Health-related quality of life is poor but does not vary with cardiovascular disease burden among patients operated for severe atherosclerotic disease

Background: Patients with cardiovascular disease (CVD) are reported to have a poorer health-related quality of life (HRQoL) compared to healthy age- and gender-matched individuals. Moreover, HRQoL seems to predict survival in CVD populations. We studied HRQoL and the association with outcome during follow-up in a population undergoing surgery for peripheral artery disease or cerebrovascular large artery disease. Methods: In the Athero-Express biobank cohort study patients filled in a questionnaire containing RAND-36. We stratified the cohort to compare HRQoL scores (range 0-100, higher scores representing better HRQoL) and assessed three-year event-free survival for composite cardiovascular endpoints of patients with good (above median) versus poor (equal to and below median) HRQoL at baseline. Additionally we compared the cohort to a healthy age-matched population. Results: 2012 and 865 patients undergoing carotid endarterectomy (CEA) or endarterectomy of femoral/iliac arteries (FEA) were included respectively. The median HRQoL was 75 (IQR 0-100 (both patient groups)) for physical role limitations versus 0 (IQR 0-100 (CEA) and 0-66.7 (FEA)) for emotional role limitations. No differences in HRQoL subscores were found, CVD burden did not associate with HRQoL and three-year composite event rates did not associate with the reported HRQoL in both CEA and FEA. Both groups had poor HRQoL scores compared to an age-matched general population, especially regarding emotional role limitations and social functioning. Conclusions: HRQoL is poor and does not associate with CVD burden within patients suffering from severe atherosclerotic disease. Reported HRQoL was not associated with incident cardiovascular events during follow-up.