Table 5.
Summary of studies assessing health related quality of life after percutaneous coronary artery intervention
| Country Author | Patients and rating scale | Results | Conclusions |
|---|---|---|---|
| Germany Kähler et al., 1999[54] |
Patients aged 80 years or above (n=34) and youngerpatients (n=34) interviewed immediately after and 6 months after PCI with SF 36 | Significant increase in theparameters RP from 29±8-61±15 (≥80) versus 26±7-46±16 (<80) and in bodily painfrom 44±16-71±22 (≥80) versus 40±19-57±29 (<80). The increase in the RP score after 6 months in the group ≥80 was significantly stronger than in the <80 group | PCI increases physicalabilities and decreases pain significantly more in octogenarians compared to younger patients with symptomatic coronary heart disease |
| Netherland Pedersen et al., 2006[39] |
692 patients 6 and 12 months after PCI HADS SF 36 | 471 (68.1%) had no symptoms of anxiety nor depression, 62 (9.0%) had anxiety only, 59 (8.5%) had depressive symptoms only, and 100 (14.5%) had co-occurring symptoms. There was an overall significant improvement in health status between 6 and 12 months post-PCI | Patients with co occurring symptoms of anxiety and depression had poorer health status compared with anxious/ depressed only and no symptom patients. Anxiety has incremental value to depressive symptoms in identifying patients at risk for impaired health status |
| Poland Dudek et al., 2007[55] |
156 patients with optimal PCI results SF 36 | SF score 1 day before PCI=45.43±14.75 1 month after PCI=59.24±14.47 6 months after PCI=55.15±16.70 12 months after PCI=55.82±15.75 |
QOL before PCI was significantly lower than after PCI. QOL 6 months after PCI was significantly worse than at 1 month after PCI |
| Slovakia Škodová et al., 2011[56] |
37 patients age <75 sinter viewed before and 1-2 years after PTCA. GHQ 28 and SF 36 | Physical and mental component of HRQOL scores at baseline 45.8±20.6 and 56.6±18.5 was significantly less than at follow up 57.7±23.4 and 62.1±19.4 | Improvement in physical HRQOL was predicted by baseline psychologic well-being and baseline HRQOL. Improvement in mental HRQOL was predicted by baseline psychologic well-being |
| India Chaudhury and Srivastava 2013[41] |
35 patients assessed before and 3 days after PCI with EQ5D | On EQ5D health status score At baseline 42.7 (15.3) was significantly <3 days after PCI 78.7 (8.3) |
Successful PTCA resulted in significant reduction in HRQOL |
| Austria Sipötz et al., 2013[43] |
163 PCI patients MHRQOL after intervention and at 1,6,12 and 24 months |
The comparison of baseline MHRQOL Global scores to the four points of follow-up showed, that clinically relevant improvement (≥0.5) occurred in 48.5-55.8% of the patients | MHRQOL improved up to 6 months after PCI. Mental distress declined during the first month after PCI. MHRQOL is negatively correlated to mental distress |
| Turkey Ekici et al., 2014[44] |
225 patients undergoing elective PCI divided into 3 groups according to their Gensini score: normal coronary arteries (Gensini score0, n=78, control group), minimal CAD (Gensini score 1-19, n=54), and significant CAD (Gensini score ≥20, n=93) NHP | Total NHP scores Control group=109.2 (54.3-198.7) minimal CAD=138.4 (103.9-245.8) significant CAD=154.5 (63.3-298.8) P=0.059 (Not significant). The control group had significantly lower NHP-E and NHP-PM scores than the other groups (P=0.048, P=0.021, respectively) |
A significant positive correlation was found between NHP-total score and Gensini scores (r=0.145, P=0.029) |
| Iran Sharif et al., 2014[46] |
The experimental group participated in a 30-min training session before and after PTCA. The control group received routine oral instructions before and after angioplasty. At discharge, both groups received an informative booklet. DASS on admission, at discharge, and 1 month after discharge |
Stress scores Experimental group: T1=6.82±4.45; T2=6.40±4.22; T3=3.57±3.50; Control group: T1=8.12±4.42; T2=8.20±4.58; T3=9.55±5.41; Experimental group T1-T3 P<0.001; Control group T1-T3 P<0.001 Experimental group T3-Control group T3 P<0.001 |
A planned discharge program in patients undergoing PTCA lowered their stress |
| Iran Moattari et al., 2014[45] |
Experimental group (n=40) underwent a 12 weeks angina plan intervention consisting of 30 min counseling interview and telephone follow up at the end of 1,4,8 and 12 weeks. SAQ at pretest and 3 months after PCI | A significant change between the groups in the perception of QoL dimension of SAQ | No significant difference in the other dimensions of the QoL |
| India Tumkur et al., 2014[57] |
75 patients treated with PTCA. EQ5D before PCI and after 1 month | HRQOL before angioplasty 0.462; 1 month after 0.6957 (P<0.001) | Improvement in QOL was highly significant |
| USA Jang et al., 2015[58] |
2765 patients PCI classified as persistent smokers (n=315), quitters (n=189), past smokers (n=1326) or never smokers (n=935) on the basis of their smoking status at baseline. SF 36 and EQ5D VAS at baseline and 1 year follow up | Persistent smokers reported significantly lower SAQ angina frequency, physical limitation, QOL, and EQ-5D VAS scores when compared with never smokers at 1-year follow-up. Quitters had significantly better angina control and higher QOL scores than persistent smokers | HRQOL benefits of PTCA are diminished by continued smoking. Efforts to promote smoking cessation at the time of PTCA may substantially improve the health outcomes |
| Iran Pournaghash-Tehrani and Abdoli-Bidhendi 2016[49] |
90 patients undergoing PTCA. SF 36, DASS21 1 day before and 2 months after PTCA | Stress and QoL had an inverse significant relationship. No significant relationship between anxiety and depression and QoL | PTCA was associated with improvement in QOL of the patients Systematic review and meta-analyis |
| Takousi et al., 2016[59] | Thirty-four longitudinal studies; included 8,027 patients who underwent PCI, 6,348 had CABG and 1,617 on medication only | Moderate long-term effect sizes were revealed for both PTCA and CABG. Both interventions had significantly greater effects on HRQoL than medication; the CR procedures did not differ significantly from each other | Benefits related to physical functioning were greater than those related to psychosocial functioning in patients treated with CABG |
| India Singh et al., 2020[60] |
30 patients each of CABG and PTCA at baseline and 6 months with WHO-QOL BREF | Scores of WHO QOL BREF were 2.5±0.63 and 3.0±0.78 in PTCA group and 2.7±0.97 and 3.1±0.84 in CABG group | Controlling for hypertension, diabetes mellitus and postintervention diet restriction CABG predicted lower improvements in overall QoL compared to PTCA |
HADS – Hospital Anxiety and Depression Scale; SF 36 – Short form; GHQ – General Health questionnaire; QOL – Quality of life; EQ5D – Euro QOL questionnaire; HRQOL – Health related QOL; MHRQOL – MacNew HRQOL; WHO-QOL BREF – The World Health Organization QOL assessment Brief; NHP – The Nottingham health profile; DASS – Depression Anxiety Stress Scale; SAQ – Seattle angina questionnaire; CR – Coronary revascularization; RP – Role physical; PTCA – Percutaneous transluminal coronary angioplasty; CAD – Coronary artery disease; VAS – Visual Analogue Scales; CABG – Coronary artery bypass graft; PM – Physical mobility