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 language | English |
|---|---|
| Pages (from-to) | 339-344 |
| Number of pages | 6 |
| Journal | Heart |
| Volume | 93 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 1 Mar 2007 |
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In: Heart, Vol. 93, No. 3, 01.03.2007, p. 339-344.
Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - The additional value of patient-reported health status in predicting 1-year mortality after invasive coronary procedures
T2 - A report from the Euro Heart Survey on Coronary Revascularisation
AU - Lenzen, Mattie J.
AU - Scholte Op Reimer, Wilma J.M.
AU - Pedersen, Susanne S.
AU - Boersma, Eric
AU - Maier, Willibald
AU - Widimsky, Petr
AU - Simoons, Maarten L.
AU - Mercado, Nestor F.
AU - Wijns, William
AU - Bertrand, M.
AU - Meier, B.
AU - Sechtem, U.
AU - Sergeant, P.
AU - Stahle, E.
AU - Unger, F.
AU - Manini, Malika
AU - Bramley, Claire
AU - Laforest, Vale´rie
AU - Taylor, Charles
AU - Del Gaiso, Susan
AU - Huber, Kurt
AU - De Backer, Guy
AU - Sirakova, Vera
AU - Cerbak, Roman
AU - Thayssen, Per
AU - Lehto, Seppo
AU - Blanc, Jean Jacques
AU - Delahaye, Franc¸ois
AU - Kobulia, Bondo
AU - Zeymer, Uwe
AU - Cokkinos, Dennis
AU - Karlocai, Kristof
AU - Graham, Ian
AU - Shelley, Emer
AU - Behar, Shlomo
AU - Maggioni, Aldo
AU - Grabauskiene, Virginija
AU - Deckers, Jaap
AU - Asmussen, Inger
AU - Stepinska, Janina
AU - Gonc¸alves, Lino
AU - Mareev, Vyacheslav
AU - Riecansky, Igor
AU - Kenda, Miran F.
AU - Alonso, Angeles
AU - Lopez-Sendon, Jose´ Luis
AU - Rosengren, Annika
AU - Buser, Peter
AU - Okay, Tugrul
AU - Sychov, Oleg
AU - Fox, Kevin
AU - Wood, David
AU - Crijns, Harry
AU - Fox, Kim
AU - McGregor, Keith
AU - Mulder, Barbara
AU - Priori, Sylvia
AU - Ryde´n, Lars
AU - Tavazzi, Luigi
AU - Vahanian, Alec
AU - Vardas, Panos
AU - Sarkisyan, Karine
AU - Glogar, H. D.
AU - Frick, Matthias
AU - Pachinger, O.
AU - Zwick, Ralf
AU - Vrints, Christiaan
AU - Van Hertbruggen, Els
AU - Vercammen, Marc
AU - Sysmans, Tineke
AU - Schroeder, E.
AU - Domange, Juliette
AU - De Pril, Hilde
AU - De Vriese, Johan
AU - Van Hecke, Tonny
AU - Legrand, V.
AU - Gillon, Marie France
AU - Richardy, Michel
AU - Doneux, P.
AU - Petrov, Ivo
AU - Jorgova, J.
AU - Starcevic, Boris
AU - Eeckhout, Eric
AU - Berger, Alexandre
AU - Prudent, Veronique
AU - Camenzind, E.
AU - Masson, Nicolas
AU - Zambartas, Costas
AU - Kleanthous, Helen
AU - Stellova, Blanka
AU - Aschermann, Michael
AU - Simek, Stanislav
AU - Kautzner, J.
AU - Karmazin, Vladimir
AU - Svab, P.
AU - Indrak, Jan
AU - Branny, M.
AU - Hladilova, Kveta
AU - Kala, P.
AU - Thayssen, P.
AU - Cappelen, Helle
AU - Jensen, Lisette Okkels
AU - Gitt, A.
AU - Gehrke, Konstanze
AU - am Rhein, Ludwigshafen
AU - Erbel, R.
