Stressful Life Events Are Associated With Health-Related Quality of Life During Cardiac Rehabilitation and at 2-yr Follow-up in Patients With Heart Failure

Purpose: According to recent literature, stressful life events might represent an important risk factor of health-related quality of life (HRQoL) in patients with heart failure. The aim of this study was to evaluate the association between stressful life events and HRQoL in patients with heart failure after acute coronary syndrome, both during cardiac rehabilitation and during 2 yr of follow-up. Methods: Patients with heart failure (n = 481; 75% male; mean age: 58 +/- 9 yr) were evaluated for sociodemographic, clinical, and mental distress factors including stressful life events, anxiety and depression symptoms, perceived social support, and type D personality. Health-related quality of life was evaluated at baseline and at follow-up by telephone interview. Patients were also tested for exercise capacity at baseline. Results: Stressful life events were associated with impaired HRQoL independently of sociodemographic characteristics, clinical factors, mental distress, social support, and type D personality. Conclusion: Stress level due to experiencing stressful life events should be specifi cally assessed during cardiac rehabilitation, as it is associated with patients HRQoL.