Association Between Myocardial Infarction and Quality of Life in the ISCHEMIA Trial

IF 11.7 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Cardiovascular interventions Pub Date : 2025-05-26 DOI:10.1016/j.jcin.2025.02.011

Mario Gaudino MD, PhD , Gregg W. Stone MD , Rachel S. Heise MS , Tulio Caldonazo MD , Jessica Kim MS , Lamia Harik MD , Sigrid Sandner MD , Giuseppe Biondi-Zoccai MD, PhD , Ruth Masterson-Creber PhD, MSc, RN , John H. Alexander MD, MHS , Deepak L. Bhatt MD, MPH, MBA , John Puskas MD , P.J. Devereaux MD, PhD , John Spertus MD, MPH , Bjorn Redfors MD, PhD

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引用次数: 0

Abstract

Background

The association between myocardial infarction (MI) subtypes (procedural MI [PMI] and spontaneous MI [SMI]) and subsequent quality of life (QoL) is incompletely understood.

Objectives

The authors analyzed the association between PMI and SMI and generic and disease-specific QoL in the ISCHEMIA (International Study of Comparative Health Effectiveness with Medical and Invasive Approaches) trial.

Methods

QoL was assessed before randomization and at 1.5, 3, and 6 months, and every 6 months thereafter. European Quality of Life-5 dimensions visual analog scale (EQ-5D VAS) (generic) and Seattle Angina Questionnaire (SAQ-7) summary score (disease-specific) were used. The primary analysis was a linear, repeated-measures, multivariable-adjusted, mixed-effects model, with a random intercept for patient. QoL assessments occurring <3 months after MI were defined as early QoL and those occurring >3 months after MI were defined as late QoL.

Results

A total of 4,375 randomized patients were included in the primary analysis population. The median duration of follow-up was 36.2 months (Q1-Q3: 23.8-49.5 months). In the primary analysis population, a total of 84 PMIs and 352 SMIs occurred. SMI was associated with significant decreases in both early (adjusted difference −5.7; 95% CI: −7.3 to −4.1 points) and late EQ-5D VAS (−3.1 points; 95% CI: −4.3 to −1.9 points) and in early (−7.7 points; 95% CI: −9.4 to −6.1 points) and late SAQ-7 (−1.9 points; 95% CI: −3.2 to −0.7 points). PMI was not associated with early (adjusted difference −0.8 points; 95% CI: −3.3 to 1.8 points) or late (−0.7 points; 95% CI: −2.7 to 1.2 points) changes in EQ-5D VAS, and was associated with a reduction in early (−3.0 points; 95% CI: −5.7 to −0.4) but not late SAQ-7 (−0.2 points; 95% CI −2.2 to 1.8 points).

Conclusions

In ISCHEMIA, SMI was associated with reductions in both early and late generic and disease-specific QoL, whereas PMI was only associated with a transient reduction in disease-specific QoL.

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缺血试验中心肌梗死与生活质量的关系。

背景：心肌梗死（MI）亚型（程序性MI [PMI]和自发性MI [SMI]）与随后的生活质量（QoL）之间的关系尚不完全清楚。目的：作者分析了在缺血试验中PMI和SMI与一般和疾病特异性生活质量之间的关系（医学和侵入性方法比较健康有效性的国际研究）。方法：随机化前、随机化后1.5、3、6个月及随机化后每6个月评估一次生活质量。采用欧洲生活质量5维视觉模拟量表（EQ-5D VAS）（通用）和西雅图心绞痛问卷（SAQ-7）总结评分（疾病特异性）。初步分析采用线性、重复测量、多变量调整、混合效应模型，患者随机截距。在心肌梗死后3个月进行的生活质量评估被定义为晚期生活质量。结果：4375名随机患者被纳入主要分析人群。中位随访时间为36.2个月（Q1-Q3: 23.8-49.5个月）。在主要分析人群中，共发生84例pmi和352例smi。重度精神障碍与两种早期的显著降低相关(调整后差异-5.7；95% CI: -7.3至-4.1点)和晚期EQ-5D VAS(-3.1点；95% CI: -4.3至-1.9点)和早期(-7.7点；95% CI: -9.4至-6.1点)和SAQ-7晚期(-1.9点；95% CI: -3.2至-0.7点)。PMI与早期(调整后的差异-0.8点；95% CI: -3.3至1.8点)或晚期(-0.7点；95% CI: -2.7至1.2点)EQ-5D VAS的变化，并且与早期(-3.0点；95% CI: -5.7至-0.4)，但不晚SAQ-7(-0.2点；95% CI -2.2 ~ 1.8点)。结论：在缺血中，SMI与早期和晚期一般生活质量和疾病特异性生活质量的降低有关，而PMI仅与疾病特异性生活质量的短暂降低有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JACC. Cardiovascular interventions CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

11.60

自引率

8.80%

发文量

756

审稿时长

4-8 weeks

期刊介绍： JACC: Cardiovascular Interventions is a specialist journal launched by the Journal of the American College of Cardiology (JACC). It covers the entire field of interventional cardiovascular medicine, including cardiac, peripheral, and cerebrovascular interventions. The journal publishes studies that will impact the practice of interventional cardiovascular medicine, including clinical trials, experimental studies, and in-depth discussions by respected experts. To enhance visual understanding, the journal is published both in print and electronically, utilizing the latest technologies.