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1.
Health Qual Life Outcomes ; 18(1): 377, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-33261627

RESUMO

BACKGROUND: The Seattle Angina Questionnaire (SAQ) is a widely-used patient-reported outcomes measure in patients with heart disease. This study assesses the validity and reliability of the SAQ in a Canadian cohort of individuals with stable angina. METHODS AND RESULTS: Data are from the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) registry, a population-based registry of patients who received cardiac catheterization in Alberta, Canada. The cohort consists of 4052 patients undergoing cardiac catheterization for stable angina and completed the SAQ within 2 weeks. Exploratory factor analysis and confirmatory factor analysis (CFA) were used to assess the factorial structure of the SAQ. Internal and test-retest reliabilities of a new measure (i.e., SAQ-CAN) was measured using Cronbach α and intraclass correlation coefficient, respectively. CFA model fit was assessed using the root mean square error of approximation (RMSEA) and comparative fit index (CFI). Construct validity of the SAQ-CAN was assessed in relation to Hospital Anxiety and Depression Scales (HADS), Euro Quality of life 5 dimension (EQ5D), and original SAQ. Of the 4052 patients included in this analysis, 3281 (80.97%) were younger than 75 years old, while 3239 (79.94%) were male. Both exploratory and confirmatory factor analyses revealed a four-factorial structure consisting of 16 items that provided a better fit to the data (RMSEA = 0.049 [90% CI = (0.047, 0.052)]; CFI = 0.975). The 16-item SAQ demonstrated good to excellent internal reliability (Cronbach's α range from 0.77 to 0.90), moderate to strong correlation with the Original SAQ and EQ5D but negligible correlations with HADS. CONCLUSION: The SAQ-CAN has acceptable psychometric properties that are comparable to the original SAQ. We recommend its use for assessing coronary health outcomes in Canadian patients with Coronary Artery Disease.


Assuntos
Angina Estável/psicologia , Medidas de Resultados Relatados pelo Paciente , Qualidade de Vida , Idoso , Alberta , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Sistema de Registros , Reprodutibilidade dos Testes
2.
Clin Gerontol ; 43(3): 331-339, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30587089

RESUMO

Objective: To assess factorial and construct validity along with reliability of the Russian version of the Multidimensional Scale of Perceived Social Support (MSPSS) in cardiac patients.Methods: The study included 1018 patients with coronary artery disease. All patients were offered the opportunity to complete a questionnaire to detect psychosocial risk and protective factors, including the MSPSS.Results: Internal consistency of the Russian version of the MSPSS was high: Cronbach's alpha coefficient in the group of patients with stable angina was .91 vs. .90 in the group with acute coronary syndrome. The three-factor structure of the MSPSS was proved with exploratory and confirmatory factor analyses. As expected, the Russian version of the MSPSS was negatively correlated with measures of anxiety and depression, and positively correlated with curiosity.Conclusions: The Russian version of MSPSS corresponds closely with the English version in reliability, consistency, and internal structure. Test-retest reliability was satisfactorally high and construct validity was supported with the results of the correlation analysis.Clinical Implications: Our study confirms that MSPSS questionnaire is a high valid tool to estimate social support and it can be successfully applied to define social support in patients with cardiac pathology.


Assuntos
Angina Estável/psicologia , Ansiedade/psicologia , Doença da Artéria Coronariana/psicologia , Depressão/psicologia , Inquéritos e Questionários/estatística & dados numéricos , Idoso , Angina Estável/epidemiologia , Ansiedade/diagnóstico , Doença da Artéria Coronariana/epidemiologia , Doença da Artéria Coronariana/terapia , Depressão/diagnóstico , Análise Fatorial , Feminino , Humanos , Idioma , Masculino , Pessoa de Meia-Idade , Análise de Escalonamento Multidimensional , Fatores de Proteção , Psicometria/métodos , Reprodutibilidade dos Testes , Fatores de Risco , Federação Russa/epidemiologia , Apoio Social , Tradução
3.
Eur J Intern Med ; 70: 60-67, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31704164

