Format

Send to

Choose Destination
J Am Heart Assoc. 2017 Aug 22;6(8). pii: e006096. doi: 10.1161/JAHA.117.006096.

Self-Reported Health and Outcomes in Patients With Stable Coronary Heart Disease.

Author information

1
Auckland City Hospital, Auckland, New Zealand rstewart@adhb.govt.nz.
2
Department of Medical Sciences Cardiology and Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
3
Auckland City Hospital, Auckland, New Zealand.
4
Canadian VIGOUR Centre, University of Alberta, Edmonton, Canada.
5
South Australian Health and Medical Research Institute, Flinders University and Medical Centre, Adelaide, Australia.
6
Cardiovascular Division, Brigham and Women's Hospital, Boston, MA.
7
Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.
8
DZHK (German Centre for Cardiovascular Research) partner site Munich Heart Alliance, Munich, Germany.
9
Department of Internal Medicine II-Cardiology, University of Ulm Medical Center, Ulm, Germany.
10
Hospital Universitario La Paz IdiPaz, Madrid, Spain.
11
Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
12
Metabolic Pathways and Cardiovascular Therapeutic Area, GlaxoSmithKline, King of Prussia, PA.
13
San Jose Satelite Hospital, Naucalpan de Juárez, Mexico.
14
Punjab Medical Center Jail road Lahore, Punjab, Pakistan.
15
Département Hospitalo-Universitaire FIRE, AP-HP Hôpital Bichat, Paris, France.
16
Sorbonne Paris Cité Diderot University, Paris, France.
17
NHLI Imperial College, ICMS, Royal Brompton Hospital, London, United Kingdom.
18
FACT (French Alliance for Cardiovascular Trials), an F-CRIN Network, INSERM U1148, Paris, France.

Abstract

BACKGROUND:

The major determinants and prognostic importance of self-reported health in patients with stable coronary heart disease are uncertain.

METHODS AND RESULTS:

The STABILITY (Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy) trial randomized 15 828 patients with stable coronary heart disease to treatment with darapladib or placebo. At baseline, 98% of participants completed a questionnaire that included the question, "Overall, how do you feel your general health is now?" Possible responses were excellent, very good, good, average, and poor. Adjudicated major adverse cardiac events, which included cardiovascular death, myocardial infarction, and stroke, were evaluated by Cox regression during 3.7 years of follow-up for participants who reported excellent or very good health (n=2304), good health (n=6863), and average or poor health (n=6361), before and after adjusting for 38 covariates. Self-reported health was most strongly associated with geographic region, depressive symptoms, and low physical activity (P<0.0001 for all). Poor/average compared with very good/excellent self-reported health was independently associated with major adverse cardiac events (hazard ratio [HR]: 2.30 [95% confidence interval (CI), 1.92-2.76]; adjusted HR: 1.83 [95% CI, 1.51-2.22]), cardiovascular mortality (HR: 4.36 [95% CI, 3.09-6.16]; adjusted HR: 2.15 [95% CI, 1.45-3.19]), and myocardial infarction (HR: 1.87 [95% CI, 1.46-2.39]; adjusted HR: 1.68 [95% CI, 1.25-2.27]; P<0.0002 for all).

CONCLUSIONS:

Self-reported health is strongly associated with geographical region, mood, and physical activity. In a global coronary heart disease population, self-reported health was independently associated with major cardiovascular events and mortality beyond what is measurable by established risk indicators.

CLINICAL TRIAL REGISTRATION:

URL: http://www.ClinicalTrials.gov. Unique identifier: NCT00799903.

KEYWORDS:

coronary artery disease; general health; prognostic studies

PMID:
28862971
PMCID:
PMC5586450
DOI:
10.1161/JAHA.117.006096
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Atypon Icon for PubMed Central
Loading ...
Support Center