|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.|
|PMID: 22607856 Owner: NLM Status: MEDLINE|
|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.
|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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|Type: Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't|
|Title: American heart journal Volume: 163 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2012 May|
|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|
|Languages: eng Pagination: 790-6 Citation Subset: AIM; IM|
|Copyright © 2012 Mosby, Inc. All rights reserved.|
|APA/MLA Format Download EndNote Download BibTex|
Activities of Daily Living
Angioplasty, Balloon, Coronary / adverse effects, methods*
Attitude to Health*
Cardiac Catheterization / methods
Coronary Angiography / methods
Depression / epidemiology, etiology, physiopathology
Electrocardiography / methods
Independent Living / statistics & numerical data*
Myocardial Infarction / complications, radiography, therapy*
Physical Fitness / physiology*
Predictive Value of Tests
Quality of Life
Sickness Impact Profile
Translational Medical Research
|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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