RESUMO

OBJECTIVE: to explore 1) the perception of stable angina (SA) - impact on quality of life (QoL) and current condition related to SA; 2) SA burden - symptoms and frequency of anginal episodes; 3) impairment attributable to SA - limitations in daily activities and impact on work; 4) characteristics that might affect the patients' perception." METHOD: a proprietary questionnaire was administered on-line to SA patients selected using a purpose-built screening program from general population panels collaborating with IQVIA in Italy, Germany, Spain, and the UK. Exploratory analyses were performed: descriptive statistics on the total sample and different stratifications (gender, age class, time since diagnosis) were provided; we used Chi-square tests to compare subgroups. RESULTS: of more than 25,000 subjects who accessed the survey, 268 were eligible and completed the questionnaire: mean age was 61 years and women accounted for 30%. Despite being treated, about 40% of patients reported that SA impacted "completely" or "very much" their QoL, 10% rated their condition as "not good", and 45.1% stated that they felt "Fair". The majority of patients were still symptomatic and many of them perceived that SA had a major impact on their working life. Women, younger patients and those with a more recent diagnosis reported a worse self-assessment of their condition, QoL and symptom burden. CONCLUSIONS: the results of our survey provide new insights on how patients with SA perceived their own health status and suggest that any patient with SA deserves a more detailed and accurate evaluation by their physicians.


Assuntos
Angina Estável/terapia , Nível de Saúde , Qualidade de Vida , Idoso , Angina Estável/fisiopatologia , Angina Estável/psicologia , Europa (Continente) , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Índice de Gravidade de Doença , Fatores Sexuais , Inquéritos e Questionários , Fatores de Tempo
4.
BMJ Open ; 9(9): e029661, 2019 09 04.
Artigo em Inglês | MEDLINE | ID: mdl-31488483

RESUMO

OBJECTIVES: Although substantial progress in the treatment of stable angina pectoris (sAP) has been made, little is known about the functional status and quality of life (QoL) of patients in different healthcare systems. DESIGN AND METHODS: We undertook a survey using the Seattle Angina Questionnaire (SAQ) (five domains scored form 0-worst assessment to 100-best assessment) to assess symptoms, QoL (including limitation of activities), demographics, geographic distribution and individual disease data in patients with stable coronary artery disease in Austrian cardiology practices. RESULTS: A total of 660 patients with sAP with a mean age of 69.2 years were included. SAQ scores were 67.5±24.4 for physical limitation, 65.5±26.6 for angina stability, 79.3±23.2 for angina frequency, 86.3±16.2 for treatment satisfaction and 63.7±24.2 for overall QoL. Multiple regression identified male gender, but also female gender, Eastern Austrian residence and high body mass index as predictive factors for SAQ scoring. A total of 35.6% of the patients reported at least one desirable activity that was limited through AP symptoms. CONCLUSIONS: Activity and QoL assessments are in accordance with published literature: The number and the diversity of desired activities indicate the need to focus on patient's individual activity level to improve symptom management.


Assuntos
Angina Estável/psicologia , Satisfação Pessoal , Qualidade de Vida , Atividades Cotidianas , Adulto , Idoso , Idoso de 80 Anos ou mais , Áustria , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Desempenho Físico Funcional , Inquéritos e Questionários
5.
Angiology ; 70(5): 397-406, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30149731

RESUMO

Stable angina (SA) is a chronic condition reducing physical activity and quality of life (QoL). Physicians treating patients with SA in Italy, Germany, Spain, and United Kingdom completed a web-based survey. The objective was to assess physician perceptions of patient needs, the impact of SA on QoL, and evaluate SA management. Overall, 659 physicians (cardiologists and general practitioners) entered data from 1965 eligible patients. The perceived importance of everyday activities for patients with a recent diagnosis (≤2 years) was higher than for patients with a longer diagnosis (>2 years), while severity of limitations for those activities were rated similarly for both groups. Gender-based analyses revealed that physicians documented more severe SA, more symptoms and more angina attacks in women, yet they rated the patients' condition as similar for both sexes. Women also received less medical and interventional treatment. Patients who have previously had a percutaneous coronary intervention (PCI) had more severe SA, despite more intense medical treatment, than patients with no previous PCI. In conclusion, severity, symptoms, and impact of SA on health status and everyday life activities vary by duration of disease, gender, and previous PCI. However, physicians do not seem to attach appropriate importance to these differences.


