The additional value of patient-reported health status in predicting 1-year mortality after invasive coronary procedures: A report from the Euro Heart Survey on Coronary Revascularisation

Mattie J. Lenzen*, Wilma J.M. Scholte Op Reimer, Susanne S. Pedersen, Eric Boersma, Willibald Maier, Petr Widimsky, Maarten L. Simoons, Nestor F. Mercado, William Wijns, M. Bertrand, B. Meier, U. Sechtem, P. Sergeant, E. Stahle, F. Unger, Malika Manini, Claire Bramley, Vale´rie Laforest, Charles Taylor, Susan Del GaisoKurt Huber, Guy De Backer, Vera Sirakova, Roman Cerbak, Per Thayssen, Seppo Lehto, Jean Jacques Blanc, Franc¸ois Delahaye, Bondo Kobulia, Uwe Zeymer, Dennis Cokkinos, Kristof Karlocai, Ian Graham, Emer Shelley, Shlomo Behar, Aldo Maggioni, Virginija Grabauskiene, Jaap Deckers, Inger Asmussen, Janina Stepinska, Lino Gonc¸alves, Vyacheslav Mareev, Igor Riecansky, Miran F. Kenda, Angeles Alonso, Jose´ Luis Lopez-Sendon, Annika Rosengren, Peter Buser, Tugrul Okay, Oleg Sychov, Kevin Fox, David Wood, Harry Crijns, Kim Fox, Keith McGregor, Barbara Mulder, Sylvia Priori, Lars Ryde´n, Luigi Tavazzi, Alec Vahanian, Panos Vardas, Karine Sarkisyan, H. D. Glogar, Matthias Frick, O. Pachinger, Ralf Zwick, Christiaan Vrints, Els Van Hertbruggen, Marc Vercammen, Tineke Sysmans, E. Schroeder, Juliette Domange, Hilde De Pril, Johan De Vriese, Tonny Van Hecke, V. Legrand, Marie France Gillon, Michel Richardy, P. Doneux, Ivo Petrov, J. Jorgova, Boris Starcevic, Eric Eeckhout, Alexandre Berger, Veronique Prudent, E. Camenzind, Nicolas Masson, Costas Zambartas, Helen Kleanthous, Blanka Stellova, Michael Aschermann, Stanislav Simek, J. Kautzner, Vladimir Karmazin, P. Svab, Jan Indrak, M. Branny, Kveta Hladilova, P. Kala, P. Thayssen, Helle Cappelen, Lisette Okkels Jensen, A. Gitt, Konstanze Gehrke, Ludwigshafen am Rhein, R. Erbel, Achim Gutersohn, Holger Eggebrecht, Murad Al Khani, Udo Sechtem, Antje Rosenberger, Holger Vogelsberg, H. Klepzig, Arnold Schmidt, Sigmund Silber, Birgit Mau, Christian Leuner, Karen Czyborra, Christina Reuschling, Eva Muno, Bad Nauheim, F. Kleber, Sascha Rux, U. Zeymer, Aly Saad, Maged Elabady, A. Castro Beiras, Jorge Salgado Fernandez, Felipe Navarro del Arno, A. Iniguez Romo, J. M.Cruz Fernandez, Alejandro Recio Mayoreal, Franciso Javier Rivero Rebanal, Mariano Garcia de la Borbolla, Marinela Chaparro, C. Brotons, C. Permanyer Miralda, Srta Irma Vila i Perez, Cesar Moris, F. Fernandez Aviles, Luis de la Fuente Galan, Paula Tejedor Vinuela, F. Malpartida de Torres, Javier Mora, Ignacio Santos Rodriguez, Itziar Piedra Bustamante, Pedro L.Sanchez Fernandez, J. L.Diago Torrent, Jose L. Diez Gil, Javier Perpinan, V. Palacios Motilla, M. Soledad Alcasena Juango, Jesus Berjon-Reyero, R. Melgares Moreno, Juan Carlos Fernandez Guerrero, S. Lehto, Kirsti Savolainen, Mikko Syvanne, A. Cohen-Solal, Antoine Sylvain Oboa, J. P. Bassand, Denis Pales Espinosa, Veronique Jouet, Besancon Cedex, G. Montalescot, Vanessa Gallois, J. C. Daubert, Jean Michel Clerc, Jacques Machecourt, Y. Cottin, D. Walker, Fhiona Holland, D. Wood, Jenni Prosser, Lis Muir, Kate Barber, J. G.F. Cleland, Jocelyn Cook, Zaza Chapichadze, Ioannis Skoularigisn Athanasiou Christos, Nastasia Tsiavou, Christina Chrysohoou, Athanassios Manginas, John Terrovitis, John Kanakakis, Manolis Vavuranakis, Stavros Drakos, Thomas Farmakis, C. Samara, Christina Papakosta, Christos Bourantas, L. K. Michalis, Mpourantas Christos, Stefanos Foussas, Evdokia Adamopoulou, P. E. Vardas, Mary Marketou, N. Alotti, Anna Maria Basa, Andras Vigh, Istvan Preda, Eva Csoti, M. Keltai, G. Kerkovits, Alberto Hendler, Alex Blatt, Beer Yakov, R. Beyar, Arie Shefer, David Halon, Margalait Bentzvi, Naomi Avramovitch, Avinoam Bakst, Kfar Saba, Carlos Cafri, Aviva Grosbard, Beer Sheva, Bella Margolis, Khalid Suleiman, Shmuel Banai, David Meerkin, Morris Mosseri, Pnina Guita, Rifat Jabara, Jamal Jafari, Debi Ben Shitrit, Ghasan, Salameh, Marc Brezins, Lily van den Akker-Berman, Victor Guetta, Tel Hashomer, Yoseph Rozenman, A. Biagini, Sergio Berti, Massimo Ferrero, A. Colombo, R. Roccaforte, Caterina Milici, L. Scarpino, A. Salvi, Alessandro Desideri, Daniela Sabbadin, Castelfranco Veneto, Alfredo Galassi, Giuseppe Giuffrida, Andrea Rognoni, Corrado Vassanelli, Paola Paffoni, Angelo Cioppa, Paolo Rubino, Marco de Carlo, Anna Sonia Petronio, F. Naccarella, Francesco Saia, Antonio Marzocchi, Stefano Sdringola Maranga, P. Presbitero, Fazya Valsecchi, Federico Piscione, Giovanni Esposito, Napoli M. Santini, Marco Tubaro, A. Erglis, Inga Narbute, Ausra Kavoliuniene, R. Zaliunas, Ramunas Navickas, V. Grabauskiene, Davia Luckute, Eduardas Subkovas, Daniel Wagner, F. Vermeer, Aimee Lousberg, Heidi Fransen, Arno Breeman, Henriette Tebbe, M. J. De Boer, Metske van der Wal, J. Deckers, Jeroen Vos, C. M. Leenders, M. J. Veerhoek, Chris Jansen, M. Bijl, Colinda Koppelaar, Van den Linden, R. Brons, J. W.M.G. Widdershofen, Herman Broers, F. Kontny, Marianne Jonzon, Jan Wodniecki, Andrzej Tomasik, M. Trusz-Gluza, Seweryn Nowak, Witold Ruzyllo, Tomasz Deptuch, Jorge Marques, F. Matias, H. Madeira, Joaquim Oliveira, Luis Sargento, Adina Ionac, Iosif Stefan Dragulescu, Bogdan Mut-Vitcu, Daniela Maximov, M. Dorobantu, E. Apetrei, Rodica Niculescu, Virgil Petrescu, Adrian Bucsa, Dan Deleanu, Bucharest, I. S. Benedek, Theodora Hintea, D. Aronov, Elena Tikhomirova, I. Kranjec, Katja Prokselj, Vojko Kanic, Ahmet Sepetoglu, S. Aytekin, V. Aytekin, Alp Burak Catakoglu, Hayri Parlar, Suavi Tufekcioglu, Zeki Ozyedek, Mehmet Baltali, Dr Kiziltan, Milan Vukovic, A. N. Neskovic