AU - Gutersohn, Achim
AU - Eggebrecht, Holger
AU - Al Khani, Murad
AU - Sechtem, Udo
AU - Rosenberger, Antje
AU - Vogelsberg, Holger
AU - Klepzig, H.
AU - Schmidt, Arnold
AU - Silber, Sigmund
AU - Mau, Birgit
AU - Leuner, Christian
AU - Czyborra, Karen
AU - Reuschling, Christina
AU - Muno, Eva
AU - Nauheim, Bad
AU - Kleber, F.
AU - Rux, Sascha
AU - Zeymer, U.
AU - Saad, Aly
AU - Elabady, Maged
AU - Beiras, A. Castro
AU - Fernandez, Jorge Salgado
AU - del Arno, Felipe Navarro
AU - Romo, A. Iniguez
AU - Fernandez, J. M.Cruz
AU - Mayoreal, Alejandro Recio
AU - Rebanal, Franciso Javier Rivero
AU - de la Borbolla, Mariano Garcia
AU - Chaparro, Marinela
AU - Brotons, C.
AU - Miralda, C. Permanyer
AU - Vila i Perez, Srta Irma
AU - Moris, Cesar
AU - Aviles, F. Fernandez
AU - de la Fuente Galan, Luis
AU - Vinuela, Paula Tejedor
AU - de Torres, F. Malpartida
AU - Mora, Javier
AU - Rodriguez, Ignacio Santos
AU - Bustamante, Itziar Piedra
AU - Fernandez, Pedro L.Sanchez
AU - Torrent, J. L.Diago
AU - Diez Gil, Jose L.
AU - Perpinan, Javier
AU - Motilla, V. Palacios
AU - Juango, M. Soledad Alcasena
AU - Berjon-Reyero, Jesus
AU - Moreno, R. Melgares
AU - Guerrero, Juan Carlos Fernandez
AU - Lehto, S.
AU - Savolainen, Kirsti
AU - Syvanne, Mikko
AU - Cohen-Solal, A.
AU - Oboa, Antoine Sylvain
AU - Bassand, J. P.
AU - Espinosa, Denis Pales
AU - Jouet, Veronique
AU - Cedex, Besancon
AU - Montalescot, G.
AU - Gallois, Vanessa
AU - Daubert, J. C.
AU - Clerc, Jean Michel
AU - Machecourt, Jacques
AU - Cottin, Y.
AU - Walker, D.
AU - Holland, Fhiona
AU - Wood, D.
AU - Prosser, Jenni
AU - Muir, Lis
AU - Barber, Kate
AU - Cleland, J. G.F.
AU - Cook, Jocelyn
AU - Chapichadze, Zaza
AU - Christos, Ioannis Skoularigisn Athanasiou
AU - Tsiavou, Nastasia
AU - Chrysohoou, Christina
AU - Manginas, Athanassios
AU - Terrovitis, John
AU - Kanakakis, John
AU - Vavuranakis, Manolis
AU - Drakos, Stavros
AU - Farmakis, Thomas
AU - Samara, C.
AU - Papakosta, Christina
AU - Bourantas, Christos
AU - Michalis, L. K.
AU - Christos, Mpourantas
AU - Foussas, Stefanos
AU - Adamopoulou, Evdokia
AU - Vardas, P. E.
AU - Marketou, Mary
AU - Alotti, N.
AU - Basa, Anna Maria
AU - Vigh, Andras
AU - Preda, Istvan
AU - Csoti, Eva
AU - Keltai, M.
AU - Kerkovits, G.
AU - Hendler, Alberto
AU - Blatt, Alex
AU - Yakov, Beer
AU - Beyar, R.
AU - Shefer, Arie
AU - Halon, David
AU - Bentzvi, Margalait
AU - Avramovitch, Naomi
AU - Bakst, Avinoam
AU - Saba, Kfar
AU - Cafri, Carlos
AU - Grosbard, Aviva
AU - Sheva, Beer
AU - Margolis, Bella
AU - Suleiman, Khalid
AU - Banai, Shmuel
AU - Meerkin, David
AU - Mosseri, Morris
AU - Guita, Pnina
AU - Jabara, Rifat
AU - Jafari, Jamal
AU - Shitrit, Debi Ben
AU - Ghasan,
AU - Salameh,
AU - Brezins, Marc
AU - van den Akker-Berman, Lily
AU - Guetta, Victor
AU - Hashomer, Tel
AU - Rozenman, Yoseph
AU - Biagini, A.
