title: Quality of life in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention--radial versus femoral access (from the OCEAN RACE Trial).
abstract: Numerous studies have compared transradial (TR) versus transfemoral (TF) access for percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction. These studies have focused on clinical efficacy and safety; yet little is known about the effect of the vessel access on the health-related quality of life (HRQoL). In the present study, patients were randomly assigned to TR (n = 52) or TF (n = 51) access groups. Generic (EQ-5D-3L) and cardiac-specific (Quality of Life Index and MacNew) tools were used to assess HRQoL before PCI and 2 hours and 4 days after PCI. Baseline HRQoL was comparable in both groups and improved after PCI. The mean ± SD EQ-5D-3L health utility score 2 hours after PCI was 0.46 ± 0.291 and was higher in the TR group (TR: 0.60 ± 0.299 versus TF: 0.32 ± 0.283, p <0.001). Patients in the TR group reported fewer problems with mobility (TR: 71.7% vs TF: 94.4%, p <0.01) and self-care (TR: 62.5% vs TF: 97.2%, p <0.001). At day 4, fewer patients reported problems with anxiety and/or depression in the TR group than in the TF group (TR: 42.9% vs TF: 75.0%, p <0.001); no differences between groups in other measures were observed (Quality of Life Index and MacNew). The N-terminal of the prohormone brain natriuretic peptide levels were inversely correlated with EQ-5D-3L visual analog scale (r = -0.348, p <0.05) and EQ-5D-3L health utility score (r = -0.322, p <0.05). There was a correlation between in-hospital mortality and 2 MacNew domains: physical (r = -0.329, p <0.05) and emotional (r = -0.374, p <0.01). In conclusion, radial access should be the preferred approach in patients with ST-segment elevation myocardial infarction undergoing PCI when considering HRQoL. Radial access is associated with fewer problems with mobility and self-care and better psychological outcome after PCI.
authors.affiliation: 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Lukasz
authors.initials: L
authors.lastname: Koltowski
authors.affiliation: Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Koltowska-Haggstrom
authors.affiliation: 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Krzysztof Jerzy
authors.initials: KJ
authors.lastname: Filipiak
authors.affiliation: 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland. Electronic address: jkochman@amwaw.edu.pl.
authors.forename: Janusz
authors.initials: J
authors.lastname: Kochman
authors.affiliation: Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Dominik
authors.initials: D
authors.lastname: Golicki
authors.affiliation: 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Arkadiusz
authors.initials: A
authors.lastname: Pietrasik
authors.affiliation: 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Zenon
authors.initials: Z
authors.lastname: Huczek
authors.affiliation: 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Pawel
authors.initials: P
authors.lastname: Balsam
authors.affiliation: 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Scibisz
authors.affiliation: 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Opolski
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D004562:Electrocardiography; D005060:Europe / Q000453:epidemiology; D005260:Female; D005263:Femoral Artery; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000379:methods* / Q000523:psychology*; D011446:Prospective Studies; D011788:Quality of Life; D017534:Radial Artery; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D016896:Treatment Outcome