Patients with myocardial infarction (MI) often report lower health-related quality of life (HRQoL) than those without MI. Interventions can affect HRQoL of these patients. The purpose of this review was to identify effective strategies for improving HRQoL among individuals with MI.
Three electronic databases were searched and limited to articles peer-reviewed and published in English between 1995 and 2015. We screened titles and abstracts of the retrieved articles for studies that examined effectiveness of interventions to improve HRQoL in patients with MI.
Twenty-three studies were found that examined the effects of behavioural interventions—cardiac rehabilitation programmes (CRP), education and counselling programmes, and other psychological and cognitive interventions—to improve HRQoL in patients with MI. The studies included were mainly randomised controlled trials (14 studies) with a wide age range of participants (18–80 years) and a mean age group of 50–70 years. CRPs, including home- and hospital-based CRPs, regular weekly aerobic training programmes, and group counselling mostly resulted in improvement of HRQoL in patients with MI.
Most CRPs and other interventions were beneficial to MI patients. Therefore, patients with MI should be encouraged to participate in programmes that can help promote their HRQoL.
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World Health Organisation (2015). Fact sheet N°317: Cardiovascular diseases (CVDs). http://www.who.int/mediacentre/factsheets/fs317/en/viewed. February 2015.
World Health Organisation (2014). Fact sheet N°310: The top 10 causes of death. http://www.who.int/mediacentre/factsheets/fs310/en/viewed. February 2015.
Thygesen, K., Alpert, J. S., Jaffe, A. S., White, H. D., Simoons, M. L., Chaitman, B. R., et al. (2012). Third universal definition of myocardial infarction. Journal of the American College of Cardiology, 60(16), 1581–1598.
Runge, M. S., Stouffer, G., & Patterson, C. (2010). Netter’s cardiology. Philadelphia, PA: Elsevier Health Sciences.
Eriksson, M., Asplund, K., Hochwälder, J., & Svedlund, M. (2013). Changes in hope and health-related quality of life in couples following acute myocardial infarction: A quantitative longitudinal study. Scandinavian Journal of Caring Sciences, 27(2), 295–302.
Foxwell, R., Morley, C., & Frizelle, D. (2013). Illness perceptions, mood and quality of life: A systematic review of coronary heart disease patients. Journal of Psychosomatic Research, 75(3), 211–222.
Centres for Disease Control and Prevention (2012). Health-related quality of life (HRQOL). http://www.cdc.gov/hrqol/Retrieved. 26 September 2014.
Rumsfeld, J. S., Alexander, K. P., Goff, D. C., Graham, M. M., Ho, P. M., Masoudi, F. A., et al. (2013). Cardiovascular health: The importance of measuring patient-reported health status a scientific statement from the american heart association. Circulation, 127(22), 2233–2249.
Wingate, S. (1995). Quality of life for women after a myocardial infarction. Heart and Lung, 24(6), 467–473.
Sun, J., Buys, N., & Jayasinghe, R. (2014). Effects of community-based meditative Tai Chi programme on improving quality of life, physical and mental health in chronic heart-failure participants. Aging and Mental Health, 18(3), 289–295.
Dal Boni, A. L. M., Martinez, J. E., & da Silva Saccomann, I. C. R. (2013). Quality of Life of patients undergoing coronary artery bypass grafting. Acta Paulista de Enfermagem, 26(6), 575–580.
Pettersen, K. I. (2008). Health-related quality of life after myocardial infarction: methods for assessment and determinants. PhD, University of Oslo.
Marchionni, N., Fattirolli, F., Fumagalli, S., Oldridge, N., Del Lungo, F., Morosi, L., et al. (2003). Improved exercise tolerance and quality of life with cardiac rehabilitation of older patients after myocardial infarction results of a randomized, controlled trial. Circulation, 107(17), 2201–2206.
Yu, C. M., Lau, C. P., Chau, J., McGhee, S., Kong, S. L., Cheung, B. M. Y., et al. (2004). A short course of cardiac rehabilitation program is highly cost effective in improving long-term quality of life in patients with recent myocardial infarction or percutaneous coronary intervention. Archives of Physical Medicine and Rehabilitation, 85(12), 1915–1922.
Hawkes, A. L., Patrao, T. A., Atherton, J., Ware, R. S., Taylor, C. B., O’Neil, A., et al. (2013). Effect of a telephone-delivered coronary heart disease secondary prevention program (ProActive Heart) on quality of life and health behaviours: Primary outcomes of a randomised controlled trial. International Journal Of Behavioral Medicine, 20(3), 413–424. doi:10.1007/s12529-012-9250-5.
Benetti, M., Araujo, C. L. P. D., & Santos, R. Z. D. (2010). Cardiorespiratory fitness and quality of life at different exercise intensities after myocardial infarction. Arquivos Brasileiros de Cardiologia, 95(3), 399–404.
Dugmore, L., Tipson, R., Phillips, M., Flint, E., Stentiford, N., Bone, M., et al. (1999). Changes in cardiorespiratory fitness, psychological wellbeing, quality of life, and vocational status following a 12 month cardiac exercise rehabilitation programme. Heart, 81(4), 359–366.
