, lending support to a positive albeit small association between an early invasive approach to post-AMI care and improved QOL.
Pilote
Louise
L
McGill University Health Centre, Montreal, Québec, Canada. louise.pilote@musica.mcgill.ca
Lauzon
Claude
C
Huynh
Thao
T
Dion
Danielle
D
Roux
René
R
Racine
Normand
N
Carignan
Suzanne
S
Diodati
Jean G
JG
Lévesque
Claude
C
Charbonneau
François
F
Pouliot
Joël
J
Joseph
Lawrence
L
Eisenberg
Mark J
MJ
D000203:Activities of Daily Living; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000628:therapy; D011446:Prospective Studies; D011788:Quality of Life; D011792:Quebec; D018434:Sickness Impact Profile; D016896:Treatment Outcome