Qualidade de vida após infarto agudo do miocárdio: avaliação com os questionários Mac New QLMI e SF-36

Abstract

The acute myocardial infarction (AMI) is a disease that commonly results of the coronary atherosclerosis, which serves as anatomical substrate for the development of the thrombosis, causing a sudden unbalance between the oxygen supply and myocardial oxygen consumption. In Brazil, approximately 300 350 one thousand case of AMI accounts for 214,000 deaths annually. Health-related quality of life refers to the limitation and discomfort degree that a certain disease or treatment related to it affects the patient life. It is a concept with high influence of subjectivity and social or cultural variables. The so-called generic and specific questionnaires are instruments used to measure life quality. The aim of this study was to correlate the quality of life after acute myocardial infarction through the MacNew QLMI and SF-36 questionnaires, by associating the scores of the physical, emotional and social domains with the instituted treatment, risk factors and time after onset the infarction. A total of 96 patients (25 women and 71 men, mean age of 54.3 ± 5.9 years) with an episode of AMI between 3 and 18 months before the questionnaire application were studied. The patients were selected during the period December 2003 to January 2004 through the medical files of the Clinics Hospital of Uberlândia (UFU). The QV MacNew QLMI and SF-36 questionnaires, a specific and a generic instrument, respectively, were applied. The data were analyzed by descriptive techniques and the correlation between the scores of each domain of the questionnaires was evaluated by the variance analysis. The results demonstrated that: a) the scores of the physical and social domains showed high correlation between the questionnaires; b) the catheterization was the only instituted treatment that showed correlation with all domains of the specific questionnaire; c) the presence of risk factors as diabetes mellitus and dyslipidemia showed a significant correlation with the QV index (P < 0.01) for both questionnaires. Other risk factors, such as arterial hypertension, smoking habits, depression/anxiety and stress showed a significant correlation (P < 0.01) only for the generic SF-36 questionnaire. There was no significant difference in the domain scores of the questionnaires when correlating with the QV index up to 18 months after AMI. We concluded that the non-accomplishment of catheterization and the presence of diabetes mellitus and dyslipidemia contribute significantly for the reduction in the quality of life of the interviewed individuals. The most important changes found in this patient group are related to the physical and social scores in both questionnaires.