Effect of percutaneous coronary intervention on quality of life: A consensus statement from the society for cardiovascular angiography and interventions

Blankenship, James C.; Marshall, J. Jeffrey; Pinto, Duane S.; Lange, Richard A.; Bates, Eric R.; Holper, Elizabeth M.; Grines, Cindy L.; Chambers, Charles E.

doi:10.1002/ccd.24376

Cited by 43 publications

(32 citation statements)

References 165 publications

(206 reference statements)

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“…Patient-centred treatment outcome measures such as HRQL questionnaires are now recommended in relevant research studies as well as in clinical care by the European Medicines Agency [2] and the US Food and Drug Administration [3]. A recent consensus statement from the Society for Cardiovascular Angiography and Interventions called for the use of quality of life outcome in clinical trials, appropriate use criteria, practice guidelines, and reimbursement policies for percutaneous coronary intervention (PCI) [4]. …”

Section: Introductionmentioning

confidence: 99%

Health related quality of life and mental distress after PCI: restoring a state of equilibrium

Sipötz

Friedrich

Höfer

et al. 2013

Health Qual Life Outcomes

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BackgroundPatient self reported measures for Health Related Quality of Life (HRQOL) and mental distress are frequently used to evaluate outcome of therapeutic strategies in cardiac patients.Our study aims to describe changes in HRQOL and mental distress after percutaneous coronary intervention (PCI) focusing on temporal pattern of change and interdependences between both outcome measures.Method163 PCI patients recruited at 7 cardiovascular care units in Austria answered MacNew Health Related Quality of Life and Hospital Anxiety and Depression Scale (HADS) questionnaires during hospital stay after intervention and at 1, 6, 12 and 24 months.ResultsImprovement of MacNew HRQOL was found up to 6 month after PCI. Mental distress declined during the first month of the follow-up period. MacNew HRQOL is negatively correlated to mental distress. The relationship could be well described by a linear regression with MacNew HRQOL as dependent and HADS Total score as independent variable. The explained variance (R2) of the regression equation increases drastically from 45% at the baseline to a level between 67% and 77% in the follow up.ConclusionOur data suggest that the regression equation describing the relation between MacNew HRQOL and HADS-Total score six month after PCI defines a state of equilibrium: In absence of actual symptoms of coronary artery disease (CAD) both measures reflect the general health status and the general attitude underlying the self-assessment of health. At the baseline this equilibrium is imbalanced because the symptoms of CAD have a more pronounced impact on the disease specific MacNew HRQOL measure than on the non-disease specific HADS measure for mental distress. In order to use the MacNew questionnaire as a monitoring and/or prognostic tool it seems promising to refer to the state of equilibrium to define expectancy values for successful treatment.

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Section: Introductionmentioning

confidence: 99%

Health related quality of life and mental distress after PCI: restoring a state of equilibrium

Sipötz

Friedrich

Höfer

et al. 2013

Health Qual Life Outcomes

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“…American College of Cardiology/American Heart Association guidelines conclude that elective revascularization does not reduce the risk of death or MI 6 although it helps relieve angina. 7,8 Two recent reports suggest reduced mortality and MI after elective revascularization when compared with medical management, 3,9 but in different ways do not definitively resolve the issue.…”

Section: Overview: a Central Issue In Cardiology: Who Benefits From Rmentioning

confidence: 99%

Patient Selection for Elective Revascularization to Reduce Myocardial Infarction and Mortality

Gould

Johnson

Kaul

et al. 2015

Circ: Cardiovascular Imaging

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“…The cumulative data have recently been reviewed in a consensus statement from the Society for Cardiovascular Angiography and Interventions on the effect of PCI on quality of life (QOL). 17 In general, PCI is more effective than medical therapy for relieving angina, prolonging exercise time, and improving QOL. The benefit, however, is dependent on many factors, such as angina severity at baseline, completeness of revascularization, and comorbidities.…”

Section: Pci To Relieve Angina and Improved Health Statusmentioning

confidence: 99%

“…Several are specifically designed for patients with ischemic heart disease and can comprehensively measure the domains, which encompass QOL. 17 The Seattle angina questionnaire is an example of a validated instrument well suited for PCI. The relatively brief, 19-item, self-administered questionnaire covers 5 domains of CAD (physical limitation, anginal stability, anginal frequency, treatment satisfaction, and disease perception).…”

Section: Pci To Relieve Angina and Improved Health Statusmentioning

confidence: 99%

Measuring the Effectiveness of Percutaneous Coronary Intervention

Abbott

2015

Circ: Cardiovascular Interventions

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T he benchmark for demonstrating the effectiveness of a therapeutic intervention for coronary artery disease is widely accepted as a reduction in mortality or major adverse cardiac outcomes. In medicine, however, many therapies that do not prolong life are routinely practiced and considered appropriate. There has been tremendous interest in research on the comparative effectiveness of clinical practices since Title VIII of the American Recovery and Reinvestment Act of 2009.1 Over 1 billion of federal funds was authorized to conduct research in clinical outcomes, effectiveness, and appropriateness of health-related services and procedures. Federal support of research in this arena was, in part, intended to control healthcare costs. If a therapy, for example, is found to have no or little benefit then it will not be practiced and cost will be reduced. In reality, the relationship between quality and cost is much more complicated.2 The interventional cardiology community has been scrutinized for the use of percutaneous coronary intervention (PCI) in stable ischemic heart disease (SIHD). This is largely related to claims of overuse and studies showing no reduction in death or myocardial infarction (MI) when compared with medical therapy alone. The crucial question is what outcomes should be measured to demonstrate the effectiveness of PCI? In patients with acute coronary syndromes, outcomes of death and MI are relevant because of a high short-term risk of these events. Whereas in SIHD the goal of PCI is symptom relief and health status outcomes need to be measured in additional to other clinical outcomes. Presented is the evidence for the effectiveness of PCI according to clinical indication of the procedure. PCI to Reduce Major Adverse Cardiac EventsIn patients with acute coronary syndromes, there is no dispute about the effectiveness of PCI for reducing major adverse cardiac events. In ST-segment-elevation MI, reperfusion with either primary PCI or thrombolytic therapy reduces mortality when compared with conservative management. Several randomized clinical trials in the balloon angioplasty and stent era compared primary PCI with thrombolytic therapy. A metaanalysis of 23 trials, 12 with stents, showed that compared with thrombolytic therapy primary PCI reduces mortality, reinfarction, and stroke.3 In high-risk non-ST-segment-elevation MI acute coronary syndromes, a routine invasive strategy including PCI of culprit lesions is more effective for reducing the risk of death or MI than a selective strategy of revascularization only for demonstrable ischemia. 4 There is no direct evidence that PCI can reduce mortality in patients with SIHD, however, there is reason to think that there is the potential. Studies of patients undergoing noninvasive risk stratification show a relationship between ischemia burden and mortality, and a reduced risk of mortality associated with revascularization. In an observational study of 10 627 patients without previous MI or coronary revascularization referred for myocardial perfusion str...

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Effect of percutaneous coronary intervention on quality of life: A consensus statement from the society for cardiovascular angiography and interventions

Cited by 43 publications

References 165 publications

Health related quality of life and mental distress after PCI: restoring a state of equilibrium

Health related quality of life and mental distress after PCI: restoring a state of equilibrium

Patient Selection for Elective Revascularization to Reduce Myocardial Infarction and Mortality

Measuring the Effectiveness of Percutaneous Coronary Intervention

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