title: Change in health-related quality of life in patients with coronary artery disease predicts 4-year mortality.
abstract: OBJECTIVE
  Self-reported health-related quality of life (HRQL) and changes in HRQL have been shown to predict mortality and/or adverse events in patients with coronary artery disease. MacNew Heart Disease HRQL questionnaire scores were examined as predictors of 4-year all-cause mortality.
  
  
  METHODS
  Following referral for angioplasty in 385 patients with coronary artery disease, data were analyzed for differences in all-cause mortality by MacNew Global and subscale baseline and 1- and 3-month change scores (deteriorated ≥0.50; unchanged (-0.49 to +0.49); and improved ≥0.50 points).
  
  
  RESULTS
  Mean baseline, 1-month, and 3-month MacNew Global and subscale scores were similar in survivors and non-survivors. Mean 1- and 3-month Global and emotional subscale and mean 1-month social subscale change scores decreased more in non-survivors than survivors. Compared with patients whose Global MacNew HRQL scores improved at one month, 4-year all-cause mortality hazard ratio (HR) was higher in patients whose HRQL deteriorated (HR, 1.70, 95% CI, 1.09, 2.65; p=0.021). Compared with patients whose Global MacNew HRQL improved at three months, 4-year all-cause mortality was higher in both patients whose HRQL had deteriorated (HR, 2.07, 95% CI, 1.29, 3.32; p=0.003) and patients with unchanged HRQL (HR, 2.62, 95% CI, 1.11, 6.17; p=0.028).
  
  
  CONCLUSIONS
  A deterioration of ≥0.50 points in MacNew HRQL Global scores at both one and three months is predictive of 4-year all-cause mortality. Serial HRQL information may be useful to identify patients at higher risk for adverse cardiac events and mortality and may have implications for determining follow-up frequency and treatment in individual patients.
authors.affiliation: Department of Medical Psychology, Innsbruck Medical University, Austria. Electronic address: stefan.hoefer@i-med.ac.at.
authors.forename: Stefan
authors.initials: S
authors.lastname: Höfer
authors.affiliation: Department of Interventional Cardiology, Academic Hospital, Feldkirch, Austria.
authors.forename: Werner
authors.initials: W
authors.lastname: Benzer
authors.affiliation: College of Health Sciences, University of Wisconsin-Milwaukee, Milwaukee, WI, USA; Aurora Cardiovascular Services, Aurora St. Luke's Medical Center, Milwaukee, WI, USA.
authors.forename: Neil
authors.initials: N
authors.lastname: Oldridge
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: Health-related quality of life; Mortality; Predictors