Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
EuroIntervention. 2013 Jul;9(3):373-81. doi: 10.4244/EIJV9I3A60.
Long-term health-related quality of life (HRQOL) in the elderly after percutaneous coronary intervention (PCI) is unknown. We 1) compared HRQOL of elderly (≥70 years) with younger patients (<70 years) at 6, 12, 36 months post-PCI, and 2) examined whether predictors of impaired HRQOL 36 months post-PCI differed between older and younger patients.
A prospective cohort of 651 PCI patients (26.3% ≥70 years) completed the SF-36 at 6, 12 and 36 months post-PCI. Older patients experienced a poorer physical HRQOL at all time points and worse mental HRQOL with respect to vitality and role emotional functioning (all p-values<0.05). By 36 months, the HRQOL for the older patients worsened in five of the eight subdomains (all p-values<0.05). Younger patients did not experience enduring changes in HRQOL, with the exception of role physical functioning. Predictors of impaired HRQOL were generally different for the elderly (diabetes, previous PCI) compared to younger cohorts (smoking, previous bypass surgery, ACE inhibitors), although poor six-month HRQOL, anxiety and depression were common predictors for both groups.
Elderly PCI patients experience a deteriorating and poorer HRQOL than younger patients across three years. Contrary to younger patients, three-year HRQOL of elderly patients is irrespective of adverse events during outcomes.
经皮冠状动脉介入治疗(PCI)后老年人的长期健康相关生活质量(HRQOL)尚不清楚。我们 1)比较了老年(≥70 岁)和年轻患者(<70 岁)在 PCI 后 6、12、36 个月时的 HRQOL,2)检查了 36 个月时 PCI 后 HRQOL 受损的预测因素在老年和年轻患者之间是否存在差异。
前瞻性队列研究了 651 例 PCI 患者(26.3%≥70 岁),他们在 PCI 后 6、12 和 36 个月时完成了 SF-36 调查。老年患者在所有时间点的身体 HRQOL 较差,在活力和角色情感功能方面的心理 HRQOL 更差(所有 p 值均<0.05)。到 36 个月时,老年患者的 HRQOL 在八个子领域中的五个方面恶化(所有 p 值均<0.05)。年轻患者的 HRQOL 没有持久变化,除了角色身体功能。对于老年患者(糖尿病、既往 PCI)和年轻患者(吸烟、既往旁路手术、ACE 抑制剂),预测 HRQOL 受损的因素通常不同,尽管六个月时 HRQOL 较差、焦虑和抑郁是两组共同的预测因素。
与年轻患者相比,老年 PCI 患者在三年内经历了恶化和更差的 HRQOL。与年轻患者不同,老年患者的三年 HRQOL 与结果期间的不良事件无关。