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Relation of Age and Health-Related Quality of Life to Invasive Versus Ischemia-Guided Management of Patients with Non-ST Elevation Myocardial Infarction.

Publication ,  Journal Article
Patel, KK; Arnold, SV; Jones, PG; Qintar, M; Alexander, KP; Spertus, JA
Published in: Am J Cardiol
April 1, 2018

In older patients with non-ST-elevation myocardial infarction, an initial invasive strategy reduces cardiovascular events compared with an ischemia-guided approach; however its association with health status outcomes is unknown. Among patients with non-ST-elevation myocardial infarction from 2 multicenter US acute myocardial infarction (AMI) registries, health status was assessed at baseline and at 1, 6, and 12 months after AMI using the Seattle Angina Questionnaire (SAQ) and the 12-item Short-Form Health Survey (SF-12). Routine invasive management was defined as coronary angiography within 72 hours of admission without a preceding stress test. Among 3,559 patients with NSTEMI, 2,455 (69.0%) were treated with routine invasive treatment, which was more common in younger patients. In propensity-adjusted analyses, invasive treatment was associated with higher SAQ physical limitation, angina frequency, and summary scores over the year after AMI; however, the differences were small (<5 points, all p <0.05). Although there was a trend toward worse health status in patients aged ≥85 years treated with an initial invasive treatment, the interaction between age and treatment for any health status measure (all p ≥0.09) was not significant, except for SF-12 physical component score (p = 0.02), where worse scores were observed with invasive treatment in patients 85 years or older. In conclusion, an initial invasive treatment for patients with NSTEMI is associated with a small benefit in health status of marginal clinical significance, mainly in younger patients. The oldest old group trended toward less health status benefit from a routine invasive strategy-results that will need to be confirmed in a larger study.

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Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

April 1, 2018

Volume

121

Issue

7

Start / End Page

789 / 795

Location

United States

Related Subject Headings

  • Time Factors
  • Quality of Life
  • Non-ST Elevated Myocardial Infarction
  • Myocardial Revascularization
  • Middle Aged
  • Male
  • Logistic Models
  • Humans
  • Health Status
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
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Patel, K. K., Arnold, S. V., Jones, P. G., Qintar, M., Alexander, K. P., & Spertus, J. A. (2018). Relation of Age and Health-Related Quality of Life to Invasive Versus Ischemia-Guided Management of Patients with Non-ST Elevation Myocardial Infarction. Am J Cardiol, 121(7), 789–795. https://doi.org/10.1016/j.amjcard.2017.12.034
Patel, Krishna K., Suzanne V. Arnold, Philip G. Jones, Mohammed Qintar, Karen P. Alexander, and John A. Spertus. “Relation of Age and Health-Related Quality of Life to Invasive Versus Ischemia-Guided Management of Patients with Non-ST Elevation Myocardial Infarction.Am J Cardiol 121, no. 7 (April 1, 2018): 789–95. https://doi.org/10.1016/j.amjcard.2017.12.034.
Patel KK, Arnold SV, Jones PG, Qintar M, Alexander KP, Spertus JA. Relation of Age and Health-Related Quality of Life to Invasive Versus Ischemia-Guided Management of Patients with Non-ST Elevation Myocardial Infarction. Am J Cardiol. 2018 Apr 1;121(7):789–95.
Patel, Krishna K., et al. “Relation of Age and Health-Related Quality of Life to Invasive Versus Ischemia-Guided Management of Patients with Non-ST Elevation Myocardial Infarction.Am J Cardiol, vol. 121, no. 7, Apr. 2018, pp. 789–95. Pubmed, doi:10.1016/j.amjcard.2017.12.034.
Patel KK, Arnold SV, Jones PG, Qintar M, Alexander KP, Spertus JA. Relation of Age and Health-Related Quality of Life to Invasive Versus Ischemia-Guided Management of Patients with Non-ST Elevation Myocardial Infarction. Am J Cardiol. 2018 Apr 1;121(7):789–795.
Journal cover image

Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

April 1, 2018

Volume

121

Issue

7

Start / End Page

789 / 795

Location

United States

Related Subject Headings

  • Time Factors
  • Quality of Life
  • Non-ST Elevated Myocardial Infarction
  • Myocardial Revascularization
  • Middle Aged
  • Male
  • Logistic Models
  • Humans
  • Health Status
  • Female