title: The long-term effect of perioperative myocardial infarction on health-related quality-of-life after coronary artery bypass grafting.
abstract: OBJECTIVE
  To evaluate the long-term effect of perioperative myocardial infarction (PMI) on outcomes and health-related quality-of-life (QOL) after coronary artery bypass grafting (CABG).
  
  
  METHODS
  Eighty of the 501 patients (16%) fulfilled electrocardiogram or cardiac enzyme criteria for PMI and were compared with patients with no PMI. The RAND-36 Health Survey was used as an indicator of QOL. Assessments were made preoperatively and repeated 1 year and 12 years later.
  
  
  RESULTS
  Thirty-day mortality was adversely affected by PMI (6.3 vs 1.0%, P = 0.001). One-year survival rates for PMI and no-PMI patients were 92.5 and 97.6%, 10-year rates being 72.5 and 79.8%. One year after the surgery, PMI patients improved in seven and no-PMI patients in all the eight RAND-36 dimensions. In the 12-year follow-up, the scores showed a general decline tendency. PMI patients still maintained a significant improvement in four and no-PMI patients in seven of eight dimensions when compared with the baseline scores. A highly significant improvement was seen in the RAND-36 mental and physical component summary scores in the no-PMI group 1 year after CABG. PMI patients improved also significantly although the magnitude of change was lower. In the 12-year follow-up, there was a general decline tendency in the scores. Both groups showed similar freedom from anginal symptoms at 12 years.
  
  
  CONCLUSIONS
  Although PMI has a negative impact on health-related QOL 1 year after CABG, this effect is only minor in the long term. PMI increases 30-day mortality but shows no effect on later mortality.
authors: Heart Center, Tampere University Hospital, Tampere, Finland.
authors: Otso
authors: O
authors: Järvinen
authors: Matti
authors: M
authors: Hokkanen
authors: Heini
authors: H
authors: Huhtala
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000401:mortality; D004562:Electrocardiography; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000523:psychology*; D011788:Quality of Life; D012307:Risk Factors; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D013997:Time Factors
keywords: Coronary artery bypass grafting; Myocardial infarction; Quality-of-life