Health-related quality-of-life after percutaneous coronary intervention in patients with UA/NSTEMI and STEMI: the Korean multicenter registry

Abstract

Compared with ST elevation myocardial infarction (STEMI), long-term outcomes are known to be worse in patients with unstable angina/non-STEMI (UA/NSTEMI), which might be related to the worse health status of patients with UA/STEMI. In patients with UA/NSTEMI and STEMI underwent percutaneous coronary intervention (PCI), angina-specific and general health-related quality-of-life (HRQOL) was investigated at baseline and at 30 days after PCI. Patients with UA/NSTEMI were older and had higher frequencies in female, diabetes and hypertension. After PCI, both angina-specific and general HRQOL scores were improved, but improvement was much more frequent in angina-related HRQOL of patients with UA/NSTEMI than those with STEMI (44.2% vs 36.8%, P < 0.001). Improvement was less common in general HRQOL. At 30-days after PCI, angina-specific HRQOL of the patients with UA/NSTEMI was comparable to those with STEMI (56.1 ± 18.6 vs 56.6 ± 18.7, P = 0.521), but general HRQOL was significantly lower (0.86 ± 0.21 vs 0.89 ± 0.17, P = 0.001) after adjusting baseline characteristics (P < 0.001). In conclusion, the general health status of those with UA/NSTEMI was not good even after optimal PCI. In addition to angina-specific therapy, comprehensive supportive care would be needed to improve the general health status of acute coronary syndrome survivors.

Keywords: Acute Coronary Syndrome; Angioplasty, Balloon, Coronary; Health Status; Myocardial Infarction; Quality of Life.

Fig. 1

Changes of HRQOL in each group of UA/NSTEMI and STEMI. In EQ-5D index, scores increased significantly after PCI. The degree of improvement (Δ) is not different in both groups (P = 0.337). In all three SAQ subscales, scores at 30 days after PCI are significantly higher compared with the baseline in both groups. The degree of improvement is higher in patients with UA/NSTEMI than with STEMI.

Fig. 2

The frequency of significant improvement in general and angina-specific HRQOL (ΔHRQOL). Compared with general HRQOL, significant improvement is more frequently observed in angina-specific HRQOL after PCI. Patients with UA/NSTEMI show much more improvement in angina-specific HRQOL than those with STEMI.

Fig. 3

Sequentially adjusted 30-day EQ-5D index. Mean EQ-5D indices of UA/NSTEMI and STEMI groups are sequentially adjusted by demographic and clinical variables, medications and baseline SAQ QOL. P value for final adjusted scores was < 0.01. CCB, calcium channel blocker; CV history, previous history of significant cardiovascular events.