*Corresponding author for this work

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    43 Citations (Scopus)

    Abstract

    Objective: Self-perceived health status may be helpful in identifying patients at high risk for adverse outcomes. The Euro Heart Survey on Coronary Revascularization (EHS-CR) provided an opportunity to explore whether impaired health status was a predictor of 1-year mortality in patients with coronary artery disease (CAD) undergoing angiographic procedures. Methods: Data from the EHS-CR that included 5619 patients from 31 member countries of the European Society of Cardiology were used. Inclusion criteria for the current study were completion of a self-report measure of health status, the EuroQol Questionnaire (EQ-5D) at discharge and information on 1-year follow-up, resulting in a study population of 3786 patients. Results: The 1-year mortality was 3.2% (n = 120). Survivors reported fewer problems on the five dimensions of the EQ-5D as compared with non-survivors. A broad range of potential confounders were adjusted for, which reached a p<0.10 in the unadjusted analyses. In the adjusted analyses, problems with self-care (OR 3.45; 95% CI 2.14 to 5.59) and a low rating (≤ 60) on health status (OR 2.41; 95% CI 1.47 to 3.94) were the most powerful independent predictors of mortality, among the 22 clinical variables included in the analysis. Furthermore, patients who reported no problems on all five dimensions had significantly lower 1-year mortality rates (OR 0.47; 95% CI 0.28 to 0.81). Conclusions: This analysis shows that impaired health status is associated with a 2-3-fold increased risk of all-cause mortality in patients with CAD, independent of other conventional risk factors. These results highlight the importance of including patients' subjective experience of their own health status in the evaluation strategy to optimise risk stratification and management in clinical practice.

    Original languageEnglish
    Pages (from-to)339-344
    Number of pages6
    JournalHeart
    Volume93
    Issue number3
    DOIs
    Publication statusPublished - 1 Mar 2007

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