Relationship of health-related quality of life with fatigue and exercise capacity in patients with coronary artery disease

Abstract

Objective. The study objective was to evaluate the relationship of health-related quality of life (HRQoL) with fatigue and exercise capacity in coronary artery disease (CAD) patients. Methods. A total of 1072 consecutive CAD patients on admission to cardiac rehabilitation program were evaluated for HRQoL (36-item Short Form Medical Outcome Questionnaire; SF-36), body mass index, clinical characteristics (NYHA class, angina pectoris class, coronary interventions, treatment with betablockers, hypertension and diabetes), symptoms of depression and anxiety (Hospital Anxiety and Depression Scale), fatigue (Multidimensional Fatigue Inventory-20; MFI-20), and exercise capacity (bicycle ergometer test). Results. In univariate regression analyses lower scores on all SF-36 domains were associated with greater scores on all MFI-20 subscales. Exercise capacity was associated with all SF-36 domains, except for social functioning and mental health domains. In multivariate regression analyses, after adjusting for age, gender, body mass index, NYHA class, angina pectoris class, coronary interventions, treatment with betablockers, hypertension, diabetes, and symptoms of depression and anxiety, greater limitation due to physical and due to emotional problems, poor social functioning, decreased energy/vitality, worse general health perception and reduced mental component summary were independently associated with higher MFI-20 general fatigue score; worse physical functioning, greater pain and reduced physical component summary, with physical fatigue; poor mental health, with mental fatigue. Conclusion. In CAD patients undergoing rehabilitation, poor HRQoL is associated with greater fatigue and decreased exercise capacity independently from mental distress and CAD severity.