Wang, W., Chair, S. Y., Thompson, D. R., & Twinn, S. F. (2012). Effects of home-based rehabilitation on health-related quality of life and psychological status in Chinese patients recovering from acute myocardial infarction. Heart and Lung: The Journal of Acute and Critical Care, 41(1), 15–25.
Hanssen, T. A., Nordrehaug, J. E., Eide, G. E., & Hanestad, B. R. (2007). Improving outcomes after myocardial infarction: A randomized controlled trial evaluating effects of a telephone follow-up intervention. European Journal of Cardiovascular Prevention and Rehabilitation, 14(3), 429–437.
Hanssen, T. A., Nordrehaug, J. E., Eide, G. E., & Hanestad, B. R. (2009). Does a telephone follow-up intervention for patients discharged with acute myocardial infarction have long-term effects on health-related quality of life? A randomised controlled trial. Journal of Clinical Nursing, 18(9), 1334–1345.
Izawa, K., Hirano, Y., Yamada, S., Oka, K., Omiya, K., & Iijima, S. (2004). Improvement in physiological outcomes and health-related quality of life following cardiac rehabilitation in patients with acute myocardial infarction. Circulation Journal: Official Journal Of The Japanese Circulation Society, 68(4), 315–320.
Izawa, K. P., Yamada, S., Oka, K., Watanabe, S., Omiya, K., Iijima, S., et al. (2004). Long-term exercise maintenance, physical activity, and health-related quality of life after cardiac rehabilitation. American Journal Of Physical Medicine and Rehabilitation/Association Of Academic Physiatrists, 83(12), 884–892.
Mendes de Leon, C. F., Czajkowski, S. M., Freedland, K. E., Bang, H., Powell, L. H., Wu, C., et al. (2006). The effect of a psychosocial intervention and quality of life after acute myocardial infarction: The Enhancing Recovery in Coronary Heart Disease (ENRICHD) clinical trial. Journal of Cardiopulmonary Rehabilitation, 26(1), 9–13.
Uysal, H., & Özcan, Ş. (2012). The effect of individual training and counselling programme for patients with myocardial infarction over patients’ quality of life. International journal of nursing practice, 18(5), 445–453.
West, R. R., Jones, D. A., & Henderson, A. H. (2012). Rehabilitation after myocardial infarction trial (RAMIT): Multi-centre randomised controlled trial of comprehensive cardiac rehabilitation in patients following acute myocardial infarction. Heart (British Cardiac Society), 98(8), 637–644. doi:10.1136/heartjnl-2011-300302.
Yonezawa, R., Masuda, T., Matsunaga, A., Takahashi, Y., Saitoh, M., Ishii, A., et al. (2009). Effects of phase II cardiac rehabilitation on job stress and health-related quality of life after return to work in middle-aged patients with acute myocardial infarction. International Heart Journal, 50(3), 279–290.
Höfer, S., Lim, L., Guyatt, G., & Oldridge, N. (2004). The MacNew Heart Disease health-related quality of life instrument: A summary. Health Qual Life Outcomes, 2(1), 3.
Yousefy, A., Keshtiaray, N., Yamani, N., Rabiei, K., & Baghbranian, P. (2009). Quality of life in post myocardial infarction patients with or without cardiac rehabilitation. Research Journal of Biological Sciences, 4(1), 54–58.
Choo, J., Burke, L. E., & Hong, K. P. (2007). Improved quality of life with cardiac rehabilitation for post-myocardial infarction patients in Korea. European Journal of Cardiovascular Nursing, 6(3), 166–171.
Peixoto, T. C. A., Begot, I., Bolzan, D. W., Machado, L., Reis, M. S., Papa, V., et al. (2015). Early exercise-based rehabilitation improves health-related quality of life and functional capacity after acute myocardial infarction: A randomized controlled trial. The Canadian Journal Of Cardiology, 31(3), 308–313. doi:10.1016/j.cjca.2014.11.014.
Varnfield, M., Karunanithi, M., Lee, C.-K., Honeyman, E., Arnold, D., Ding, H., et al. (2014). Smartphone-based home care model improved use of cardiac rehabilitation in postmyocardial infarction patients: Results from a randomised controlled trial. Heart, 100(22), 1770–1779. doi:10.1136/heartjnl-2014-305783.
Oranta, O., Luutonen, S., Salokangas, R. K., Vahlberg, T., & Leino-Kilpi, H. (2011). The effects of interpersonal counselling on health-related quality of life after myocardial infarction. Journal of Clinical Nursing, 20(23–24), 3373–3382.
Bagheri, H., Memarian, R., & Alhani, F. (2007). Evaluation of the effect of group counselling on post myocardial infarction patients: Determined by an analysis of quality of life. Journal of Clinical Nursing, 16(2), 402–406.
Boersma, S. N., Maes, S., Joekes, K., & Dusseldorp, E. (2006). Goal processes in relation to goal attainment: Predicting health-related quality of life in myocardial infarction patients. Journal of Health Psychology, 11(6), 927–941.
