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(Circulation. 2000;102:1245.)
© 2000 American Heart Association, Inc.

Clinical Investigation and Reports

Relationship of Infarct Artery Patency and Left Ventricular Ejection Fraction to Health-Related Quality of Life After Myocardial Infarction

The GUSTO-I Angiographic Study Experience

Karin S. Coyne, PhD, MPH; Conor F. Lundergan, MD; Deneane Boyle, MPH; Samuel W. Greenhouse, PhD; Yasmine C. Draoui, MS; Pamela Walker, BSN; Allan M. Ross, MD; for the GUSTO-I Angiographic Study Investigators

From the George Washington University Cardiovascular Research Institute (K.S.C., C.F.L., D.B., Y.C.D., P.W., A.M.R.), Washington, DC; MEDTAP International (K.S.C.), Bethesda, Md; and The George Washington University Biostatistics Center (S.W.G.), Washington, DC.

Correspondence to Karin S. Coyne, PhD, RN, MPH, MEDTAP International, 7101 Wisconsin Ave, Suite 600, Bethesda, MD 20814. E-mail coyne{at}medtap.com

Background—Post–myocardial infarction global ejection fraction and infarct-related artery patency might be expected to be associated with health-related quality-of-life (HRQOL) outcomes, but this association has not been previously shown. The GUSTO-I Angiographic Study cohort 2-year follow-up afforded an examination of such potential relationships.

Methods and Results—A total of 1848 patients (87.7% response rate) who were enrolled in the GUSTO-I Angiographic Study were contacted for a telephone interview regarding their current HRQOL (physical function, psychological well-being, perceived health status, and social function) 2 years after MI. In multivariable models, left ventricular ejection fraction (EF) was significantly related to physical (P=0.021) and social (P=0.014) function, psychological well-being (P=0.042), and perceived health status (P=0.024). Infarct-related artery patency was not directly related to any HRQOL outcome. A decreasing EF was predictive of poorer outcomes in each HRQOL dimension. Men consistently had better outcomes in all HRQOL dimension with the exception of perceived health status. Increasing age was predictive of poorer outcomes in all dimensions of HRQOL except for psychological well-being where the inverse occurred; younger patients experienced greater depression, anxiety and worry than their older counterparts. The presence of comorbidities increased the likelihood of worse outcomes in all dimensions.

Conclusions—This is the first study to demonstrate a significant relationship between EF and long-term HRQOL outcomes. This advantage in left ventricular function preservation should be added to the mortality advantage when considering the impact of treatment strategies for myocardial infarction.

Key Words: myocardial infarction • quality of life • left ventricular function • patency • sex

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