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Comparison of Health Status Among Patients With Type 1 Myocardial Infarction and Type 2 Myocardial Infarction: The
Seán P Murphy1,2, Nhi Tong3, Jeff C Huffman2,4
1Heart and Vascular Institute, Mass General Brigham Boston MA USA.
Background:
Improving health status is a fundamental goal after myocardial infarction (MI). Whether health status differs between type 1 and type 2 MI is unknown.
Methods:
In this prospective study, 150 patients hospitalized with type 1 (n=75) and type 2 MI (n=75) were enrolled. Health status was assessed at baseline, 1, and 4 months using the EuroQol 5-Dimension 5-Level visual analogue scale, 7-item Seattle Angina Questionnaire, Patient-Reported Outcomes Measurement Information System Physical Function, Patient-Reported Outcomes Measurement Information System Fatigue, FRAIL Scale, and Patient Health Questionnaire-9.
Results:
A total of 149 baseline, 92 one-month, and 92 four-month assessments were analyzed. Patients with type 2 MI were older, were more frequently women, and had more comorbidities. Baseline health status was similar between type 2 and type 1 MI (EuroQol 5-Dimension 5-Level visual analog scale, 66.20±22.17 versus 69.36±20.67; P=0.37). At 1 and 4 months, the EuroQol 5-Dimension 5-Level visual analog scale was lower for type 2 MI, and adjusted analyses demonstrated less improvement (difference, - 4.8 points; P=0.04). Patients with type 2 MI had lower physical function and greater frailty throughout follow-up. Baseline fatigue and depression were similar but modestly worse for type 2 MI at follow-up. Baseline 7-item Seattle Angina Questionnaire scores were higher for type 2 MI but were similar between groups at follow-up.
Conclusions:
Although baseline overall health status was similar, patients with type 2 MI experienced smaller improvements in health status and reported a greater burden of frailty and impaired physical function over 4 months. These findings highlight the need to address health status domains beyond angina after type 2 MI.
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