Hevey, D., & Wilczkiewicz, E. (2014). Changes in language use mediate expressive writing’s benefits on health-related quality of life following myocardial infarction. Health Psychology and Behavioral Medicine, 2(1), 1053–1066.
Roncella, A., Pristipino, C., Cianfrocca, C., Scorza, S., Pasceri, V., Pelliccia, F., et al. (2013). One-year results of the randomized, controlled, short-term psychotherapy in acute myocardial infarction (STEP-IN-AMI) trial. International Journal of Cardiology, 170(2), 132–139. doi:10.1016/j.ijcard.2013.08.094.
Heran, B. S., Chen, J. M., Ebrahim, S., Moxham, T., Oldridge, N., Rees, K., et al. (2011). Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD001800.pub2.
Kim, S. S., Lee, S., Kim, G., Kang, S. M., & Ahn, J. A. (2014). Effects of a comprehensive cardiac rehabilitation program in patients with coronary heart disease in Korea. Nursing and Health Sciences, 16(4), 476–482. doi:10.1111/nhs.12155.
Anderson, L., & Taylor, R. S. (2014). Cardiac rehabilitation for people with heart disease: An overview of Cochrane systematic reviews. International Journal of Cardiology, 177(2), 348–361.
Blair, J., Corrigall, H., Angus, N. J., Thompson, D. R., & Leslie, S. (2011). Home versus hospital-based cardiac rehabilitation: A systematic review. Rural and Remote Health, 11(2), 1–17.
Song, R., Ahn, S., So, H. Y., Park, I. S., Kim, H. L., Joo, K. O., et al. (2009). Effects of Tai Chi exercise on cardiovascular risk factors and quality of life in post-menopausal women. Journal of Korean Academy of Nursing, 39(1), 136–144.
Worcester, M. C., Hare, D. L., Oliver, R. G., Reid, M. A., & Goble, A. (1993). Early programmes of high and low intensity exercise and quality of life after acute myocardial infarction. BMJ, 307(6914), 1244–1247.
Oldridge, N., Gottlieb, M., Guyatt, G., Jones, N., Streiner, D., & Feeny, D. (1998). Predictors of health-related quality of life with cardiac rehabilitation after acute myocardial infarction. Journal of Cardiopulmonary Rehabilitation, 18(2), 95–103.
Bengtsson, I., Hagman, M., & Wedel, H. (2001). Age and angina as predictors of quality of life after myocardial infarction: A prospective comparative study. Scandinavian Cardiovascular Journal: SCJ, 35(4), 252–258.
Dempster, M., Donnelly, M., & O’Loughlin, C. (2004). The validity of the MacNew Quality of Life in heart disease questionnaire. Health and Quality of Life Outcomes, 2, 6. doi:10.1186/1477-7525-2-6.
Brink, E., Karlson, B., & Hallberg, L.-M. (2002). Health experiences of first-time myocardial infarction: Factors influencing women’s and men’s health-related quality of life after five months. Psychology, Health and Medicine, 7(1), 5–16.
Bogg, J., Thornton, E., & Bundred, P. (2000). Gender variability in mood, quality of life and coping following primary myocardial infarction. Coronary Health Care, 4(4), 163–168.
Garavalia, L. S., Decker, C., Reid, K. J., Lichtman, J. H., Parashar, S., Vaccarino, V., et al. (2007). Does health status differ between men and women in early recovery after myocardial infarction? Journal of Women’s Health, 16(1), 93–101.
Norris, C. M., Hegadoren, K., & Pilote, L. (2007). Depression symptoms have a greater impact on the 1-year health-related quality of life outcomes of women post-myocardial infarction compared to men. European Journal of Cardiovascular Nursing, 6(2), 92–98.
Kristofferzon, M. L., Löfmark, R., & Carlsson, M. (2005). Perceived coping, social support, and quality of life 1 month after myocardial infarction: A comparison between Swedish women and men. Heart & Lung: The Journal of Acute and Critical Care, 34(1), 39–50.
Bucholz, E. M., Rathore, S. S., Gosch, K., Schoenfeld, A., Jones, P. G., Buchanan, D. M., et al. (2011). Effect of living alone on patient outcomes after hospitalization for acute myocardial infarction. American Journal of Cardiology, 108(7), 943–948. doi:10.1016/j.amjcard.2011.05.023.
Samartzis, L., Dimopoulos, S., Tziongourou, M., & Nanas, S. (2013). Effect of psychosocial interventions on quality of life in patients with chronic heart failure: A meta-analysis of randomized controlled trials. Journal of Cardiac Failure, 19(2), 125–134.
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Kyoungrim Kang declares that she has no conflict of interest. Leila Gholizadeh declares that she has no conflict of interest. Sally Inglis declares that she has no conflict of interest. Hae-Ra Han declares that she has no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
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Kang, K., Gholizadeh, L., Inglis, S.C. et al. Interventions that improve health-related quality of life in patients with myocardial infarction. Qual Life Res 25, 2725–2737 (2016). https://doi.org/10.1007/s11136-016-1401-8