Health utility indexes in patients with acute coronary syndromes
Baris Gencer1, Nicolas Rodondi2, Reto Auer3
1Cardiology Division , Geneva University Hospitals, University of Geneva , Geneva , Switzerland.
Insights
Patients with acute coronary syndromes (ACS) undergoing coronary angiography had similar health utilities (HUs) to the general population one year post-procedure. However, younger patients and those with specific conditions showed lower HUs, indicating a need for tailored assessments.
Area of Science:
- Cardiology
- Health Economics
- Patient-Reported Outcomes
Background:
- Acute coronary syndromes (ACS) are linked to reduced health utilities (HUs) compared to the general population.
- Prognostic improvements post-ACS with interventions like percutaneous coronary intervention (PCI) necessitate updated HU data.
- Patient-reported outcomes are crucial for deriving contemporary HU values.
Purpose of the Study:
- To assess health utilities (HUs) in patients with acute coronary syndromes (ACS) one year after coronary angiography.
- To compare HU values in ACS patients with the general population.
- To identify clinical factors influencing HU in ACS patients.
Main Methods:
- Analysis of 1882 patients with ACS from a Swiss prospective cohort, one year post-coronary angiography.
- Utilized EuroQol five-dimensional questionnaire (EQ-5D) and visual analogue scale (VAS) to derive health utility (HU) indexes.
- Employed linear regression to estimate the effects of clinical factors on HU and compared with population controls.
Main Results:
- Mean EQ-5D HU was 0.82 (±0.16) and VAS was 0.77 (±0.18) one year post-ACS.
- ACS patients' mean EQ-5D HU was similar to population controls (p=0.58), but VAS was slightly lower (p<0.001).
- Younger ACS patients (<60 years), and those with specific comorbidities or lifestyle factors, exhibited significantly lower HUs.
Conclusions:
- One year after coronary angiography for ACS, patients demonstrated health utility indexes comparable to the general population.
- Subgroup analyses and disease-specific instruments are recommended for detecting nuanced variations in quality of life.
- Further research should explore patient characteristics to refine understanding of health-related quality of life post-ACS.
Background:
Acute coronary syndromes (ACS) have been associated with lower health utilities (HUs) compared with the general population. Given the prognostic improvements after ACS with the implementation of coronary angiography (eg, percutaneous coronary intervention (PCI)), contemporary HU values derived from patient-reported outcomes are needed.
Methods:
We analysed data of 1882 patients with ACS 1 year after coronary angiography in a Swiss prospective cohort. We used the EuroQol five-dimensional questionnaire (EQ-5D) and visual analogue scale (VAS) to derive HU indexes. We estimated the effects of clinical factors on HU using a linear regression model and compared the observed HU with the average values of individuals of the same sex and age in the general population.
Results:
Mean EQ-5D HU 1-year after coronary angiography for ACS was 0.82 (±0.16) and mean VAS was 0.77 (±0.18); 40.9% of participants exhibited the highest utility values. Compared with population controls, the mean EQ-5D HU was similar (expected mean 0.82, p=0.58) in patients with ACS, but the mean VAS was slightly lower (expected mean 0.79, p<0.001). Patients with ACS who are younger than 60 years had lower HU than the general population (<0.001). In patients with ACS, significant differences were found according to the gender, education and employment status, diabetes, obesity, heart failure, recurrent ischaemic or incident bleeding event and participation in cardiac rehabilitation (p<0.01).
Conclusions:
At 1 year, patients with ACS with coronary angiography had HU indexes similar to a control population. Subgroup analyses based on patients' characteristics and further disease-specific instruments could provide better sensitivity for detecting smaller variations in health-related quality of life.
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