We tested the hypothesis that low quality of life (QOL) after discharge from hospital with ischaemic heart disease (IHD) is associated with higher rates of later adverse outcomes (death and subsequent hospital admission for acute myocardial infarction or congestive cardiac failure). Three hundred and seventy-five patients previously enrolled in an intervention study which assessed QOL six months after hospitalisation were followed up for an additional 18 months. The rates of adverse outcomes increased as QOL decreased (high QOL 9%; moderate 18%; low 28%). After adjustment for known prognostic factors, the risk of an adverse outcome was still higher in 'low' and 'moderate' compared to 'high' QOL subjects (low QOL adjusted OR = 2.6, 95% CI = 1.2-5.8; moderate 1.9, 0.8-4.2). In conclusion, QOL after discharge from hospital appears to be an independent predictor of later morbidity and mortality.