Adverse socioeconomic factors are associated with a widening gap in one-year health-related quality of life after acute myocardial infarction

Acute myocardial infarction (AMI) has a significant impact on the health-related quality of life (HRQoL) and is influenced by unfavorable socioeconomic factors. We aimed to evaluate the association between adverse socioeconomic factors including low educational level, low occupational qualification and financial hardship with presenting symptoms and HRQoL in patients hospitalized for an AMI. We hypothesized a detectable effect on a spatial level and therefore assessed the HRQoL in 298 patients with AMI using the EQ-5D-5L generic measure for health status. Sociodemographic characteristics, clinical data, medical history, and prevalence of cardiovascular risk factors were obtained. Self-reported HRQoL was determined upon hospital admission and after 12 months. Patients with lower educational attainment were more likely to report dyspnea at hospital admission, had a worse renal function and more frequently hypertension. One year post-AMI the health state of the cohort worsened in terms of the mobility, activity, pain, and anxiety/depression domains but not the self-care domain. Patients with a lower education level or a poor financial situation reported a worse HRQoL and health state at baseline and follow-up (change in EQ VAS baseline-follow-up - 7.7 and - 11.0, respectively, lowest category). In contrast, the health state of patients with a higher education level or better financial situation improved (change in EQ VAS baseline-follow-up + 4.0 and + 2.6, highest category). Our study demonstrates a substantially widening gap in the health state and HRQoL between patients with lower and higher educational attainment within the first year after AMI, already measurable on a spatial level.