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Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
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Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
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Response shift after coronary revascularization.

Tom H Oreel1, Pythia T Nieuwkerk1, Iris D Hartog1,2

  • 1Department of Medical Psychology, Amsterdam University Medical Centers, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, Netherlands.

Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation
|June 23, 2021
PubMed
Summary
This summary is machine-generated.

Response shift occurs in patients with coronary artery disease (CAD) after revascularization, affecting health-related quality of life (HRQoL) assessments. Controlling for this shift did not improve change estimates but offered deeper insights into HRQoL dynamics.

Keywords:
Cardiac diseaseDisease-specific health-related quality of lifeGeneric health-related quality of lifeLongitudinal dataResponse shiftStructural equation modelling

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Area of Science:

  • Cardiology
  • Health Psychology
  • Psychometrics

Background:

  • Coronary artery disease (CAD) significantly impacts patients' health-related quality of life (HRQoL).
  • Assessing changes in HRQoL after interventions like coronary revascularization is crucial for evaluating treatment effectiveness.
  • Response shift, a change in the meaning of one's self-evaluation, can complicate the interpretation of HRQoL changes over time.

Purpose of the Study:

  • To quantify the occurrence of response shift in patients with CAD post-coronary revascularization.
  • To determine if controlling for response shift enhances the validity of HRQoL change estimates.
  • To explore the relationship between response shift and patient characteristics.

Main Methods:

  • Patients with CAD completed the SF-36 and Seattle Angina Questionnaire (SAQ7) at baseline and 3 months post-revascularization.
  • Sociodemographic, clinical, and psychosocial variables were collected using validated questionnaires.
  • Oort's Structural Equation Modeling (SEM) was employed to analyze response shift.

Main Results:

  • Response shift was observed in both SF-36 (recalibration, reprioritization) and SAQ7 (reconceptualization) measures.
  • Controlling for response shift did not yield more valid estimates of HRQoL change.
  • Reprioritization response shift was associated with the integration of having CAD into life narratives.

Conclusions:

  • Response shift is evident in HRQoL assessments of patients following coronary revascularization.
  • While not improving change estimate validity, SEM analysis provided nuanced understanding of HRQoL changes.
  • Further research may explore the clinical implications of identified response shift types.