Gender differences in health-related quality of life in patients undergoing coronary angiography.
Health-related quality of life (HRQOL) reflects the general well-being of individuals. In patients with coronary artery disease (CAD), HRQOL is compromised. Female patients with CAD have been reported to have lower HRQOL. In this study, we investigate gender differences in HRQOL and in associations of patient characteristics with HRQOL in patients with coronary angiography (CAG).



We cross-sectionally analysed patients from the Utrecht Coronary Biobank undergoing CAG. All patients filled in an HRQOL questionnaire (RAND-36 and EuroQoL) on inclusion. RAND-36 and EuroQoL HRQOL measures were compared between the genders across indications for CAG, CAD severity and treatment of CAD. RAND-36 HRQOL measures were compared with the general Dutch population. Additionally, we assessed interactions of gender with patient characteristics in their association with HRQOL (EuroQoL).



We included 1421 patients (1020 men and 401 women) with a mean age of 65 in our analysis. Women reported lower HRQOL measures than men (mean EuroQoL self-rated health grade 6.84±1.49 in men, 6.46±1.40 in women, p<0.001). The reduction in RAND-36 HRQOL as compared with the general Dutch population was larger in women than in men. From regression analysis, we found that diabetes, a history of cardiovascular disease and symptoms of shortness of breath determined HRQOL (EuroQoL) more strongly in men than in women.



Women reported lower HRQOL than men throughout all indications for CAG and regardless of CAD severity or treatment. As compared with the general population, the reduction in HRQOL was more extreme in women than in men. Evident gender differences were found in determinants of HRQOL in patients undergoing CAG, which deserve attention in future research.



NCT02304744 (clinicaltrials.gov).
Laboratory of Experimental Cardiology, Division Heart and Lungs , University Medical Centre Utrecht , Utrecht , The Netherlands ; ICIN-Netherlands Heart Institute , Utrecht , The Netherlands.
Crystel M
CM
Gijsberts
Department of Cardiology, Division Heart and Lungs , University Medical Centre Utrecht , Utrecht , The Netherlands.
Pierfrancesco
P
Agostoni
Laboratory of Experimental Cardiology, Division Heart and Lungs , University Medical Centre Utrecht , Utrecht , The Netherlands.
Imo E
IE
Hoefer
Department of Cardiology, Division Heart and Lungs , University Medical Centre Utrecht , Utrecht , The Netherlands ; Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute , Utrecht , The Netherlands ; Faculty of Population Health Sciences , Institute of Cardiovascular Science, University College London , London , UK.
Folkert W
FW
Asselbergs
Laboratory of Experimental Cardiology, Division Heart and Lungs , University Medical Centre Utrecht , Utrecht , The Netherlands.
Gerard
G
Pasterkamp
Department of Cardiology, Division Heart and Lungs , University Medical Centre Utrecht , Utrecht , The Netherlands.
Hendrik
H
Nathoe
Department of Cardiology , VU University Medical Center , Amsterdam , The Netherlands.
Yolande E
YE
Appelman
Laboratory of Experimental Cardiology, Division Heart and Lungs , University Medical Centre Utrecht , Utrecht , The Netherlands ; ICIN-Netherlands Heart Institute , Utrecht , The Netherlands ; Department of Surgery , Yong Loo Lin School of Medicine, National University of Singapore , Singapore , Singapore ; Cardiovascular Research Institute, National University Heart Centre, National University Health System , Singapore , Singapore.
Dominique P V
DP
de Kleijn
Laboratory of Experimental Cardiology, Division Heart and Lungs , University Medical Centre Utrecht , Utrecht , The Netherlands.
Hester M
HM
den Ruijter
CORONARY ARTERY DISEASE; QUALITY OF CARE AND OUTCOMES