BACKGROUND AND RESEARCH OBJECTIVES :In recent years, health-related quality of life (HRQoL) has been increasingly used as an indicator of health outcome. The aims of the study were to compare the HRQoL of patients with coronary artery disease (CAD) to patients without CAD and also to determine the HRQoL of patients with CAD and the factors affecting their quality of life. SUBJECTS AND METHODS Patients with CAD who attend the outpatients' clinic in the Cardiology Department at Trakya University's Medicine Faculty Hospital agreed to be interviewed. One hundred patients with CAD and 100 people serving as patients without CAD were included in this cross-sectional study. Patients with CAD and patients without CAD were matched by age, sex, marital status, and income. Health-related quality of life was measured with the generic HRQoL instrument. RESULTS AND CONCLUSIONS CAD patients' HRQoL scores differed significantly from patients without CAD. Compared to patients without CAD, the HRQoL of patients with CAD was lower in the dimensions of mobility (P < .001), hearing (P = .022), breathing (P < .001), elimination (P = .035), usual activities (P < .001), mental function (P = .004), discomfort and symptoms (P = .018), vitality (P = .006), sexual activity (P < .001), and total score (P < .001). Patients with CAD had lower HRQoL scores than patients without CAD. In patients with CAD, age and sex independently affected the HRQoL. Older patients and women had worse HRQoL. Coronary artery disease negatively affects HRQoL. It is thought that interventions to increase patients' quality of life may improve their HRQoL.

Health-related quality of life in patients with coronary artery disease.

PURPOSE: Recent guidelines from the Canadian Association of Cardiac Rehabilitation highlight the importance of addressing sleep disturbance among participants of cardiac rehabilitation (CR) programs. The primary objective of this study was to examine the relationship between depressive symptoms, health-related quality of life, and sleep disturbance in CR participants. The secondary objective was to estimate the prevalence of sleep disturbance among CR participants with and without depressive symptoms and explore demographic, medical, and psychological predictors of poor sleep quality.

METHODS: Cardiac rehabilitation participants (N = 259) were included in this study. Participants completed a standardized questionnaire package including demographic, health-related, and psychosocial measures. Physiologic and anthropometric measurements were taken at baseline. Descriptive statistics were calculated for all variables, and data were analyzed using multivariate logistic regression.

RESULTS: Poor sleep quality was reported by 52% of participants in the sample, and 47% of participants in the sample reported experiencing at least mild depressive symptoms. Poor sleep occurred more often in individuals with depressive symptoms, and after adjustment for medical factors and health-related quality of life, participants with symptoms of depression were still more likely to experience sleep disturbance than those without depressive symptoms (OR = 2.80; 95% CI, 1.37-5.77). An important gender difference emerged in the relationship between symptoms of depression and sleep disturbance.

CONCLUSION: Among participants of a CR program, disturbed sleep was strongly associated with depressive symptoms and decreased health-related quality of life. Results demonstrate the importance of sleep evaluation in CR programs.

The association between sleep disturbance, depressive symptoms, and health-related quality of life among cardiac rehabilitation participants.

Quality of life and behavioral compliance in cardiac rehabilitation patients: a longitudinal survey

People aged over 60 years represent an increasingly high proportion of the population undergoing percutaneous coronary intervention. While risks are greater for older people in terms of major adverse cardiovascular events and higher mortality for this treatment, it is unclear if the benefits of health-related quality of life outcomes may outweigh risks. A search of the PubMed, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Excerpta Medica, and Cochrane databases was conducted for the period from January 1999 to June 2012 using key words "percutaneous coronary intervention"/"angioplasty," "older," "elderly," and "quality of life"/"health-related quality of life." Using a systematic review approach, data from 18 studies were extracted for description and synthesis. Findings revealed that everyone regardless of age reported better health-related quality of life, primarily from the relief of angina and improved physical and mental function. Age itself did not have an independent predictive effect when other factors such as comorbid conditions were taken into account. Assessment of older peoples' health status following percutaneous coronary intervention by nurses and other health professionals is therefore important for the provision of quality care.

Systematic review of health-related quality of life in older people following percutaneous coronary intervention.

Cardiac rehabilitation is an important component of recovery and secondary prevention following urgent primary percutaneous coronary intervention. However, attendance and factors that predict participation by patients admitted with ST-elevation myocardial infarction remain unclear. This Australian study was conducted using a descriptive, comparative design. Consecutive patients (n = 246) at two hospitals were interviewed by telephone at four weeks and six months. Open-ended questions were used to assess cardiac rehabilitation attendance, sociodemographics, modifiable risk factors, clinical outcomes, and post-discharge health support. Post-discharge home visits at four weeks (odds ratio: 2.64, 95% confidence interval: 1.48-4.71) and at six months were associated with better cardiac rehabilitation attendance; more males participated at four weeks and at six months. The results suggest the need to integrate post-discharge health support with cardiac rehabilitation to facilitate recovery after primary percutaneous coronary intervention, particularly for females with ST-elevation myocardial infarction.

Predictors of cardiac rehabilitation attendance following primary percutaneous coronary intervention for ST‐elevation myocardial infarction in Australia

Associations of age, gender, cardiac procedure (coronary artery bypass grafting or percutaneous transluminal coronary angioplasty), risk stratification, and number of comorbidities with health-related quality of life (HRQL) were examined among 217 men and 84 women (mean age, 63+/-11 years) consecutively enrolled in a phase II cardiac rehabilitation program. Female gender and high-risk stratification were independently associated with impaired treatment gains in most areas of HRQL. Older age and having a greater number of comorbidities were also associated with impaired gains in specific areas. HRQL was generally lower at baseline but not post-treatment in coronary artery bypass grafting vs. percutaneous transluminal coronary angioplasty patients. Cardiac rehabilitation patients also had lower HRQL scores than an age-matched, normative sample at baseline (most areas) and post-treatment (mainly on role physical). Findings reinforce the need for cardiac rehabilitation programs to tailor assessments and risk factor modification strategies to patient characteristics associated with low levels of HRQL, especially in women and those with higher risk stratification.

Factors influencing health-related quality of life in cardiac rehabilitation patients.

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Factors influencing health-related quality of life in cardiac rehabilitation patients.