Assuntos
Angina Estável/terapia , Atitude do Pessoal de Saúde , Efeitos Psicossociais da Doença , Conhecimentos, Atitudes e Prática em Saúde , Padrões de Prática Médica , Qualidade de Vida , Atividades Cotidianas , Idoso , Angina Estável/diagnóstico , Angina Estável/fisiopatologia , Angina Estável/psicologia , Tomada de Decisão Clínica , Europa (Continente) , Feminino , Pesquisas sobre Atenção à Saúde , Nível de Saúde , Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Índice de Gravidade de Doença , Fatores Sexuais , Fatores de Tempo
6.
Clin Nutr ESPEN ; 26: 47-52, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29908682

RESUMO

BACKGROUND: Despite advances in the treatment of cardiovascular diseases in recent decades, patients experience high levels of depression, anxiety, stress, and insomnia. Since the calming effect of Melissa officinalis (MO) has been known, this study aimed to determine the effects of MO supplementation on depression, anxiety, stress, and sleep disturbances in patients with chronic stable angina (CSA). METHODS: In this double-blind placebo-controlled clinical trial, 80 patients with CSA were divided randomly into two groups (taking 3 g MO supplement or placebo daily for 8 weeks). The shortened 21-item version of the depression, anxiety and stress scale (DASS-21) test and Pittsburgh sleep quality index were done before and after the intervention. RESULTS: At the end of the study, the intervention group receiving MO capsules had a significant reduction in scores of depression, anxiety, stress, and total sleep disturbance, compared with the placebo group (P < 0.05). CONCLUSIONS: The results showed that 8-week supplementation with 3 g MO can decrease depression, anxiety, stress, and sleep disorder in patients with CSA.


Assuntos
Angina Estável/tratamento farmacológico , Ansiolíticos/uso terapêutico , Antidepressivos/uso terapêutico , Ansiedade/tratamento farmacológico , Depressão/tratamento farmacológico , Hipnóticos e Sedativos/uso terapêutico , Melissa , Extratos Vegetais/uso terapêutico , Transtornos do Sono-Vigília/tratamento farmacológico , Sono/efeitos dos fármacos , Estresse Psicológico/tratamento farmacológico , Adulto , Idoso , Angina Estável/diagnóstico , Angina Estável/fisiopatologia , Angina Estável/psicologia , Ansiolíticos/efeitos adversos , Ansiolíticos/isolamento & purificação , Antidepressivos/efeitos adversos , Antidepressivos/isolamento & purificação , Ansiedade/diagnóstico , Ansiedade/fisiopatologia , Ansiedade/psicologia , Doença Crônica , Depressão/diagnóstico , Depressão/fisiopatologia , Depressão/psicologia , Método Duplo-Cego , Feminino , Humanos , Hipnóticos e Sedativos/efeitos adversos , Hipnóticos e Sedativos/isolamento & purificação , Irã (Geográfico) , Masculino , Melissa/química , Pessoa de Meia-Idade , Extratos Vegetais/efeitos adversos , Extratos Vegetais/isolamento & purificação , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/fisiopatologia , Transtornos do Sono-Vigília/psicologia , Estresse Psicológico/diagnóstico , Estresse Psicológico/fisiopatologia , Estresse Psicológico/psicologia , Fatores de Tempo , Resultado do Tratamento
7.
Adv Ther ; 35(3): 341-352, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29508153

RESUMO

INTRODUCTION: Heart rate (HR) reduction is an integral part of antianginal therapy, but many patients do not reach the guideline-recommended target of less than 60 bpm despite high use of beta-blockers (BB). Failure to uptitrate BB doses may be partly to blame. To explore other options for lowering HR and improving angina control, CONTROL-2 was initiated to compare the efficacy and tolerability of the combination of BBs with ivabradine versus uptitration of BBs to maximal tolerated dose, in patients with stable angina. METHODS: This multicenter, open, randomized study included 1104 patients with Canadian Cardiovascular Society (CCS) class II or III stable angina, in sinus rhythm, and on background stable treatment with non-maximal recommended doses of BBs. Consecutive patients were allocated to ivabradine + BB or BB uptitration in a 4:1 ratio. RESULTS: At the end of the study (week 16), addition of ivabradine to BB treatment and BB uptitration resulted in reduction in HR (61 ± 6 vs. 63 ± 8 bpm; p = 0.001). At week 16, significantly more patients on ivabradine + BB were in CCS class I than with BB uptitration (37.1% vs. 28%; p = 0.017) and significantly more patients were angina-free (50.6% vs. 34.2%; p < 0.001). Patient health status based on the visual analogue scale (VAS) was also better in the ivabradine + BB group. Adverse events (AEs) were significantly more common with BB uptitration than with the ivabradine + BB combination (18.4% vs. 9.4%, p < 0.001). CONCLUSION: In patients with stable angina, combination therapy with ivabradine + BB demonstrated good tolerability, safety, and more pronounced clinical improvement, compared to BB uptitration. TRIAL REGISTRATION: ISRCTN30654443. FUNDING: Servier.


Assuntos
Antagonistas Adrenérgicos beta , Angina Estável/tratamento farmacológico , Ivabradina , Qualidade de Vida , Antagonistas Adrenérgicos beta/administração & dosagem , Antagonistas Adrenérgicos beta/efeitos adversos , Idoso , Angina Estável/diagnóstico , Angina Estável/fisiopatologia , Angina Estável/psicologia , Canadá , Fármacos Cardiovasculares/administração & dosagem , Fármacos Cardiovasculares/efeitos adversos , Monitoramento de Medicamentos/métodos , Quimioterapia Combinada/métodos , Feminino , Frequência Cardíaca/efeitos dos fármacos , Humanos , Ivabradina/administração & dosagem , Ivabradina/efeitos adversos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
8.
Anatol J Cardiol ; 19(2): 100-109, 2018 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29424731

RESUMO

OBJECTIVE: Despite revascularization and optimal medical treatment (OMT), patients with angina often have a reduced quality of life due to inadequate relief from symptoms. Recent studies have shown that the application of shock waves may reduce angina symptoms and improve quality of life, exercise capacity, and myocardial perfusion due to the stimulation of angiogenesis. However, there is limited evidence due to small, single-arm, single-center studies of low to moderate quality. The purpose of this study is to evaluate the impact of cardiac shock wave therapy (CSWT) on exercise tolerance and angina symptoms in patients with coronary artery disease and objective evidence of myocardial ischemia who cannot undergo traditional revascularization and experience angina despite OMT in comparison to sham procedure. METHODS: We designed a randomized, triple-blind, placebo-controlled, multicentre trial (NCT02339454) to assess the efficacy of CSWT in addition to OMT in patients with stable angina and myocardial ischemia documented by exercise treadmill test (ETT). All patients were treated with stable doses of standard medical treatment 4 weeks before screening. An increase in the total exercise duration on ETT by ≥90 s from the baseline at the end of the study was set as the primary endpoint. Secondary endpoints included angina class, Seattle angina questionnaire scores, symptoms, and ECG changes during stress test. Patients underwent nine sessions of CSWT or corresponding sham procedure applied to all segments of the left ventricle, within 9 weeks. Endpoint assessments were performed at 6-month follow-up. The imaging substudies assessed the potential of CSWT to reduce stress-induced myocardial ischemia detected by dobutamine stress echocardiography, cardiac single-photon emission computed tomography, and cardiac magnetic resonance imaging. RESULTS: At two centers, 72 of the 323 screened patients were randomized in two groups (ratio 1:1): active treatment and placebo control. Study patients were predominantly males (70.8%); the mean age of the patients was 68.4±8.3 years. Of these, 44 patients had angina Canadian Cardiovascular Society class III, and 66.7% of the patients had a history of myocardial infarction. CONCLUSION: Using sham applicators, blinding study participants, investigators, and endpoints assessors to the study data as well as centralized randomization ensures rigorous methodology and low risk of bias in this large randomized controlled CSWT study.


