Gender differences in health-related quality of life in patients with congestive heart failure and past coronary artery bypass graft surgery

Abstract

Background: Heart failure (HF) causes a large health and economic burden to society. Despite significant advances in treatment over the past twenty years, the incidence, prevalence, hospitalizations, and mortality from HF continue to increase. HF patients endure diminished health-related quality of life (HRQoL). In this study I evaluated gender differences in HRQoL in patients with HF who had had coronary artery bypass graft surgery (CABG) at Nork Marash Medical Center (NMMC) in Yerevan, Armenia. Methods: The study utilized a retrospective cohort design with a cross-sectional telephone survey. The study population included all patients who had had CABG between January 1, 2016 and December 31, 2018 and were diagnosed with HF at the time of CABG or during the followup period (end of follow-up: March 31, 2019). HRQoL was evaluated by using the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Multivariable linear regression analysis identified independent predictors of HRQoL in HF patients. Results: Overall, 86% (n=80) of 93 patients included in the final analysis were men. Women were somewhat older (66.69 vs. 61.23, p=0.017). All participants had at least one comorbid disease. The mean MLHFQ score for women was higher (66.8 vs. 59.9, p =0.354) but not statistically significant. Patients with HF functional class (NYHA) II/III/IV had MLHFQ scores 10.13 (2.73 to 17.54) points higher (i.e., worse HRQoL) than patients in HF class I. Similarly, employed patients had 16.97 (95% CI: 7.43 to 26.5) points lower MLHFQ scores (i.e., better HRQoL). Conclusions: This study found no statistically significant gender difference in disease-specific HRQoL. Class I functional status of HF (NYHA) and being employed were associated with better HRQoL. We would recommend to evaluate the impact of complications after surgery, adherence to treatment, and HF-related readmissions on HRQoL in these patients in future research.