Department of Pathophysiology, Medical University of Silesia, Katowice, Poland.
Department of Cardiology and Electrotherapy, Medical University of Gdansk, Gdansk, Poland.
Arch Med Sci. 2014 Feb 24;10(1):33-8. doi: 10.5114/aoms.2013.38708. Epub 2013 Oct 31.
Double antiplatelet therapy with clopidogrel and acetylsalicylic acid is a standard procedure after acute coronary syndrome. This treatment carries a higher risk of complications. The main goal of this research was to assess the patients' quality of life after undergoing antiplatelet therapy with clopidogrel after acute coronary syndrome (ACS).
In the questionnaire research 3220 patients after ACS and treated with clopidogrel were included. The evaluation was carried out with the quality of life questionnaire SF-12.
37.9% of the interviewees experienced ACS-ST-elevation myocardial infarction (STEMI), 62.1% non-ST-elevation myocardial Infarction (NSTEMI), on average within 23 ±42 weeks (p < 0.05). 7.2% of the interviewees were receiving non-invasive treatment and in 2.4% cases it was fibrinolysis. 90.4% were treated with primary angioplasty and stenting. In 53.8% of cases a covered stent (DES) was implanted. 95.6% of the patients received, besides clopidogrel, acetylsalicylic acid. The lowest quality of life was observed after non-invasive treatment or fibrinolytic only (p < 0.05). The quality of life in those patients who underwent angioplasty and stent implantation was similar (p < 0.05). With time, a progressive improvement of all assessed quality of life aspects was observed (p < 0.05). The improvement was noted regardless of the ACS treatment method (p < 0.001). The differences between the patients were smaller at each successive evaluation (p < 0.05). In the case of vitality, emotional and psychic condition, they disappeared completely (p < 0.05).
The quality of life rises along with time passed after acute coronary syndrome. Invasive methods provide better quality of life than fibrinolysis and non-invasive treatment in the acute coronary syndrome patients.
氯吡格雷和乙酰水杨酸双联抗血小板治疗是急性冠脉综合征后的标准治疗方法。这种治疗方法会增加并发症的风险。本研究的主要目的是评估急性冠脉综合征（ACS）后接受氯吡格雷抗血小板治疗的患者的生活质量。
在问卷调查研究中，纳入了 3220 名 ACS 后接受氯吡格雷治疗的患者。采用生活质量问卷 SF-12 进行评估。
37.9%的受访者患有急性冠脉综合征伴 ST 段抬高型心肌梗死（STEMI），62.1%患有非 ST 段抬高型心肌梗死（NSTEMI），平均时间为 23±42 周（p<0.05）。7.2%的受访者接受非侵入性治疗，2.4%的患者接受纤溶治疗。90.4%的患者接受了经皮冠状动脉介入治疗和支架置入术。53.8%的患者植入了覆盖支架（DES）。95.6%的患者在接受氯吡格雷治疗的同时还接受了乙酰水杨酸治疗。仅接受非侵入性治疗或纤溶治疗的患者生活质量最低（p<0.05）。接受经皮冠状动脉介入治疗和支架置入术的患者生活质量相似（p<0.05）。随着时间的推移，所有评估的生活质量方面都有逐渐改善（p<0.05）。无论 ACS 的治疗方法如何，这种改善都很明显（p<0.001）。在随后的每次评估中，患者之间的差异都更小（p<0.05）。在活力、情绪和精神状况方面，这些差异完全消失（p<0.05）。
急性冠脉综合征后，随着时间的推移，生活质量逐渐提高。与纤溶治疗和非侵入性治疗相比，介入治疗方法可为急性冠脉综合征患者提供更好的生活质量。
