TY - JOUR
T1 - Ovality of life after balloon angioplasty or stenting for acute myocardial infarction
T2 - One-year results from the Stent-PAMI trial
AU - Rinfret, Stéphane
AU - Grines, Cindy L.
AU - Cosgrove, Roberta S.
AU - Ho, Kalon K.L.
AU - Cox, David A.
AU - Brodie, Bruce R.
AU - Morice, Marie Claude
AU - Stone, Gregg W.
AU - Cohen, David J.
N1 - Funding Information:
Dr. Rinfret was supported, in part, by a Detweiler Fellowship Grant from the Royal College of Physicians and Surgeons of Canada and by the Samuel McLaughlin Foundation. Dr. Cohen was supported, in part, by a Clinician-Scientist Award from the American Heart Association. Additional support was provided by an unrestricted grant from Cordis, Inc., Warren, New Jersey.
PY - 2001/11/15
Y1 - 2001/11/15
N2 - OBJECTIVES: The goal of this study was to compare the impact of primary stenting or percutaneous transluminal coronary angioplasty (PTCA) on health-related quality of life (HRQOL) in patients undergoing direct angioplasty for acute myocardial infarction (AMI). BACKGROUND: Previous studies have demonstrated that coronary stenting reduces clinical and angiographic restenosis compared with PTCA. However, the impact of stenting on HRQOL from the patient's perspective remains unknown. METHODS: We administered the Seattle Angina Questionnaire and the Medical Outcomes Study Short-form Survey at 1, 6 and 12 months after initial treatment to all North American patients in the Stent-Primary Angioplasty for Myocardial Infarction trial (Stent-PAMI) (n = 509) - a randomized trial comparing primary stenting to conventional PTCA for patients with AMI. RESULTS: At one month, most HRQOL measures were similar for the two groups, but stent patients reported less bodily pain than PTCA patients (p = 0.03). At six-month follow-up, stenting resulted in significant improvements in several dimensions of HRQOL including reduced anginal frequency and bodily pain as well as improved disease perception (all p ≤ 0.03) and a trend towards better anginal stability (p = 0.056). By 12-month follow-up, however, none of these differences remained statistically significant. These differences in HRQOL were largely explained by the greater need for ischemia-driven target-vessel repeat revascularization procedures in PTCA patients during the first six months (16.0% vs. 6.2%, p < 0.001). CONCLUSIONS: In patients undergoing revascularization for AMI, initial stent placement is associated with improvements in several dimensions of health status during the first six months of follow-up. In the absence of differences in mortality, these findings add to the overall argument in favor of initial stenting in patients treated with mechanical reperfusion for myocardial infarction.
AB - OBJECTIVES: The goal of this study was to compare the impact of primary stenting or percutaneous transluminal coronary angioplasty (PTCA) on health-related quality of life (HRQOL) in patients undergoing direct angioplasty for acute myocardial infarction (AMI). BACKGROUND: Previous studies have demonstrated that coronary stenting reduces clinical and angiographic restenosis compared with PTCA. However, the impact of stenting on HRQOL from the patient's perspective remains unknown. METHODS: We administered the Seattle Angina Questionnaire and the Medical Outcomes Study Short-form Survey at 1, 6 and 12 months after initial treatment to all North American patients in the Stent-Primary Angioplasty for Myocardial Infarction trial (Stent-PAMI) (n = 509) - a randomized trial comparing primary stenting to conventional PTCA for patients with AMI. RESULTS: At one month, most HRQOL measures were similar for the two groups, but stent patients reported less bodily pain than PTCA patients (p = 0.03). At six-month follow-up, stenting resulted in significant improvements in several dimensions of HRQOL including reduced anginal frequency and bodily pain as well as improved disease perception (all p ≤ 0.03) and a trend towards better anginal stability (p = 0.056). By 12-month follow-up, however, none of these differences remained statistically significant. These differences in HRQOL were largely explained by the greater need for ischemia-driven target-vessel repeat revascularization procedures in PTCA patients during the first six months (16.0% vs. 6.2%, p < 0.001). CONCLUSIONS: In patients undergoing revascularization for AMI, initial stent placement is associated with improvements in several dimensions of health status during the first six months of follow-up. In the absence of differences in mortality, these findings add to the overall argument in favor of initial stenting in patients treated with mechanical reperfusion for myocardial infarction.
UR - http://www.scopus.com/inward/record.url?scp=0035889231&partnerID=8YFLogxK
U2 - 10.1016/S0735-1097(01)01599-6
DO - 10.1016/S0735-1097(01)01599-6
M3 - Article
C2 - 11704371
AN - SCOPUS:0035889231
SN - 0735-1097
VL - 38
SP - 1614
EP - 1621
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 6
ER -