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Percutaneous Coronary Revascularization in Elderly Patients: Impact on Functional Status and Quality of Life

Todd B. Seto, MD, MPH; Deborah A. Taira, ScD; Ronna Berezin, MPH; Manish S. Chauhan, MD; Donald E. Cutlip, MD; Kalon K.L. Ho, MD, MSc; Richard E. Kuntz, MD, MSc; and David J. Cohen, MD, MSc
[+] Article and Author Information

From Beth Israel Deaconess Medical Center and Harvard School of Public Health, Boston, Massachusetts; the University of Rochester Medical Center, Rochester, New York; and Queen's Medical Center, Hawaii Medical Service Association, and University of Hawaii School of Medicine, Honolulu, Hawaii.


Acknowledgments: The authors thank Roger Davis, ScD, and John Spertus, MD, for thoughtful review of an earlier draft of this manuscript.

Grant Support: In part by a Clinician-Scientist Award from the American Heart Association (Dr. Cohen) and an unrestricted grant from Guidant, Inc. (Santa Clara, California).

Requests for Single Reprints: David J. Cohen, MD, MSc, Cardiovascular Division, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215.

Current Author Addresses: Dr. Seto: Queen's Medical Center, 1301 Punchbowl Street, Honolulu, HI 96813.

Dr. Taira: Hawaii Medical Service Association, Care Management, 818 Keeaumoku Street, Honolulu, HI 96814.

Ms. Berezin: Cardiovascular Data Analysis Center, 900 Commonwealth Avenue, 2nd Floor, Boston, MA 02215.

Drs. Chauhan, Ho, Kuntz, and Cohen: Cardiovascular Division, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA 02215.

Dr. Cutlip: University of Rochester Medical Center, Rochester, NY 14620.

Author Contributions: Conception and design: T.B. Seto, D.A. Taira, R.E. Kuntz, D.J. Cohen.

Analysis and interpretation of the data: T.B. Seto, D.A. Taira, R. Berezin, D.E. Cutlip, K.K.L. Ho, D.J. Cohen.

Drafting of the article: T.B. Seto, D.A. Taira, D.J. Cohen.

Critical revision of the article for important intellectual content: T.B. Seto, D.A. Taira, M.S. Chauhan, D.E. Cutlip, K.K.L. Ho, R.E. Kuntz, D.J. Cohen.

Final approval of the article: T.B. Seto, D.A. Taira, R. Berezin, M.S. Chauhan, D.E. Cutlip, K.K.L. Ho, R.E. Kuntz, D.J. Cohen.

Statistical expertise: R.E. Kuntz, D.J. Cohen.

Obtaining of funding: D.J. Cohen.

Administrative, technical, or logistic support: R. Berezin, M.S. Chauhan, D.E. Cutlip.

Collection and assembly of data: R. Berezin, M.S. Chauhan, D.E. Cutlip, K.K.L. Ho, R.E. Kuntz.


Ann Intern Med. 2000;132(12):955-958. doi:10.7326/0003-4819-132-12-200006200-00005
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Background: Percutaneous coronary intervention (PCI) is frequently performed in elderly patients, but little is known about its impact on overall health and quality of life.

Objective: To examine changes in health-related quality of life among elderly patients after PCI.

Design: Observational study.

Setting: 75 U.S. hospitals.

Patients: Participants in two clinical trials of PCI.

Measurements: Health-related quality of life was assessed by using the Medical Outcomes Study Short Form (SF-36) survey and the Seattle Angina Questionnaire at baseline, 6 months, and 1 year.

Results: Serial data on health-related quality of life were available for 295 elderly (≥ 70 years) and 1150 nonelderly (<70 years) patients. At 6 months, physical health had improved in 51% of elderly patients and mental health had improved in 29%. Cardiovascular-specific health status had improved in 58% to 75% of elderly patients. Improvement did not significantly differ between elderly and nonelderly patients at 6 months or 1 year.

Conclusions: Elderly patients selected for participation in a trial of PCI had substantial improvements in health-related quality of life after PCI that were similar to those in younger patients.

Figures

Grahic Jump Location
Figure.
Standardized estimates of the percentage of patients expected to have improvements in health-related quality of life (QOL) 6 months after percutaneous coronary intervention, according to age.

The probability of clinically meaningful improvement was not significantly associated with age. White bars represent patients younger than 70 years of age; striped bars represent patients 70 years of age or older. SAQ = Seattle Angina Questionnaire; SF-36 = Medical Outcomes Study Short-Form Survey.

Grahic Jump Location

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Summary for Patients

Percutaneous Coronary Angioplasty in the Elderly: Impact on Functional Status and Quality of Life

The summary below is from the full report titled “Percutaneous Coronary Revascularization in Elderly Patients: Impact on Functional Status and Quality of Life.” It is in the 20 June 2000 issue of Annals of Internal Medicine (volume 132, pages 955-958). The authors are T.B. Seto, D.A. Taira, R. Berezin, M.S. Chauhan, D.E. Cutlip, K.K.L. Ho, R.E. Kuntz, and D.J. Cohen.

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