Assuntos
Angina Estável/terapia , Tratamento por Ondas de Choque Extracorpóreas , Idoso , Angina Estável/fisiopatologia , Angina Estável/psicologia , Método Duplo-Cego , Tolerância ao Exercício , Feminino , Humanos , Lituânia , Masculino , Placebos , Qualidade de Vida , Resultado do Tratamento
10.
Int J Cardiol ; 250: 43-48, 2018 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-28992998

RESUMO

BACKGROUND: Since the early 2000s the treatment of choice for an acute myocardial infarction has moved from thrombolytic therapy to primary PCI (pPCI). As a result, the majority of patients undergoing PCI shifted from stable angina pectoris (SA) to acute coronary syndrome (ACS). Additionally the previously observed association between depression and anxiety and long-term outcome in patients who underwent a PCI may have been changed. The main objective of this study was to investigate the predictive value of depression and anxiety for 10-year mortality, in a cohort with post-PCI patients treated for SA versus patients treated for ACS. METHODS: This prospective single center cohort consists of a consecutive series of patients (n=528) treated with PCI. At 1month post-PCI, patients completed the Dutch version of the Hospital Anxiety and Depression Scale (HADS). RESULTS: After adjustment for baseline characteristics depression was associated with higher 10-year mortality post-PCI (HR 1.58 95% Confidence Interval [95% CI] 1.04-2.40). In the ACS population no association between depression and 10-year mortality was found (HR 1.05 95% CI 0.62-1.79), in contrast to the SA population (HR 1.97 95% CI 1.09-3.57). After additional adjustment for anxiety, depression was no longer associated with higher mortality. CONCLUSIONS: Anxiety at baseline was associated with an increased 10-year mortality rate after PCI. Depression was also associated with higher 10-year mortality, however the association disappeared after additional adjustment for anxiety. This finding was more pronounced in patients presenting with SA as compared to those presenting with ACS, which might be a result of the increasing number of ACS patients treated with pPCI.


Assuntos
Síndrome Coronariana Aguda/mortalidade , Angina Estável/mortalidade , Ansiedade/mortalidade , Depressão/mortalidade , Síndrome Coronariana Aguda/diagnóstico , Síndrome Coronariana Aguda/psicologia , Idoso , Angina Estável/diagnóstico , Angina Estável/psicologia , Ansiedade/diagnóstico , Ansiedade/psicologia , Depressão/diagnóstico , Depressão/psicologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade/tendências , Valor Preditivo dos Testes , Estudos Prospectivos , Escalas de Graduação Psiquiátrica , Fatores de Risco , Resultado do Tratamento
11.
Expert Rev Cardiovasc Ther ; 15(1): 47-58, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27935738

RESUMO

INTRODUCTION: Chronic refractory angina is often a disabling condition, predominantly due to severe obstructive coronary artery disease, that is inadequately controlled by optimal medical therapy and not amenable to further percutaneous or surgical revascularization. mortality rates associated with this condition are relatively low in clinically stable patients. however, it is associated with a high hospitalization rate and a reduction in both exercise capacity and quality of life. due to the paucity of available treatment options, there is an unmet need for new therapies for these patients and for a reduction in the associated economic healthcare burden. Areas covered: This review is focusing on the clinical evidence and technical aspects of this new therapeutic modality in refractory angina patients unsuitable for revascularization. Expert commentary: The Coronary Sinus Reducer (Neovasc Inc. Richmond B.C., Canada) is a new percutaneous device designed to achieve a controlled narrowing of the coronary sinus that may alleviate myocardial ischemia, possibly by redistributing blood from the less ischemic sub-epicardium to the more ischemic sub-endocardium, or by neoangiogenesis. Recently, a randomized, double-blind, multi-center clinical trial demonstrated a benefit in improving symptoms in 104 refractory angina patients, when compared to placebo.


