title: Low risk is associated with poorer quality of life than high risk following acute coronary syndrome.
abstract: BACKGROUND
  Morbidity after acute coronary syndromes includes both physical and mental disorders affecting quality of life. The aim of this investigation was to study quality of life at a 3-month follow-up in patients with acute coronary syndrome, with the main objective of exploring whether unstable angina pectoris and myocardial infarction (MI) patients differ in this respect.
  
  
  METHODS
  This investigation was part of a prospective risk stratification study of consecutive patients with acute coronary syndrome of whom 814 below the age of 75 years (278 diagnosed with unstable angina pectoris and 536 with myocardial infarction) accepted an invitation to a follow-up visit 3 months after discharge. At follow-up, the patients completed the Cardiac Health Profile, a disease-specific quality of life questionnaire, designed to evaluate perceived cognitive, emotional, social and physical function.
  
  
  RESULTS
  Quality of life was mainly influenced by patient characteristics and previous history. The Cardiac Health Profile scores in unstable angina pectoris patients were significantly higher (i.e. poorer quality of life) than myocardial infarction patients at the 3-month visit (34, 22, 50; median, 25th, 75th percentile and 30, 19, 44; median, 25th, 75th percentile, respectively, P=0.006). The adjusted odds ratio for a poorer quality of life in unstable angina pectoris patients in relation to myocardial infarction patients was 1.39 (95% confidence interval 1.03, 1.87; P=0.03). The highest Cardiac Health Profile scores were seen in the unstable angina pectoris patients without electrocardiogram signs of ongoing ischemia and/or elevated markers of myocardial necrosis.
  
  
  CONCLUSIONS
  Patients with unstable angina pectoris, especially of the low-risk type, and therefore treated accordingly, are more likely to experience poorer quality of life following an acute hospitalization than patients with other types of acute coronary syndrome. Once myocardial infarction or high-risk unstable angina pectoris has been ruled out, these patients still require a careful and systematic follow-up.
authors.affiliation: Department of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden. elisabeth.perers@hjl.gu.se
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Perers
authors.forename: Mona
authors.initials: M
authors.lastname: From Attebring
authors.forename: Kenneth
authors.initials: K
authors.lastname: Caidahl
authors.forename: Johan
authors.initials: J
authors.lastname: Herlitz
authors.forename: Thomas
authors.initials: T
authors.lastname: Karlsson
authors.forename: Peter
authors.initials: P
authors.lastname: Wahrborg
authors.forename: Marianne
authors.initials: M
authors.lastname: Hartford
mesh_terms: D000208:Acute Disease; D000789:Angina, Unstable / Q000523:psychology*; D016009:Chi-Square Distribution; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000523:psychology*; D011446:Prospective Studies; D011788:Quality of Life; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires