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Self-Reported Health and Outcomes in Patients With Stable Coronary Heart Disease.
Ralph A H Stewart1, Emil Hagström2, Claes Held2
1Auckland City Hospital, Auckland, New Zealand rstewart@adhb.govt.nz.
Journal of the American Heart Association
|September 2, 2017
Summary
Self-reported health in stable coronary heart disease patients is linked to region, mood, and activity. Poor self-rated health independently predicts major adverse cardiac events and mortality, beyond known risk factors.
Area of Science:
- Cardiology
- Public Health
- Psychosomatic Medicine
Background:
- Prognostic importance of self-reported health in stable coronary heart disease (CHD) is not fully understood.
- Factors influencing self-reported health in CHD patients require further investigation.
Purpose of the Study:
- To determine the major determinants of self-reported health in stable CHD patients.
- To assess the prognostic significance of self-reported health on major adverse cardiac events (MACE) and mortality in a large CHD cohort.
Main Methods:
- Analysis of data from the STABILITY trial, including 15,828 patients with stable CHD.
- Baseline questionnaire assessed self-reported health using a 5-point scale.
- Cox regression analysis evaluated MACE (cardiovascular death, myocardial infarction, stroke) over 3.7 years, adjusting for 38 covariates.
Main Results:
- Self-reported health strongly correlated with geographic region, depressive symptoms, and physical activity (P<0.0001).
- Poor/average self-reported health was independently associated with increased risk of MACE (adjusted HR: 1.83), cardiovascular mortality (adjusted HR: 2.15), and myocardial infarction (adjusted HR: 1.68).
Conclusions:
- Self-reported health in stable CHD patients is significantly influenced by geographical factors, mood, and physical activity levels.
- Self-reported health provides independent prognostic information for cardiovascular events and mortality in a global CHD population, exceeding established risk indicators.
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