Open Access Research article

Predictors of physical and mental health-related quality of life outcomes among myocardial infarction patients

Anna L Hawkes12*, Tania A Patrao3, Robert Ware4, John J Atherton5, Craig B Taylor6 and Brian F Oldenburg7

Author Affiliations

1 School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, Brisbane, Australia

2 School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Australia

3 Menzies School of Health Research, Brisbane, Australia

4 School of Population Health, The University of Queensland, Herston, Brisbane, Australia

5 Department of Cardiology, Royal Brisbane and Women’s Hospital and University of Queensland School of Medicine, Herston, Brisbane, Australia

6 Department of Psychiatry, Stanford Medical Center, Stanford, California, USA

7 Department of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia

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BMC Cardiovascular Disorders 2013, 13:69  doi:10.1186/1471-2261-13-69

Published: 10 September 2013



Health-related quality of life (HRQoL) is an important outcome for patients diagnosed with coronary heart disease. This report describes predictors of physical and mental HRQoL at six months post-hospitalisation for myocardial infarction.


Participants were myocardial infarction patients (n=430) admitted to two tertiary referral centres in Brisbane, Australia who completed a six month coronary heart disease secondary prevention trial (ProActive Heart). Outcome variables were HRQoL (Short Form-36) at six months, including a physical and mental summary score. Baseline predictors included demographics and clinical variables, health behaviours, and psychosocial variables. Stepwise forward multiple linear regression analyses were used to identify significant independent predictors of six month HRQoL.


Physical HRQoL was lower in participants who: were older (p<0.001); were unemployed (p=0.03); had lower baseline physical and mental HRQoL scores (p<0.001); had lower confidence levels in meeting sufficient physical activity recommendations (p<0.001); had no intention to be physically active in the next six months (p<0.001); and were more sedentary (p=0.001). Mental HRQoL was lower in participants who: were younger (p=0.01); had lower baseline mental HRQoL (p<0.001); were more sedentary (p=0.01) were depressed (p<0.001); and had lower social support (p=0.001).


This study has clinical implications as identification of indicators of lower physical and mental HRQoL outcomes for myocardial infarction patients allows for targeted counselling or coronary heart disease secondary prevention efforts.

Trial registration

Australian Clinical Trials Registry, Australian New Zealand Clinical Trials Registry, CTRN12607000595415.

Myocardial infarction; Secondary prevention; Cardiac rehabilitation; Telephone-delivered; Health-related quality of life; Health coaching; Tele-health