Clinical efficacy of different treatments and their impacts on the quality of life of octogenarians with coronary artery disease
Autor: | Xiang-Yu Wu, Tao Ying, Cheng-Qian Yin, Su Wang, Yu-Long Gao, Yu-Tong Cheng, Zhao Li, Zhi-Zhong Li, Li-Shao Guo |
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Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: |
Male
medicine.medical_specialty Gastrointestinal bleeding medicine.medical_treatment lcsh:Medicine Coronary Artery Disease Coronary Angiography Percutaneous coronary intervention Angina Coronary artery disease 03 medical and health sciences Life quality 0302 clinical medicine Quality of life Octogenarian Coronary artery bypass graft Internal medicine medicine Risk of mortality Humans cardiovascular diseases Coronary Artery Bypass Aged 80 and over business.industry Mortality rate lcsh:R Original Articles General Medicine medicine.disease Death 030220 oncology & carcinogenesis Conventional PCI Quality of Life Female business 030217 neurology & neurosurgery |
Zdroj: | Chinese Medical Journal, Vol 132, Iss 22, Pp 2657-2663 (2019) Chinese Medical Journal |
ISSN: | 2542-5641 0366-6999 |
Popis: | Background: Coronary artery disease (CAD) in octogenarians (age of ≥80 years) has a high risk of mortality and high medical expenses. Research shows that the prevalence of CAD is higher among octogenarians than that among younger people, but few such patients undergo percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). This study aimed to evaluate different treatments with respect to their clinical effects and impacts on quality of life of octogenarians with CAD. Methods: Data of 519 octogenarians with CAD consecutively treated at Beijing Anzhen Hospital, Capital Medical University (Beijing, China) from January 2010 to January 2016 were collected in this study. The patients were categorized into three groups based on the treatments they received: the PCI group (n = 292), CABG group (n = 110), and medical treatment group (n = 117). The followings were recorded during follow-up: clinical data, death (all-cause and cardiovascular-related), re-hospitalization time, Seattle Angina Questionnaire (SAQ) score, and occurrence of hemorrhagic events (cerebral bleeding, gastrointestinal bleeding, and dermal ecchymosis). Results: The median follow-up duration was 25.0 (25th, 75th percentile: 17.0, 55.5) months among 417 patients. The all-cause death rates (28.2% vs. 12.0% and 14.6%, respectively) and cardiovascular-related death rates (15.4% vs. 3.8% and 6.4%, respectively) were significantly higher in the medical treatment group than those in the PCI group and CABG group (all P < 0.05). The re-hospitalization rate for cardiovascular events was significantly lower in the CABG group than those in the PCI group and medical treatment group (3.8% vs. 12.8% and 14.9%, respectively) (χ2 = 8.238, P = 0.018). The SAQ scores of physical limitation, angina frequency, treatment satisfaction, and disease perception were significantly higher in the PCI group and CABG group than those in the medical treatment group (all P < 0.05). No significant difference in the angina stability score was observed among the three groups (F = 3.179, P = 0.204). Conclusion: PCI and CABG result in reduced mortality and better quality of life in octogenarians with CAD. Key words: Coronary artery disease; Octogenarian; Percutaneous coronary intervention; Coronary artery bypass graft; Death; Life quality |
Databáze: | OpenAIRE |
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