Assuntos
Angina Estável/cirurgia , Cateterismo Venoso Central , Cateteres Venosos Centrais , Seio Coronário , Qualidade de Vida , Angina Estável/diagnóstico , Angina Estável/fisiopatologia , Angina Estável/psicologia , Cateterismo Venoso Central/efeitos adversos , Cateterismo Venoso Central/instrumentação , Cateterismo Venoso Central/métodos , Seio Coronário/diagnóstico por imagem , Seio Coronário/fisiopatologia , Seio Coronário/cirurgia , Humanos , Dor Intratável/fisiopatologia , Dor Intratável/psicologia , Dor Intratável/cirurgia , Desenho de Prótese , Ajuste de Prótese/métodos , Resultado do Tratamento
12.
Am J Cardiol ; 118(10): 1437-1441, 2016 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-27634030

RESUMO

Cerebral microemboli are frequently observed during coronary angiography (CA) and percutaneous coronary intervention (PCI), and their numbers have been related to the vascular access site used. Although cerebral microemboli can cause silent cerebral lesions, their clinical impact is debated. To study this, 93 patients referred for CA or PCI underwent serial cognitive testing using the Montreal Cognitive Assessment (MoCA) test to detect postprocedural cognitive impairment. Patients were randomized to radial or femoral access. In a subgroup of 35 patients, the number of cerebral microemboli was monitored with transcranial Doppler technique. We found the median precatheterization result of the MoCA test to be 27, and it did not change significantly 4 and 31 days, respectively, after the procedure. There was no significant correlation between the number of cerebral microemboli and the difference between preprocedural and postprocedural MoCA tests. The test results did not differ between vascular access sites. One-third of the patients had a precatheterization median MoCA test result <26 corresponding to mild cognitive impairment. In conclusion, using the MoCA test, we could not detect any cognitive impairment after CA or PCI, and no significant correlations were found between the results of the MoCA test and cerebral microemboli or vascular access site, respectively. In patients with suspected coronary heart disease, mild cognitive impairment was common.


Assuntos
Angina Estável/psicologia , Transtornos Cognitivos/fisiopatologia , Cognição/fisiologia , Angiografia Coronária/psicologia , Intervenção Coronária Percutânea/psicologia , Idoso , Angina Estável/diagnóstico , Angina Estável/cirurgia , Transtornos Cognitivos/psicologia , Feminino , Seguimentos , Humanos , Masculino , Testes Neuropsicológicos , Prognóstico , Estudos Retrospectivos , Fatores de Risco
13.
Am Heart J ; 175: 94-100, 2016 05.
Artigo em Inglês | MEDLINE | ID: mdl-27179728

RESUMO

BACKGROUND: A principal goal of treating patients with coronary artery disease (CAD) is to minimize angina and optimize quality of life. For this, physicians must accurately assess presence and frequency of patients' angina. The accuracy with which cardiologists estimate their patients' angina in contemporary, busy outpatient clinics across the United States (US) is unknown. METHODS: We enrolled patients with CAD across 25 US cardiology outpatient practices. Patients completed the Seattle Angina Questionnaire before their visit, which assessed their angina and quality of life over the prior 4 weeks. The Seattle Angina Questionnaire angina frequency domain categorized patients' angina as none, daily/weekly, or monthly. After the visit, cardiologists estimated the frequency of their patients' angina using the same categories. Kappa statistic helped to assess agreement between patient-reported and cardiologist-estimated angina. RESULTS: Among 1,257 outpatients with CAD, 67% reported no angina, 25% reported monthly angina, and 8% reported daily/weekly angina. When patients reported no angina, cardiologists accurately estimated this 93% of the time, but when patients reported monthly or daily/weekly angina symptoms, cardiologists agreed 17% and 69% of the time, respectively. Among patients with daily/weekly angina, 26% were noted as having no angina by their physicians. Agreement between patients' and cardiologists' reports (assessed by the kappa statistic) was 0.48 (95% CI 0.44-0.53), indicating moderate agreement. CONCLUSIONS: Among outpatients with stable CAD, there is substantial discordance between patient-reported and cardiologist-estimated burden of angina. Inclusion of patient-reported health status measures in routine clinical care may support better recognition of patients' symptoms by physicians.


