Clinic for Cardiology, Clinical Center of Serbia.
School of Medicine, University of Belgrade.
Int Heart J. 2021;62(1):16-22. doi: 10.1536/ihj.20-427.
The aim of this randomized prospective study was to evaluate the quality of life (QoL) using the "Seattle Angina Questionnaire" (SAQ) in patients with chronic total occlusion (CTO) in coronary arteries treated with either percutaneous coronary intervention (PCI) or optimal medical therapy (OMT), or only with OMT.The potential benefits of recanalization of CTO by PCI have been controversial because of the scarcity of randomized controlled trials.A total of 100 patients with CTO were randomized (1:1) prospectively into the PCI CTO or the OMT group (50 patients in each group). There were no baseline differences in the SAQ scores between the groups, except for physical limitation scores (P = 0.03). During the mean follow-up (FUP) of 275 ± 88 days, patients in the PCI group reported less physical activity limitations (72.7 ± 21.3 versus 60.5 ± 27, P = 0.014), less frequent angina episodes (89.8 ± 17.6 versus 76.8 ± 27.1, P = 0.006), better QoL (79.9 ± 22.7 versus 62.5 ± 25.5, P = 0.001), greater treatment satisfaction (91.2 ± 13.6 versus 81.4 ± 18.4, P = 0.003), and borderline differences in angina stability (61.2 ± 26.5 versus 51.0 ± 23.7, P = 0.046) compared to patients in the OMT group. There were no significant differences in SAQ scores in the OMT group at baseline and during the FUP. There was a statistically significant increase in all five domains in the PCI group.Symptoms and QoL measured by the SAQ were significantly improved after CTO PCI compared to OMT alone.
本随机前瞻性研究旨在通过西雅图心绞痛问卷（SAQ）评估慢性完全闭塞（CTO）患者的生活质量（QoL），这些患者接受了经皮冠状动脉介入治疗（PCI）或最佳药物治疗（OMT），或仅接受 OMT 治疗。由于随机对照试验的稀缺性，CTO 经 PCI 再通的潜在益处一直存在争议。共 100 例 CTO 患者前瞻性随机（1:1）分为 PCI CTO 或 OMT 组（每组 50 例）。两组间 SAQ 评分无基线差异，除体力限制评分（P = 0.03）外。在平均随访（FUP）275 ± 88 天期间，PCI 组患者报告的体力活动受限程度较轻（72.7 ± 21.3 比 60.5 ± 27，P = 0.014），心绞痛发作频率较低（89.8 ± 17.6 比 76.8 ± 27.1，P = 0.006），生活质量较好（79.9 ± 22.7 比 62.5 ± 25.5，P = 0.001），治疗满意度较高（91.2 ± 13.6 比 81.4 ± 18.4，P = 0.003），心绞痛稳定性略有差异（61.2 ± 26.5 比 51.0 ± 23.7，P = 0.046）。与 OMT 组相比，OMT 组在基线和 FUP 期间 SAQ 评分无显著差异。PCI 组所有五个领域的评分均有统计学显著增加。与单独 OMT 相比，CTO PCI 后 SAQ 测量的症状和生活质量显著改善。
