The Effect of Age on Improvement in Health-Related Quality of Life After Percutaneous Coronary Intervention
Laura Lappalainen1, Piia Lavikainen2, Risto P Roine3
1Kuopio University Hospital, Kuopio, Finland.
Insights
Older adults experience similar health-related quality of life (HRQoL) improvements after percutaneous coronary intervention (PCI) as younger patients. However, age-related declines in HRQoL may occur, necessitating comprehensive assessment.
Area of Science:
- Cardiology
- Geriatrics
- Health Services Research
Background:
- Percutaneous coronary intervention (PCI) is a primary treatment for coronary artery disease (CAD), aiming to improve symptoms and quality of life.
- Emphasis is placed on symptom relief and enhanced health-related quality of life (HRQoL) for older adults undergoing PCI.
- Limited data exists on whether older patients achieve comparable HRQoL benefits from PCI relative to younger individuals.
Purpose of the Study:
- To compare the improvements in HRQoL after PCI across different age groups.
- To evaluate the effectiveness of PCI in enhancing HRQoL in older versus younger populations.
- To investigate potential age-related factors influencing HRQoL changes post-PCI.
Main Methods:
- 300 patients undergoing PCI were stratified into three age groups: ≥75 years (n=89), 66-74 years (n=117), and ≤65 years (n=94).
- Health-related quality of life (HRQoL) was assessed using the Seattle Angina Questionnaire (SAQ-7) and the 15D instrument at baseline, 1 month, and 12 months post-procedure.
- Changes in HRQoL scores were analyzed across the three age cohorts.
Main Results:
- All age groups demonstrated statistically and clinically significant improvements in both SAQ-7 and 15D scores at 1 and 12 months post-PCI.
- No significant differences were observed in the 12-month HRQoL improvements between the age groups.
- A decline in 15D scores was noted after 1 month, particularly in the oldest group, linked to age-related rather than CAD-specific factors.
Conclusions:
- PCI offers comparable disease-specific and generic HRQoL benefits for both older and younger patients.
- These findings are encouraging, aligning with the goals of symptom alleviation and improved daily functioning in older adults.
- Incorporating disease-specific instruments alongside generic measures is recommended for a comprehensive evaluation of PCI's impact on HRQoL, especially considering age-related changes.
Introduction:
Percutaneous coronary intervention (PCI) is the first-line therapy in patients scheduled for coronary revascularization, aiming to relieve symptoms of coronary artery disease (CAD) and improve health-related quality of life (HRQoL) and prognosis. Particularly, in older adults, symptom alleviation and HRQoL are emphasized. However, it is not known whether older patients benefit from PCI equally to their younger peers. We used disease-specific and generic instruments to evaluate the improvement in HRQoL after PCI, comparing changes in three age groups.
Methods:
Altogether 300 patients undergoing PCI were divided into three age groups: ≥ 75 years (n = 89), 66-74 years (n = 117), and ≤ 65 years (n = 94). HRQoL was measured using the disease-specific Seattle Angina Questionnaire (SAQ-7) and the generic 15D instrument at baseline, one, and 12 months.
Results:
Statistically and clinically significant improvements in the SAQ-7 and 15D scores were observed after one- and 12-month follow-up in all age groups. There were no differences in the 12-month improvements in the SAQ-7 and 15D scores between the groups. The 15D score started to decline after 1 month, particularly in the oldest group. The decline was associated with age-related rather than CAD-related 15D dimensions.
Conclusions:
Our findings on comparable improvement in disease-specific and generic HRQoL after PCI in older and younger patients are encouraging, particularly considering that the aims of PCI in older adults are predominantly symptom alleviation and improvement of daily activities. In addition, to overcome age-related changes in HRQoL, a disease-specific instrument should be incorporated in the evaluation of PCI on HRQoL.
Clinical Trial Registration:
5101114.
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