QUALITY-OF-LIFE ON ENALAPRIL AFTER ACUTE MYOCARDIAL-INFARCTION

Quality of life was assessed 4-6 months after an acute myocardial infarction in a randomized double-blind study of enalapril versus placebo. Quality of life was evaluated using the Nottingham Health Profile (NHP), the Physical Symptoms Distress Index (PSDI), the Work Performance Scale (WPS) and the Life Satisfaction Index (LSI). The study comprised 36 women (aged 46-85 years, mean 68) and 96 males (aged 39-81 years, mean 62). Quality of life did not differ significantly between patients treated with enalapril versus placebo. The scores were (enalapril vs placebo, mean ± SE): average NHP 15.4 ± 2.3 vs 17.1 ± 2.3; PSDI 9.5 ± 1.0 vs 10.8 ± 0.9; WPS 19.8 ± 2.0 vs 19.4 ± 1.4; LSI 24.1 ± 1.0 vs 22.5 ± 1.4. Men reported a better quality of life than women on most assessments and non-smokers and ex-smokers better than smokers. Patients with moderate or severe angina pectoris had a worse quality of life measured by PSDI and NHP than patients with minimal or no angina pectoris. Patients with congestive heart failure had a higher PSDI than those without (13.6 ± 1.7 vs 9.4 ± 0.7, P < 0.05), while no significant differences were observed in the NHP scores. In conclusion, quality of life was similar in enalapril and placebo-treated patients after an acute myocardial infarction. However it was reduced in patients with angina pectoris or heart failure and in those who continued smoking.