Quality of life of patients with chronic stable angina before and four years after coronary revascularisation compared with a normal population
Quality of life of patients with chronic stable angina before and four years after coronary revascularisation compared with a normal population
复制标题
DOI：
10.1136/heart.87.2.140
复制
发表时间：
2002-02-01
期刊：
影响因子：
5.7
通讯作者：
Werkö, L
中科院分区：
文献类型：
--
作者：
Brorsson, B;Bernstein, SJ;Werkö, L
目的：评价冠状动脉再通术对慢性稳定型心绞痛患者健康相关生活质量(HRQOL)的影响。设计：前瞻性调查和病历回顾。地点：瑞典8家接受冠状动脉介入治疗的公共心脏中心中的7家。对象：827名年龄55-79岁的慢性稳定型心绞痛患者，他们在1994年或1995年接受冠状动脉血管重建术，并完成了4年的HRQOL调查。主要观察指标：瑞典生活质量调查的5个组成部分。结果：与年龄和性别调整的人群常模相比，基线状态的患者在所有五个功能和幸福感量表上的平均得分显著降低(p<；0.001)。血运重建四年后，除睡眠质量(P<；0.001)外，平均功能和幸福感水平与正常人群相似(P>；0.05)。不同年龄段的男性和女性的改善是相同的。然而，36%的男性和55%的女性在四年后仍未完全摆脱心绞痛(P<；0.001)。四年后没有心绞痛的男性在除睡眠质量以外的所有维度上都比他们的社区常模(P<；0.001)有更好的高质量生活质量。与社区同龄人相比，没有心绞痛的女性疼痛更少(P<；0.01)，总体健康感知更好(P<；0.05)，但身体功能、睡眠质量和情感健康状况相似。在过去四周内至少有一次心绞痛发作的男性和女性的HRQOL比他们的社区常模差了四年(P<；0.01)。结论：在血管重建术后的四年里，五分之三的慢性稳定型心绞痛患者没有心绞痛，他们的HRQOL与普通瑞典人相同或更好。然而，在接受血管重建术的所有女性中，只有不到一半的人和三分之二的男性在四年后心绞痛消失。新发心绞痛和持续性心绞痛患者的HRQOL均低于社区常模。
Objective: To assess the impact of coronary revascularisation on the health related quality of life (HRQOL) of patients with chronic stable angina compared with data from "community" norms four years following revascularisation.Design: Prospective survey and review of medical records.Setting: Seven of the eight public Swedish heart centres that performed coronary artery interventions.Subjects: 827 patients aged 55-79 years with chronic stable angina who underwent coronary artery revascularisation in 1994 or 1995 and completed the four year HRQOL survey.Main outcome measures: Five components of the Swedish quality of life survey.Results: Compared with age and sex adjusted population norms, patients at baseline had significantly lower mean scores on all five functioning and wellbeing scales (p < 0.001). Four years after revascularisation, the mean levels of functioning and wellbeing were similar to those in the normative population (p > 0.05) except for quality of sleep (p < 0.001). The improvements were the same across age groups and for men and women. However, 36% of men and 55% of women were not completely free from angina by four years (p < 0.001). Men without angina after four years had better HRQOL than their community norms (p < 0.001) on all dimensions except quality of sleep (p > 0.05). Women without angina had less pain (p < 0.01) and better general health perception (p < 0.05) but similar physical functioning, quality of sleep, and emotional wellbeing compared with their community counterparts. Both men and women who had suffered at least one anginal attack during the preceding four weeks had significantly worse HRQOL by four years than their community norms (p < 0.01).Conclusions: By four years following revascularisation, three fifths of patients with chronic stable angina were free of angina and their HRQOL was the same as or better than that of the general Swedish population. However, fewer than half of all women and two thirds of men who underwent revascularisation were angina-free after four years. Among patients with new or persistent angina, the HRQOL was worse than that in community norms.