Health-related quality of life in older patients with acute coronary syndrome randomised to an invasive or conservative strategy. The After Eighty randomised controlled trial

Tegn, Nicolai; Abdelnoor, Michael; Aaberge, Lars; Ranhoff, Anette Hylen; Endresen, Knut; Gjertsen, Erik; Skårdal, Rita; Gullestad, Lars; Bendz, Bjørn; investigators, After Eighty study

doi:10.1093/ageing/afx121

Cited by 22 publications

(12 citation statements)

References 34 publications

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“…Wahrborg et al [33] found similar scores of QoL in patients with and without therapeutic strategies. Tegn et al [48] also found no statistically significant difference in QoL score between invasive strategy (IS) and conservative strategy (CS) treatments in all domains except for bodily pain.…”

Section: Changes In Qol Among Acs Patients After Treatmentmentioning

confidence: 95%

“…Upon further critical appraisal through peer review, seven articles which assessed the secondary outcome were excluded as (i) the outcome of interest was not measured before and/or after treatment (5), (ii) outcome compared between ACS and non-ACS (1), and (iii) ACS patients who also had chronic kidney disease (1). Finally, 29 studies were included for review of which 16 studies [15,28,29,33,[39][40][41][42][43][44][45][46][47][48][49][50] assessed disease specific QoL and 13 studies [26,[51][52][53][54][55][56][57][58][59][60][61][62] assessed generic QoL. Of these studies, 13 studies were RCTs, 12 were cohort studies, two were cross-sectional studies, and two were reviews.…”

Section: Description Of Studiesmentioning

confidence: 99%

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Quality of Life Changes in Acute Coronary Syndromes Patients: A Systematic Review and Meta-Analysis

Kaambwa

Gesesew

Horsfall

et al. 2020

IJERPH

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There is little up-to-date evidence about changes in quality of life following treatment for acute coronary syndrome (ACS) patients. The main aim of this review was to assess the changes in QoL in ACS patients after treatment. We undertook a systematic review and meta-analysis of quantitative studies. The search included studies that described the change of QoL of ACS patients after receiving treatment options such as percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG) and medical therapy (MT). We synthesized findings using content analysis and pooled the estimates using meta-analysis. We used the PRISMA guidelines to select and appraise the studies and report the findings. Twenty-nine (29) articles were included in the review. We found a significant improvement of QoL in ACS patients after receiving treatment. Particularly, the meta-analytic association found that the mean QoL of patients diagnosed with ACS was higher after receiving treatment compared to baseline (overall pooled mean difference = 31.88; 95% CI = 31.64–52.11, I2 = 98) with patients on PCI having slightly lower QoL gains (pooled mean difference = 30.22; 95% CI = 29.9–30.53, I2 = 0%) compared to those on CABG (pooled mean difference = 34.01; 95% CI = 33.66–34.37, I2 = 0%). The review confirmed that QoL of ACS patients improved after receiving treatment therapies although varied by the treatment options and patients’ preferences. This suggests the need to perform further study on the QoL, patient preferences and physicians’ decision to prescription of treatment options.

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Section: Changes In Qol Among Acs Patients After Treatmentmentioning

confidence: 95%

Section: Description Of Studiesmentioning

confidence: 99%

Quality of Life Changes in Acute Coronary Syndromes Patients: A Systematic Review and Meta-Analysis

Kaambwa

Gesesew

Horsfall

et al. 2020

IJERPH

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“…The superiority of the invasive strategy was diluted with increasing age, and was not reflected by changes in health-related quality of life, as measured by the SF-36. 4 Here, we report the angiographic and procedural results of the After Eighty study. Analysis was performed to identify independent predictors of revascularisation.…”

Section: Introductionmentioning

confidence: 98%

“…The superiority of the invasive strategy was diluted with increasing age, and was not reflected by changes in health-related quality of life, as measured by the SF-36. 4 …”

