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Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2004

Open Access 01-12-2004 | Research

Women with coronary artery disease report worse health-related quality of life outcomes compared to men

Authors: Colleen M Norris, William A Ghali, P Diane Galbraith, Michelle M Graham, Louise A Jensen, Merril L Knudtson, the APPROACH Investigators

Published in: Health and Quality of Life Outcomes | Issue 1/2004

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Abstract

Background

Although there have been substantial medical advances that improve the outcomes following cardiac ischemic events, gender differences in the treatment and course of recovery for patients with coronary artery disease (CAD) continue to exist. There is a general paucity of data comparing the health related quality of life (HRQOL) in men and women undergoing treatment for CAD. The purpose of this study was to compare HRQOL outcomes of men and women in Alberta, at one-year following initial catheterization, after adjustment for known demographic, co-morbid, and disease severity predictors of outcome.

Method

The HRQOL outcome data were collected by means of a self-reported questionnaire mailed to patients on or near the one-year anniversary of their initial cardiac catheterization. Using the Seattle Angina Questionnaire (SAQ), 5 dimensions of HRQOL were measured: exertional capacity, anginal stability, anginal frequency, quality of life and treatment satisfaction. Data from the APPROACH registry were used to risk-adjust the SAQ scale scores. Two analytical strategies were used including general least squares linear modeling, and proportional odds modeling sometimes referred to as the "ordinal logistic modeling".

Results

3392 (78.1%) patients responded to the follow-up survey. The adjusted proportional odds ratios for men relative to women (PORs > 1 = better) indicated that men reported significantly better HRQOL on all 5 SAQ dimensions as compared to women. (PORs: Exertional Capacity 3.38 (2.75–4.15), Anginal Stability 1.23 (1.03–1.47), Anginal Frequency 1.70 (1.43–2.01), Treatment Satisfaction 1.27 (1.07–1.50), and QOL 1.74 (1.48–2.04).

Conclusions

Women with CAD consistently reported worse HRQOL at one year follow-up compared to men. These findings underline the fact that conclusions based on research performed on men with CAD may not be valid for women and that more gender-related research is needed. Future studies are needed to further examine gender differences in psychosocial adjustment following treatment for CAD, as adjustment for traditional clinical variables fails to explain sex differences in health related quality of life outcomes.
Appendix
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Metadata
Title
Women with coronary artery disease report worse health-related quality of life outcomes compared to men
Authors
Colleen M Norris
William A Ghali
P Diane Galbraith
Michelle M Graham
Louise A Jensen
Merril L Knudtson
the APPROACH Investigators
Publication date
01-12-2004
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2004
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-2-21

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