Life quality parameters in patients with combination of stable ischemic heart disease and chronic obstructive...

Introduction: The part of patients with comorbide pathology, which includes ischemic heart disease (IHD) and chronic obstructive pulmonary disease (COPD), increases among patients aged 40 and older. Combination of diseases has a great influence on patients' quality of life (QOL). The aim of the work was investigation of features of QOL parameters in patients with combination of stable IHD and COPD.

Materials and methods: 272 patients have been studied; they have been divided into three groups: group I included 98 patients with combination of stable IHD and COPD, the average age 65.8±0.83 years, group II - 96 patients with stable IHD, the average age 58.9±0.9; group III consisted of 78 patients with COPD without IHD, the average age 57.9±0.85 years. Typical clinical examination, 6-minute walking test (6 MWT) and evaluation of QOL parameters with health survey questionnaire MOS SF 36 have been conducted.

Results: Patients with combination of stable IHD and COPD have decreased all life quality indices in comparison with patients of groups II and III: physical health in group I was 33.5 points, mental health - 27.5, general health - 50.3 points. QOL parameters in group I corelate with the doctor's visit rate and the number of, hospitalizations and emergency calls. Significantly lower exercise tolerance (distance 336.8±40.8 m per 6 minutes) has been established in group I, as well as marked dyspnea (р=0,003), tachycardia (р=0,017) and a tendency towards blood pressure decrease during exercises (р=0,013).

Conclusions: Combination of IHD and COPD is accompanied by worsening of QOL parameters, which should be estimated in clinical practice. Combination of IHD and COPD is associated with requirement of hospital treatment (5.2 times in 5 years) and emergency aid (once a year), that distinguish such patients from patients with isolated IHD or COPD. Patients with combined diseases often need outpatient care, 70.4% - more than 3 times per year.