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6-month health-related quality of life in ST elevation myocardial infarction patients following thrombolysis or primary percutaneous coronary intervention
  1. CS Rogers1,
  2. L McGowan2,
  3. H Iles-Smith1,
  4. C Dickens3,
  5. F Fath-Ordoubadi1
  1. 1Manchester Heart Centre, Central Manchester and Manchester Children’s University Hospitals NHS Trust, Manchester, UK
  2. 2School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
  3. 3School of Community-based Medicine, University of Manchester, Manchester, UK

Abstract

Introduction Difficulty with psychological adjustment post ST elevation myocardial infarction (STEMI) has been reported in as many as 40% of patients. The process of rehabilitation, recovery and the time taken to return to work can be adversely affected. Treatment such as primary percutaneous coronary intervention (PPCI) or thrombolysis (lysis), can also influence post-STEMI rehabilitation and recovery. At present few published data are available evaluating the health-related quality of life (HR-QoL) for lysis and PPCI patients. The purpose of this cohort study is to ascertain predictors of physical health status in STEMI patients receiving lysis or PPCI for future service provision and adaptations.

Methods A total of 430 STEMI patients will be recruited (200 lysis and 230 PPCI) across the Manchester conurbation; the study is in the recruitment phase at present. Four self-report questionnaires including the ENRICHD social support instrument (ESSI), the hospital anxiety and depression scale (HADS), the medical outcomes study Short Form 36 (SF-36) and the brief illness perception questionnaire will be collected at baseline, 6 and 12 months. Further data including demographics, relevant medical history and index treatment details are also recorded.

Results Six-month interim data are available for 179 patients (94 lysis and 85 PPCI). Participant demographics are: lysis group 80% male, mean age 61 years (38–90; SD 12.5) and PPCI group 72% male, mean age 60 years (37–83; SD 11.2). Baseline data analysis showed no differences on the ESSI, HADS and aspects of the SF-36 between the two groups. Physical component scores of the SF-36, 6-month data were analysed using regression analyses and showed baseline levels of anxiety, depression, education level and several quality of life indicators significantly predicted physical components of HR-QoL.

Conclusions/Implications Analyses for interim data show no significant difference between treatment groups on a range of psychosocial variables at baseline. However, patients’ own self-rating of their physical HR-QoL at 6 months was predicted by quality of life and levels of psychological distress measured at baseline. The findings show that a subgroup of patients post-STEMI may benefit from targeted psychosocial interventions in order to maintain their quality of life and aid recovery over time.

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