Predictors of quality of life after revascularization for ischemic heart disease: A systematic review

Background: Quality of life is a key outcome after coronary revascularization for ischemic heart disease in the modern era. 6–12 months after coronary revascularization, recovery from the intervention itself, especially coronary artery bypass grafting, is no longer the key determinant of quality of life, while the benefits (or lack thereof) of revascularization become more apparent. Potential determinants of quality of life that are not directly related to the form of intervention have been less frequently examined in this group of patients. Methods: This systematic review examined the association of published contributors to quality of life in patients following coronary revascularization for ischemic heart disease 6–12 months post intervention. Studies that reported such associations were identified and assessed for quality. 11 were included in this review. Quality of life was measured by the Short Forms 36 and 12, and the Seattle Angina Questionnaire. Results: Of potentially modifiable factors, current smoking and hypertension displayed the most consistent associations with reduced quality of life after intervention. Quality of life was positively associated with baseline quality of life and being partnered/married, and negatively associated with female sex, diabetes, and lung or renal disease, and only minimally associated with ejection fraction. Age and prior myocardial infarction displayed conflicting associations. Conclusion: To improve patient outcomes following coronary revascularization, other potentially modifiable non-procedural factors that affect quality of life could be targeted for more intensive management. Smoking cessation and anti-hypertensive therapies treat the most consistent factors associated with reduced quality of life after revascularization.