AU - Berti, Sergio
AU - Ferrero, Massimo
AU - Colombo, A.
AU - Roccaforte, R.
AU - Milici, Caterina
AU - Scarpino, L.
AU - Salvi, A.
AU - Desideri, Alessandro
AU - Sabbadin, Daniela
AU - Veneto, Castelfranco
AU - Galassi, Alfredo
AU - Giuffrida, Giuseppe
AU - Rognoni, Andrea
AU - Vassanelli, Corrado
AU - Paffoni, Paola
AU - Cioppa, Angelo
AU - Rubino, Paolo
AU - de Carlo, Marco
AU - Petronio, Anna Sonia
AU - Naccarella, F.
AU - Saia, Francesco
AU - Marzocchi, Antonio
AU - Maranga, Stefano Sdringola
AU - Presbitero, P.
AU - Valsecchi, Fazya
AU - Piscione, Federico
AU - Esposito, Giovanni
AU - Santini, Napoli M.
AU - Tubaro, Marco
AU - Erglis, A.
AU - Narbute, Inga
AU - Kavoliuniene, Ausra
AU - Zaliunas, R.
AU - Navickas, Ramunas
AU - Grabauskiene, V.
AU - Luckute, Davia
AU - Subkovas, Eduardas
AU - Wagner, Daniel
AU - Vermeer, F.
AU - Lousberg, Aimee
AU - Fransen, Heidi
AU - Breeman, Arno
AU - Tebbe, Henriette
AU - De Boer, M. J.
AU - van der Wal, Metske
AU - Deckers, J.
AU - Vos, Jeroen
AU - Leenders, C. M.
AU - Veerhoek, M. J.
AU - Jansen, Chris
AU - Bijl, M.
AU - Koppelaar, Colinda
AU - den Linden, Van
AU - Brons, R.
AU - Widdershofen, J. W.M.G.
AU - Broers, Herman
AU - Kontny, F.
AU - Jonzon, Marianne
AU - Wodniecki, Jan
AU - Tomasik, Andrzej
AU - Trusz-Gluza, M.
AU - Nowak, Seweryn
AU - Ruzyllo, Witold
AU - Deptuch, Tomasz
AU - Marques, Jorge
AU - Matias, F.
AU - Madeira, H.
AU - Oliveira, Joaquim
AU - Sargento, Luis
AU - Ionac, Adina
AU - Dragulescu, Iosif Stefan
AU - Mut-Vitcu, Bogdan
AU - Maximov, Daniela
AU - Dorobantu, M.
AU - Apetrei, E.
AU - Niculescu, Rodica
AU - Petrescu, Virgil
AU - Bucsa, Adrian
AU - Deleanu, Dan
AU - Bucharest,
AU - Benedek, I. S.
AU - Hintea, Theodora
AU - Aronov, D.
AU - Tikhomirova, Elena
AU - Kranjec, I.
AU - Prokselj, Katja
AU - Kanic, Vojko
AU - Sepetoglu, Ahmet
AU - Aytekin, S.
AU - Aytekin, V.
AU - Catakoglu, Alp Burak
AU - Parlar, Hayri
AU - Tufekcioglu, Suavi
AU - Ozyedek, Zeki
AU - Baltali, Mehmet
AU - Kiziltan, Dr
AU - Vukovic, Milan
AU - Neskovic, A. N.
PY - 2007/3/1
Y1 - 2007/3/1
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=34247141953&partnerID=8YFLogxK
U2 - 10.1136/hrt.2005.086868
DO - 10.1136/hrt.2005.086868
M3 - Article
C2 - 16980515
AN - SCOPUS:34247141953
SN - 1355-6037
VL - 93
SP - 339
EP - 344
JO - Heart
JF - Heart
IS - 3
ER -