南亚裔冠心病患者的健康状况和生活质量改变。
Altered health status and quality of life in South Asians with coronary artery disease.
机构信息
University of Alberta, Edmonton, Alberta, Canada.
出版信息
Am Heart J. 2011 Sep;162(3):501-6. doi: 10.1016/j.ahj.2011.06.009.
BACKGROUND
People of South Asian (SA) ancestry are susceptible to coronary artery disease (CAD). Although studies suggest that SA with CAD has a worse prognosis compared with Europeans, it is unknown whether corresponding differences in functional status and quality-of-life (QOL) measures exist. Accordingly, we compared symptoms, function, and QOL in SA and European Canadians with CAD using the Seattle Angina Questionnaire (SAQ).
METHODS
Using the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease, an outcomes registry that captures patients undergoing cardiac catheterization in Alberta, Canada, we identified 635 SA and 18,934 European patients with angiographic CAD from January 1995 to December 2006 who reported health status outcomes using the SAQ at 1 year after the index catheterization. To obtain comparable clinical variables among SA and Europeans, we used a propensity score-matching technique.
RESULTS
One-year adjusted mean (SD) scores were significantly lower in SA compared with European Canadians for most SAQ domains: exertional capacity (75 [23] vs 80 [23], P = .011), anginal stability (77 [28] vs 77 [27], P = .627), anginal frequency (86 [23] vs 88 [20], P < .001), treatment satisfaction (86 [19] vs 89 [16], P < .001), and SAQ QOL (71 [24] vs 76 [21], P < .001). These results could not be accounted for by differences in baseline QOL scores or changes in health status from baseline to 1 year.
CONCLUSION
South Asian Canadians with established CAD have significantly worse health status outcomes at 1 year after angiography compared with European Canadians. Further studies are warranted to improve functional outcomes in SA with CAD.
背景
南亚（SA）血统的人易患冠状动脉疾病（CAD）。尽管研究表明，患有 CAD 的南亚人比欧洲人预后更差，但尚不清楚是否存在相应的功能状态和生活质量（QOL）差异。因此，我们使用西雅图心绞痛问卷（SAQ）比较了 CAD 患者的 SA 和欧洲加拿大患者的症状、功能和 QOL。
方法
利用加拿大艾伯塔省的冠状动脉心脏病结局评估省级项目（一种在艾伯塔省进行心脏导管检查的患者结局登记），我们从 1995 年 1 月至 2006 年 12 月确定了 635 名 SA 和 18934 名患有血管造影 CAD 的欧洲患者，他们在指数导管插入术后 1 年使用 SAQ 报告了健康状况。为了在 SA 和欧洲人之间获得可比的临床变量，我们使用了倾向评分匹配技术。
结果
与欧洲加拿大患者相比，SA 患者的 SAQ 大多数领域的 1 年调整后平均（SD）评分显著较低：体力活动能力（75 [23] vs 80 [23]，P =.011），稳定性心绞痛（77 [28] vs 77 [27]，P =.627），心绞痛发作频率（86 [23] vs 88 [20]，P <.001），治疗满意度（86 [19] vs 89 [16]，P <.001），以及 SAQ QOL（71 [24] vs 76 [21]，P <.001）。这些结果不能用基线 QOL 评分的差异或从基线到 1 年的健康状况变化来解释。
结论
与欧洲加拿大患者相比，患有 CAD 的南亚加拿大患者在血管造影后 1 年的健康状况明显较差。需要进一步研究以改善 CAD 患者的功能预后。
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