Document Detail


Physical function and independence 1 year after myocardial infarction: observations from the Translational Research Investigating Underlying disparities in recovery from acute Myocardial infarction: Patients' Health status registry.
MedLine Citation:
PMID:  22607856     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Acute myocardial infarction (AMI) may contribute to health status declines including "independence loss" and "physical function decline." Despite the importance of these outcomes for prognosis and quality of life, their incidence and predictors have not been well described.
METHODS: We studied 2,002 patients with AMI enrolled across 24 sites in the TRIUMPH registry who completed assessments of independence and physical function at the time of AMI and 1 year later. Independence was evaluated by the EuroQol-5D (mobility, self-care, and usual activities), and physical function was assessed with the Short Form-12 physical component score. Declines in ≥1 level on EuroQol-5D and >5 points in PCS were considered clinically significant changes. Hierarchical, multivariable, modified Poisson regression models accounting for within-site variability were used to identify predictors of independence loss and physical function decline.
RESULTS: One-year post AMI, 43.0% of patients experienced health status declines: 12.8% independence loss alone, 15.2% physical function decline alone, and 15.0% both. After adjustment, variables that predicted independence loss included female sex, nonwhite race, unmarried status, uninsured status, end-stage renal disease, and depression. Variables that predicted physical function decline were uninsured status, lack of cardiac rehabilitation referral, and absence of pre-AMI angina. Age was not predictive of either outcome after adjustment.
CONCLUSIONS: >40% of patients experience independence loss or physical function decline 1 year after AMI. These changes are distinct but can occur simultaneously. Although some risk factors are not modifiable, others suggest potential targets for strategies to preserve patients' health status.
Authors:
John A Dodson; Suzanne V Arnold; Kimberly J Reid; Thomas M Gill; Michael W Rich; Frederick A Masoudi; John A Spertus; Harlan M Krumholz; Karen P Alexander
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  163     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-05-21     Completed Date:  2012-07-31     Revised Date:  2014-04-16    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  790-6     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Mosby, Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living
Age Factors
Aged
Angioplasty, Balloon, Coronary / adverse effects,  methods*
Attitude to Health*
Cardiac Catheterization / methods
Coronary Angiography / methods
Depression / epidemiology,  etiology,  physiopathology
Electrocardiography / methods
Female
Follow-Up Studies
Health Surveys
Humans
Incidence
Independent Living / statistics & numerical data*
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction / complications,  radiography,  therapy*
Physical Fitness / physiology*
Poisson Distribution
Predictive Value of Tests
Quality of Life
Questionnaires
Registries*
Risk Assessment
Sickness Impact Profile
Survivors
Time Factors
Translational Medical Research
Grant Support
ID/Acronym/Agency:
P30 AG021342/AG/NIA NIH HHS; P50 HL077113/HL/NHLBI NIH HHS; T32 AG019134/AG/NIA NIH HHS; T32 AG019134-11/AG/NIA NIH HHS
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