Physical functioning and mental well-being in association with health outcome in patients enrolled in the Multicenter Automatic Defibrillator Implantation Trial II.
OBJECTIVE
The association of psychosocial and physical factors with health outcome in patients with congestive heart failure (CHF) has not been fully explored. The aim of this study was to assess the physical and mental health in relationship to health outcome in post-infarction patients with advanced left ventricular dysfunction.


RESULTS
A total of 1058 patients enrolled in the Multicenter Automatic Defibrillator Implantation Trial II (MADIT II) completed the Medical Outcome Trust Short Form (SF-12) at baseline. Physical component summary (PCS) and mental component summary (MCS) of SF-12 were analysed in relationship to survival, hospitalization due to CHF, and implantable cardioverter-defibrillator (ICD) therapy. Both baseline PCS and MCS were significantly associated with death (P < 0.001 and P < 0.016, respectively) and hospitalization due to CHF (P <or= 0.001). After adjustment for significant clinical covariates and treatment group, low PCS and low MCS groups remained significant predictors of mortality and CHF hospitalization. Neither PCS nor MCS was associated with appropriate ICD therapy for ventricular tachyarrhythmias. Patients who experienced appropriate ICD shocks had a statistically significant deterioration of PCS but not MCS from baseline to 12 months.


CONCLUSIONS
Lower baseline PCS and MCS are associated with unfavourable health outcome in MADIT II patients, but not with appropriate ICD therapy for ventricular tachyarrhythmias. Patients who experience ICD shock reported a decrease in PCS, but little or no changes in MCS.
Piotrowicz
Katarzyna
K
Heart Research Follow-up Program, Cardiology Division, Department of Medicine, University of Rochester Medical Center, 601 Elmwood Ave, PO Box 653, Rochester, NY 14642, USA.
Noyes
Katia
K
Lyness
Jeffrey M
JM
McNitt
Scott
S
Andrews
Mark L
ML
Dick
Andrew
A
Hall
W Jackson
WJ
Moss
Arthur J
AJ
Zareba
Wojciech
W
D000328:Adult; D000368:Aged; D017147:Defibrillators, Implantable; D005260:Female; D006333:Heart Failure / Q000401:mortality / Q000523:psychology / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D016019:Survival Analysis; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000401:mortality / Q000523:psychology / Q000628:therapy*