College of Medicine and Public Health, Flinders University, Adelaide 5042, Australia.
Epidemiology, College of Health Sciences, Mekelle University, Mekelle 231, Ethiopia.
Int J Environ Res Public Health. 2020 Sep 21;17(18):6889. doi: 10.3390/ijerph17186889.
There is little up-to-date evidence about changes in quality of life following treatment for acute coronary syndrome (ACS) patients. The main aim of this review was to assess the changes in QoL in ACS patients after treatment. We undertook a systematic review and meta-analysis of quantitative studies. The search included studies that described the change of QoL of ACS patients after receiving treatment options such as percutaneous coronary intervention (PCI), coronary artery bypass grafting (CABG) and medical therapy (MT). We synthesized findings using content analysis and pooled the estimates using meta-analysis. We used the PRISMA guidelines to select and appraise the studies and report the findings. Twenty-nine (29) articles were included in the review. We found a significant improvement of QoL in ACS patients after receiving treatment. Particularly, the meta-analytic association found that the mean QoL of patients diagnosed with ACS was higher after receiving treatment compared to baseline (overall pooled mean difference = 31.88; 95% CI = 31.64-52.11, I = 98) with patients on PCI having slightly lower QoL gains (pooled mean difference = 30.22; 95% CI = 29.9-30.53, I = 0%) compared to those on CABG (pooled mean difference = 34.01; 95% CI = 33.66-34.37, I = 0%). The review confirmed that QoL of ACS patients improved after receiving treatment therapies although varied by the treatment options and patients' preferences. This suggests the need to perform further study on the QoL, patient preferences and physicians' decision to prescription of treatment options.
关于急性冠状动脉综合征 (ACS) 患者治疗后生活质量变化的最新证据很少。本综述的主要目的是评估 ACS 患者治疗后 QoL 的变化。我们对定量研究进行了系统评价和荟萃分析。搜索包括描述接受经皮冠状动脉介入治疗 (PCI)、冠状动脉旁路移植术 (CABG) 和药物治疗 (MT) 等治疗方案后 ACS 患者 QoL 变化的研究。我们使用内容分析综合研究结果,并使用荟萃分析汇总估计值。我们使用 PRISMA 指南选择和评估研究并报告研究结果。共有 29 篇文章纳入综述。我们发现 ACS 患者接受治疗后 QoL 显著改善。特别是,荟萃分析关联发现,与基线相比,诊断为 ACS 的患者在接受治疗后 QoL 更高(总体汇总平均差异=31.88;95%CI=31.64-52.11,I=98%),接受 PCI 的患者 QoL 获益略低(汇总平均差异=30.22;95%CI=29.9-30.53,I=0%),而接受 CABG 的患者(汇总平均差异=34.01;95%CI=33.66-34.37,I=0%)。该综述证实,ACS 患者在接受治疗后 QoL 得到改善,但治疗方案和患者偏好存在差异。这表明需要进一步研究 QoL、患者偏好和医生对治疗方案的处方决策。