Cardiovascular Center, Incheon St. Mary's Hospital, The Catholic University of Korea, Bupyeong-gu, Incheon, Korea.
J Korean Med Sci. 2013 Jun;28(6):848-54. doi: 10.3346/jkms.2013.28.6.848. Epub 2013 Jun 3.
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.
与 ST 段抬高型心肌梗死 (STEMI) 相比,不稳定型心绞痛/非 ST 段抬高型心肌梗死 (UA/NSTEMI) 患者的长期预后较差,这可能与 UA/NSTEMI 患者的健康状况较差有关。在接受经皮冠状动脉介入治疗 (PCI) 的 UA/NSTEMI 和 STEMI 患者中,在基线和 PCI 后 30 天评估了心绞痛特异性和一般健康相关生活质量 (HRQOL)。UA/NSTEMI 患者年龄较大,女性、糖尿病和高血压的发生率较高。PCI 后,心绞痛特异性和一般 HRQOL 评分均有所改善,但 UA/NSTEMI 患者的心绞痛相关 HRQOL 改善更为频繁 (44.2% vs 36.8%,P < 0.001),而一般 HRQOL 改善较少。在 PCI 后 30 天,UA/NSTEMI 患者的心绞痛特异性 HRQOL 与 STEMI 患者相当 (56.1 ± 18.6 vs 56.6 ± 18.7,P = 0.521),但一般 HRQOL 明显较低 (0.86 ± 0.21 vs 0.89 ± 0.17,P = 0.001),在调整基线特征后 (P < 0.001)。总之,即使在最佳 PCI 后,UA/NSTEMI 患者的整体健康状况也不佳。除了心绞痛特异性治疗外,还需要全面的支持性护理来改善急性冠状动脉综合征幸存者的整体健康状况。