Lifestyle Habits and Comorbidities as Determinants of Quality of Life in Coronary Artery Disease: A Single-Center Prospective Study

TL;DR

This study found that lifestyle factors and comorbidities, not the type of coronary disease, most strongly affect quality of life in patients with coronary artery disease.

Contribution

The study identifies smoking, alcohol, and cardiopulmonary comorbidities as key lifestyle and health factors affecting quality of life in CAD patients.

Findings

Smoking was the strongest determinant of poorer quality of life and life satisfaction in CAD patients.

Alcohol consumption, hypertension, and COPD were independently associated with lower WHOQOL-BREF scores.

Quality of life was more influenced by lifestyle and comorbidities than by whether patients had MI or CCS.

Abstract

Background: Although survival in coronary artery disease (CAD) has improved with modern therapies, quality of life (QoL) remains an important clinical concern. Our study aimed to evaluate QoL, life satisfaction, and disease acceptance in CAD patients and to identify their clinical and lifestyle determinants. Methods: This single-center, prospective study included patients undergoing percutaneous coronary intervention for myocardial infarction (MI) or chronic coronary syndrome (CCS). QoL was assessed using validated questionnaires (WHOQOL-BREF, SWLS, AIS). Comparative analyses between the MI and CCS groups were performed, and the determinants of the outcomes were evaluated using regression models. Results: The study included 220 patients (110 MI and 110 CCS) with a median age of 64 years (IQR 54–70); 30% were women. The WHOQOL-BREF-assessed QoL was comparable between MI and CCS patients, whereas MI patients reported higher life satisfaction (SWLS 24 vs. 20, p = 0.003). Smoking was the strongest determinant of poorer QoL, associated with lower SWLS (β = −2.75; p < 0.001) and WHOQOL-BREF (β = −4.46; p = 0.014). Alcohol consumption (β = −6.22; p = 0.008), hypertension (β = −7.10; p < 0.001), and chronic obstructive pulmonary disease (β = −9.84; p < 0.001) were also independently associated with lower WHOQOL-BREF scores. Subgroup analyses showed heterogeneity between MI and CCS patients. Conclusions: QoL in CAD patients might be influenced more by lifestyle factors and multimorbidity than by CAD phenotype. Smoking, alcohol, and cardiopulmonary comorbidities might have the most consistent adverse associations with QoL. These findings highlight the potential importance of integrating lifestyle and comorbidity management to improve QoL and patient-reported outcomes in CAD care.

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