Quality of life after myocardial infarction in the pakistani population - insights from a single-center cohort study

Background: Health-related Quality of life (HRQoL) assessment is essential for optimizing patient care, treatment adjustments, and medical decision-making, particularly in post-Myocardial Infarction (MI) patients, but limited data exists on HRQOL post-MI from Pakistan. This study aimed to assess HRQoL and its determinants in the Pakistani population.

Methods: A single-center cross-sectional study was conducted at a tertiary care hospital in Karachi, Pakistan. Patients ≥ 18 years old with a primary diagnosis of acute MI (ICD-9 codes: 410.0-410.9 and ICD-10 codes: 121.0-121.9) discharged from the Cardiology Service from January 2019 to December 2020 who could be contacted and consented to participate were included. Data was collected from electronic records, and patients were interviewed via phone calls using a validated Urdu version of the WHOQOL-BREF questionnaire. Statistical analysis was performed using non-parametric tests via RStudio (Version 1.4.1717).

Results: The final study cohort was 440 patients with a median age of 63.0 (IQR: 56.0,72.0) years, with a male predominance (68.2%). Physical health was the most affected domain. Females, lower-income individuals, and those with lower levels of education had lower HRQoL scores in all domains. Diabetes and the presence of multiple co-morbidities were associated with lower HRQoL. Marital and socioeconomic status, along with psychosocial factors were significantly associated with HRQoL scores. Notably, 62.0% of post-MI patients rated their overall HRQoL as good (4-5 on a Likert scale of 1-5). Cronbach's alpha values indicated good internal consistency, with an overall Cronbach's alpha of 0.902.

Conclusion: Although a significant proportion of patients in our cohort reported good HRQoL post-MI, several social factors were associated with lower HRQoL. These factors must be investigated further in discharge planning and post-discharge of patients with MI.