Quality of life after percutaneous coronary intervention in the elderly with acute coronary syndrome.
BACKGROUND
Health-related quality of life (HRQoL) is an important but often neglected outcome measure in acute coronary syndrome (ACS) management. The prevalence of elderly presenting with ACS and undergoing percutaneous coronary intervention (PCI) is rising. We aimed to explore the impact of PCI on health status in elderly ACS patients.


METHODS
We prospectively enrolled 624 patients admitted to our institution with ACS from February 2006 to May 2008. Short Form (SF)-36 health survey was used to assess HRQoL at baseline and 6 months. Baseline characteristics and HRQoL were compared for patients treated with PCI within 30 days of index ACS admission vs. medical therapy across 3 age groups (<60, 60-79 and ≥80 years).


RESULTS
PCI was performed in 73.6%, 55.7% and 21.3% in patients aged <60, 60-79 and older than 80 years, respectively (p<0.01). Elderly patients were more likely to be female (16.9 vs. 35.4 vs. 54.6%, p<0.01) and had more co-morbidities (p<0.01). Older patients were less likely to undergo angiography (84.8 vs. 65.2 vs. 24.8%, p<0.01). Baseline HRQoL decreased with advancing age (p<0.01). However, elderly patients who underwent PCI experienced the most improvement in physical health than younger age groups. PCI was an independent predictor (Odds Ratio = 1.79, 95% CI: 1.10-2.92) of better physical health status at 6 months.


CONCLUSIONS
Elderly ACS patients who underwent PCI experienced the most improvement in physical health compared to younger patients. Our findings suggest that age per se should not deter against revascularization because of potential benefits in HRQOL.
Institute of Vascular Medicine and Division of Cardiology, Prince of Wales Hospital, The Chinese University of Hong Kong, China.
Ruijie
R
Li
Bryan P
BP
Yan
Ming
M
Dong
Qing
Q
Zhang
Gabriel Wai-Kwok
GW
Yip
Chin-Pang
CP
Chan
Mang
M
Zhang
Qianhuan
Q
Zhang
John E
JE
Sanderson
Cheuk-Man
CM
Yu
D054058:Acute Coronary Syndrome / Q000503:physiopathology* / Q000523:psychology / Q000601:surgery*; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life