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Gender differences in health-related quality of life in patients undergoing coronary angiography
Crystel M Gijsberts1, Pierfrancesco Agostoni2, Imo E Hoefer3
1Laboratory of Experimental Cardiology, Division Heart and Lungs , University Medical Centre Utrecht , Utrecht , The Netherlands ; ICIN-Netherlands Heart Institute , Utrecht , The Netherlands.
Insights
Women with coronary artery disease (CAD) experience lower health-related quality of life (HRQOL) than men. This study found significant gender differences in HRQOL and its determinants in patients undergoing coronary angiography (CAG).
Area of Science:
- Cardiology
- Public Health
- Health Outcomes Research
Background:
- Health-related quality of life (HRQOL) is a crucial indicator of general well-being.
- Coronary artery disease (CAD) significantly compromises HRQOL, with previous reports indicating lower HRQOL in female patients.
- Gender disparities in HRQOL among CAD patients warrant further investigation.
Purpose of the Study:
- To investigate gender differences in HRQOL among patients undergoing coronary angiography (CAG).
- To examine how patient characteristics are associated with HRQOL in relation to gender.
- To compare HRQOL in CAD patients with the general Dutch population.
Main Methods:
- Cross-sectional analysis of 1421 patients (1020 men, 401 women) from the Utrecht Coronary Biobank undergoing CAG.
- HRQOL assessment using RAND-36 and EuroQoL questionnaires.
- Comparison of HRQOL measures between genders, across CAG indications, CAD severity, and treatment, and with the general population. Regression analysis explored gender interactions with patient characteristics.
Main Results:
- Women reported significantly lower HRQOL than men (EuroQoL: 6.46 vs. 6.84, p<0.001).
- The reduction in HRQOL compared to the general population was more pronounced in women.
- Diabetes, prior cardiovascular disease, and shortness of breath were stronger determinants of HRQOL in men than in women.
Conclusions:
- Women consistently reported lower HRQOL than men across all CAG indications, CAD severities, and treatments.
- HRQOL deficits relative to the general population were more severe in women.
- Significant gender differences in HRQOL determinants among patients undergoing CAG necessitate targeted future research and interventions.
Background:
Health-related quality of life (HRQOL) reflects the general well-being of individuals. In patients with coronary artery disease (CAD), HRQOL is compromised. Female patients with CAD have been reported to have lower HRQOL. In this study, we investigate gender differences in HRQOL and in associations of patient characteristics with HRQOL in patients with coronary angiography (CAG).
Methods:
We cross-sectionally analysed patients from the Utrecht Coronary Biobank undergoing CAG. All patients filled in an HRQOL questionnaire (RAND-36 and EuroQoL) on inclusion. RAND-36 and EuroQoL HRQOL measures were compared between the genders across indications for CAG, CAD severity and treatment of CAD. RAND-36 HRQOL measures were compared with the general Dutch population. Additionally, we assessed interactions of gender with patient characteristics in their association with HRQOL (EuroQoL).
Results:
We included 1421 patients (1020 men and 401 women) with a mean age of 65 in our analysis. Women reported lower HRQOL measures than men (mean EuroQoL self-rated health grade 6.84±1.49 in men, 6.46±1.40 in women, p<0.001). The reduction in RAND-36 HRQOL as compared with the general Dutch population was larger in women than in men. From regression analysis, we found that diabetes, a history of cardiovascular disease and symptoms of shortness of breath determined HRQOL (EuroQoL) more strongly in men than in women.
Conclusions:
Women reported lower HRQOL than men throughout all indications for CAG and regardless of CAD severity or treatment. As compared with the general population, the reduction in HRQOL was more extreme in women than in men. Evident gender differences were found in determinants of HRQOL in patients undergoing CAG, which deserve attention in future research.
Trial Registration:
NCT02304744 (clinicaltrials.gov).
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