title: Health utility indexes in patients with acute coronary syndromes.
abstract: Acute coronary syndromes (ACS) have been associated with lower health utilities (HUs) compared with the general population. Given the prognostic improvements after ACS with the implementation of coronary angiography (eg, percutaneous coronary intervention (PCI)), contemporary HU values derived from patient-reported outcomes are needed.
  
  
  
  We analysed data of 1882 patients with ACS 1 year after coronary angiography in a Swiss prospective cohort. We used the EuroQol five-dimensional questionnaire (EQ-5D) and visual analogue scale (VAS) to derive HU indexes. We estimated the effects of clinical factors on HU using a linear regression model and compared the observed HU with the average values of individuals of the same sex and age in the general population.
  
  
  
  Mean EQ-5D HU 1-year after coronary angiography for ACS was 0.82 (±0.16) and mean VAS was 0.77 (±0.18); 40.9% of participants exhibited the highest utility values. Compared with population controls, the mean EQ-5D HU was similar (expected mean 0.82, p=0.58) in patients with ACS, but the mean VAS was slightly lower (expected mean 0.79, p<0.001). Patients with ACS who are younger than 60 years had lower HU than the general population (<0.001). In patients with ACS, significant differences were found according to the gender, education and employment status, diabetes, obesity, heart failure, recurrent ischaemic or incident bleeding event and participation in cardiac rehabilitation (p<0.01).
  
  
  
  At 1 year, patients with ACS with coronary angiography had HU indexes similar to a control population. Subgroup analyses based on patients' characteristics and further disease-specific instruments could provide better sensitivity for detecting smaller variations in health-related quality of life.
authors.affiliation: Cardiology Division , Geneva University Hospitals, University of Geneva , Geneva , Switzerland.
authors.forename: Baris
authors.initials: B
authors.lastname: Gencer
authors.affiliation: Department of General Internal Medicine , Inselspital, Bern University Hospital, University of Bern , Bern , Switzerland.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Rodondi
authors.affiliation: Department of Community Medicine and Ambulatory Care , University of Lausanne , Lausanne , Switzerland.
authors.forename: Reto
authors.initials: R
authors.lastname: Auer
authors.affiliation: Department of Community Medicine and Ambulatory Care , University of Lausanne , Lausanne , Switzerland.
authors.forename: David
authors.initials: D
authors.lastname: Nanchen
authors.affiliation: Department of Cardiology , Inselspital, Bern University Hospital, University of Bern , Bern , Switzerland.
authors.forename: Lorenz
authors.initials: L
authors.lastname: Räber
authors.affiliation: Department of Cardiology , University Heart Center , Zurich , Switzerland.
authors.forename: Roland
authors.initials: R
authors.lastname: Klingenberg
authors.affiliation: Winterthur Institute of Health Economics, Zurich University of Applied Sciences , Winterthur , Switzerland.
authors.forename: Mark
authors.initials: M
authors.lastname: Pletscher
authors.affiliation: Institute of Primary Health Care, University of Bern, Bern, Switzerland; Applied Health Research Centre (AHRC), Li Ka Shing Knowledge Institute of St. Michael's Hospital, University of Toronto, Toronto, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Jüni
authors.affiliation: Department of Cardiology , Inselspital, Bern University Hospital, University of Bern , Bern , Switzerland.
authors.forename: Stephan
authors.initials: S
authors.lastname: Windecker
authors.affiliation: Department of Cardiology , University Heart Center , Zurich , Switzerland.
authors.forename: Christian M
authors.initials: CM
authors.lastname: Matter
authors.affiliation: Department of Cardiology , University Heart Center , Zurich , Switzerland.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Lüscher
authors.affiliation: Cardiology Division , Geneva University Hospitals, University of Geneva , Geneva , Switzerland.
authors.forename: François
authors.initials: F
authors.lastname: Mach
authors.affiliation: Division of Clinical Epidemiology , University Hospital , Geneva , Switzerland.
authors.forename: Thomas V
authors.initials: TV
authors.lastname: Perneger
authors.affiliation: Medical Directorate, University Hospital of Geneva, Geneva, Switzerland; Department of Anaesthesiology, Clinical Pharmacology, and Intensive Care Medicine, University Hospitals of Geneva, Switzerland.
authors.forename: François R
authors.initials: FR
authors.lastname: Girardin
keywords: Acute coronary syndromes; health utility; patient-reported outcomes; quality of life