Section: Introductionmentioning

confidence: 99%

Patients aged 80 years or older with non-ST-elevation myocardial infarction or unstable angina pectoris randomised to an invasive versus conservative strategy: angiographic and procedural results from the After Eighty study

et al. 2020

Self Cite

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ObjectivesWe aimed to report the angiographic and procedural results of the After Eighty study (ClinicalTrials.gov, NCT01255540), and to identify independent predictors of revascularisation.MethodsPatients of ≥80 years old with non-ST-elevation myocardial infarction and unstable angina pectoris were randomised to an invasive or conservative strategy. Angiographic and procedural results were recorded. Univariate and multivariate analyses were performed to explore variables predicting revascularisation.ResultsAmong 229 patients in the invasive group, 220 underwent immediate coronary angiography (90% performed via the radial artery). Of these patients, 48% had three-vessel disease or left main stenosis, 18% two-vessel disease, 16% one-vessel disease, 17% minor coronary vessel wall changes and two patients had normal coronary arteries. Six patients (3%) underwent coronary artery bypass graft. Percutaneous coronary intervention (PCI) was performed in 107 patients (49%), with 57% treated with bare metal stents, 37% drug-eluting stents and 6% balloon angioplasty. On average, 1.7 lesions were treated and 2 stents delivered per patient. Complications included 1 major PCI-related bleeding (successfully treated), 2 minor access site-related bleedings, 3 side branch occlusions during PCI and 11 periprocedural myocardial infarctions (considered end points). Sex, bundle branch block and smoking were independent predictors of revascularisation.ConclusionsPCI was performed in approximately half of the patients, similar to findings in younger populations. Procedural success was high, with few complications.Trial registration numberNCT01255540

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“…In recent years, the vascular interventional therapy for lower extremities has developed rapidly in China. However, there are some deficiencies in the preoperative evaluation of patients and the control of postoperative metabolic indices, accompanied by short follow-up period, small sample size and low success rate of surgery [2]. In this study, therefore, the therapeutic effects of interventional therapy and conservative therapy on ASO were compared, and the risk factors for prognosis were analyzed, aiming to provide a valuable evidence for clinical treatment.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Effects of Interventional Therapy and Conservative Therapy on Lower Extremity Arteriosclerosis Obliterans and Risk Factors for Prognosis

Chen¹,

Zhang²,

Jiang³

et al. 2021

ARTRES

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Background: Arteriosclerosis Obliterans (ASO) is an important cause for lower limb amputation. We aimed to compare the effects of interventional and conservative therapies on lower extremity ASO, and to analyze the risk factors for prognosis.Methods: Ninety-eight eligible patients were randomly divided into experimental (n = 50) and control groups (n = 48). Conservative therapy was conducted for control group, and experimental group was given conservative and interventional therapies. Their baseline clinical data, hospital stay length, claudication distance, Rutherford stage, diseased arteries, Ankle-Brachial Index (ABI), clinical outcomes and adverse events were recorded. Then they were divided into poor (n = 31) and good prognosis groups (n = 67), and risk factors were explored by univariate and multivariate analyses. Results:The hospital stay length of experimental group was significantly shorter than that of control group (p < 0.05). After treatment, Rutherford stage decreased, and vascular patency rate and total response rate rose in experimental group (p < 0.05). Claudication distance and ABI significantly increased in both groups compared with those before treatment, especially in experimental group (p < 0.05). The incidence rates of cardiovascular and cerebrovascular events, amputation and death were significantly lower in experimental group (p < 0.05). Age, conservative therapy, smoking, hypertension, diabetes mellitus, hyperlipidemia and fibrinogen were independent risk factors for poor prognosis (p < 0.05). Age of >70 years old and fibrinogen level of >4 g/L had greater effects on prognosis. Conclusion:Interventional therapy works well for lower extremity ASO, with high safety, easy recovery and mild complications. Poor prognosis is caused by old age, conservative therapy, smoking, hypertension, diabetes mellitus, hyperlipidemia and increased fibrinogen.

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Health-related quality of life in older patients with acute coronary syndrome randomised to an invasive or conservative strategy. The After Eighty randomised controlled trial

Abstract: NCT01255540.

Cited by 22 publications

References 34 publications

Quality of Life Changes in Acute Coronary Syndromes Patients: A Systematic Review and Meta-Analysis

Quality of Life Changes in Acute Coronary Syndromes Patients: A Systematic Review and Meta-Analysis

Patients aged 80 years or older with non-ST-elevation myocardial infarction or unstable angina pectoris randomised to an invasive versus conservative strategy: angiographic and procedural results from the After Eighty study

Therapeutic Effects of Interventional Therapy and Conservative Therapy on Lower Extremity Arteriosclerosis Obliterans and Risk Factors for Prognosis

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