Health-related quality of life 1-3 years post-myocardial infarction: Its impact on prognosis

Stuart Pocock, David B. Brieger, Ruth Owen, Jiyan Chen, Mauricio G. Cohen, Shaun Goodman, Christopher B. Granger, José C. Nicolau, Tabassome Simon, Dirk Westermann, Satoshi Yasuda, Katarina Hedman, Carl Mellström, Karolina Andersson Sundell, Richard Grieve

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13 Citations (Scopus)


Objective To assess associations of health-related quality of life (HRQoL) with patient profile, resource use, cardiovascular (CV) events and mortality in stable patients post-myocardial infarction (MI). Methods The global, prospective, observational TIGRIS Study enrolled 9126 patients 1-3 years post-MI. HRQoL was assessed at enrolment and 6-month intervals using the patient-reported EuroQol-5 dimension (EQ-5D) questionnaire, with scores anchored at 0 (worst possible) and 1 (perfect health). Resource use, CV events and mortality were recorded during 2-years' follow-up. Regression models estimated the associations of index score at enrolment with patient characteristics, resource use, CV events and mortality over 2-years' follow-up. Results Among 8978 patients who completed the EQ-5D questionnaire, 52% reported a € some' or a € severe' problems on one or more health dimensions. Factors associated with a lower index score were: female sex, older age, obesity, smoking, higher heart rate, less formal education, presence of comorbidity (eg, angina, stroke), emergency room visit in the previous 6 months and non-ST-elevation MI as the index event. Compared with an index score of 1 at enrolment, a lower index score was associated with higher risk of all-cause death, with an adjusted rate ratio of 3.09 (95% CI 2.20 to 4.31), and of a CV event, with a rate ratio of 2.31 (95% CI 1.76 to 3.03). Patients with lower index score at enrolment had almost two times as many hospitalisations over 2-years' follow-up. Conclusions Clinicians managing patients post-acute coronary syndrome should recognise that a poorer HRQoL is clearly linked to risk of hospitalisations, major CV events and death. Trial registration number Registry (NCT01866904) (

Original languageEnglish
Article numbere001499
JournalOpen Heart
Issue number1
Publication statusPublished - 2021 Feb 9


  • coronary artery disease
  • myocardial infarction
  • quality of healthcare


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