Quality of life in patients with cardiac disease

Abstract

Measurement of quality of life

(QOL) as an indicator of health outcome has become increasingly

important in patients with coronary artery disease. Nitrates can

effectively control symptoms of angina. A once daily dosage regimen of isosorbide mononitrate might provide better QOL than conventional multiple daily dosage regimen. To assess this, we performed two studies in patients with angina pectoris. We conclude that replacement of a multiple daily dosage regimen with a once daily dosage regimen results in an improved QOL, anginal NYHA class and exercise capacity. We also conclude that patients with certain cardiac risk factors and co-morbidities might particularly benefit. In a separate chapter we study the influence of pschychological factors on QOL in patients with heart failure and in patients on the waiting list for coronary angiography. Finale we discuss a study concerning early discharge in patients with acute myocardial infarction treated with primary PCI. We conclude that hospital discharge on the day after admission in combination with a rehabilitation program is feasible and offers a safe and patient-friendly alternative to the usual 3 to 4 days of in hospital care, without negative effect on QOL or secondary prevention goals.