Procena kvaliteta života kod bolesnika sa hroničnom totalnom okluzijom koronarne arterije: randomizovano poređenje optimalne medikamentne terapije i perkutane revaskularizacije hronične totalne okluzije
Assessment of quality of life in patients with chronic total coronary artery occlusion: randomized comparison of optimal drug therapy and percutaneous revascularization of chronic total occlusion
Докторанд
Juričić, StefanМентор
Stojković, SinišaЧланови комисије
Nedeljković, MilanBeleslin, Branko
Tomašević, Miloje
Метаподаци
Приказ свих података о дисертацијиСажетак
Do početka naše studije nije publikovana randomizovana prospektivna studija koja bi poredila elektivne bolesnike sa hroničnom totalnom okluzijom (CTO) lečene optimalnom medikamentnom terapijom (OMT) ili perkutanom koronarnom intervencijom (PCI).
Ciljevi: Cilj ove prospektivne randomizovane studije bio je da proceni kvalitet života bolesnika sa CTO koristeći „Sijetl Angina Upitnik” (SAQ) lečenih OMT uz PCI ili samo OMT.
Metode: U periodu od oktobra 2015. do maja 2017.god ukupno 100 bolesnika je prospektivno randomizovano prema kompijuterski generisanom kodu (1:1). Sve PCI su urađene u Sali za kateterizaciju Klinike za kardiologiju, Kliničkog centra Srbije.
Rezultati: Nakon randomizacije nije bilo razlike u SAQ skorovima između grupa, sem za domen fizičkog ograničenja (p=0.03). Tokom prosečnog perioda praćenja od 275±88 dana, bolesnici u PCI grupi su imali statistički niže vrednosti u domenu fizičkog ograničenja tokom aktivnosti (72.7±21.3 vs 60.5±27, p=0.014), manju učestalost epizoda a...ngine pektoris (89.8±17.6 vs 76.8±27.1, p=0.006), bolji ukupan kvalitet života (79.9±22.7 vs 62.5±25.5, p=0.001), veće vrednosti u domenu zadovoljstva primenjenom terapijom (91.2±13.6 vs 81.4±18.4, p=0.003) i graničnu značajnost u domenu stabilnosti angine (61.2±26.5 vs 51.0±23.7, p=0.046) u poređenju sa OMT grupom. Nije bilo statistički značajne razlike u SAQ skoru u OMT grupi nakon randomizacije i tokom perioda praćenja, dok je nađeno statistički značajno povećanje skora u svih 5 domena u PCI grupi.
Zaključak: Simptomi i kvalitet života procenjeni preko SAQ su značajno poboljšani u grupi bolesnika PCI CTO u poređenju sa grupom bolesnika lečenih samo OMT.
Until the start of this study no published data of the prospective randomized trial comparing percutaneous revascularization of chronic total occlusion (CTO) of the coronary artery with optimal medical therapy (OMT) in elective patients were available. Objectives: The aim of this randomized prospective study was to evaluate quality of life (QoL) using the „Seattle Angina Questionnaire” (SAQ) in patients with chronic total occlusion (CTO) on coronary arteries treated with either percutaneous coronary intervention (PCI) and optimal medical therapy (OMT) or only with OMT. Methods: Between October 2015 and May 2017, a total of 100 patients with CTO were randomized prospectively according to a computer-generated code (1:1 ratio). All PCIs were performed in the catheterization laboratory at the Cardiology Clinic in Belgrade, Clinical Centre of Serbia.
Results: There were no baseline differences in the SAQ scores between the groups, except for physical limitation scores (p=0.03). During the m...ean follow-up (FUP) of 275±88 days, patients in the PCI group reported less physical activity limitations (72.7±21.3 vs 60.5±27, p=0.014), less frequent angina episodes (89.8±17.6 vs 76.8±27.1, p=0.006), better quality of life (79.9±22.7 vs 62.5±25.5, p=0.001), greater treatment satisfaction (91.2±13.6 vs 81.4±18.4, p=0.003) and borderline difference in angina stability (61.2±26.5 vs 51.0±23.7, p=0.046) compared to patients in the OMT group. There were no significant differences in SAQ scores in the OMT group at baseline and during FUP. There was statistically significant increase in all 5 domains in the PCI group. Conclusion: Symptoms and QoL measured by SAQ were significantly improved after CTO PCI compared to OMT alone.