Assuntos
Angina Estável , Autoavaliação Diagnóstica , Qualidade de Vida , Avaliação de Sintomas/métodos , Idoso , Angina Estável/diagnóstico , Angina Estável/epidemiologia , Angina Estável/psicologia , Austrália/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Estatística como Assunto , Inquéritos e Questionários
14.
Can J Cardiol ; 32(8): 986.e23-9, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27038505

RESUMO

BACKGROUND: Noninvasive stress tests play a determinant role in the initial management of patients with chronic angina. Nonetheless, their use in the same patient population is considered inappropriate within 2 years after percutaneous coronary intervention (PCI). Indeed, early abnormal results correlate less well with angiographic control and are attributed to a number of confounding factors. We prospectively assessed prevalence and impact on the quality of life of abnormal stress test results in a highly selected patient population. METHODS: Patients with no cardiac comorbidities who underwent successful and complete PCI with stenting for typical angina and had an abnormal exercise stress test (EST) under guideline-directed medical treatment were administered the Seattle Angina Questionnaire (SAQ). Clinical evaluation, EST, and the SAQ were repeated at 1, 6, and 12 months after the index PCI. RESULTS: One hundred ninety-eight patients qualified and were included in the study (mean age, 64 years; 79% men). Although the majority had normal EST results or an increased threshold to angina, at 1 month after the index PCI, 29% of patients still had an abnormal result. At 6 and 12 months, 31% and 29% of patients had abnormal results, respectively. Quality-of-life assessment by the SAQ showed consistent results, with persistent angina in one third of patients. Control angiography documented a critical lesion, attributable to in-stent coronary restenosis, in only 8% of patients. CONCLUSIONS: When stress testing is systematically performed after PCI, the prevalence of abnormal results is high and is associated with impaired quality of life. Prognostic significance along with the underlying pathophysiological mechanisms of such findings should be investigated.


Assuntos
Angina Estável/psicologia , Teste de Esforço , Intervenção Coronária Percutânea , Qualidade de Vida , Angina Estável/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Inquéritos e Questionários
15.
Medicine (Baltimore) ; 95(15): e3364, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27082597

RESUMO

To investigate the effects of personality type and psychological stress on the occurrence of major adverse cardiovascular events (MACEs) at 5 years in patients with coronary artery disease (CAD) after percutaneous coronary intervention (PCI). Two hundred twenty patients with stable angina (SA) or non-ST segment elevation acute coronary syndrome (NSTE-ACS) treated with PCI completed type A behavioral questionnaire, type D personality questionnaire, Self-Rating Depression Scale (SDS), Self-Rating Anxiety Scale (SAS), Trait Coping Style Questionnaire (TCSQ), and Symptom Checklist 90 (SCL-90) at 3 days after PCI operation. Meanwhile, biomedical markers (cTnI, CK-MB, LDH, LDH1) were assayed. MACEs were monitored over a 5-year follow-up. NSTE-ACS group had higher ratio of type A behavior, type A/D behavior, and higher single factor scores of type A personality and type D personality than control group and SAP group. NSTE-ACS patients had more anxiety, depression, lower level of mental health (P < 0.05; P < 0.01), more negative coping styles and less positive coping styles. The plasma levels of biomedical predictors had positive relation with anxiety, depression, and lower level of mental health. Type D patients were at a cumulative increased risk of adverse outcome compared with non-type D patients (P < 0.05). Patients treated with PCI were more likely to have type A and type D personality and this tendency was associated with myocardial injury. They also had obvious anxiety, depression emotion, and lower level of mental health, which were related to personality and coping style. Type D personality was an independent predictor of adverse events.


Assuntos
Síndrome Coronariana Aguda/psicologia , Angina Estável/psicologia , Intervenção Coronária Percutânea/psicologia , Personalidade , Estresse Psicológico/epidemiologia , Síndrome Coronariana Aguda/cirurgia , Adaptação Psicológica , Idoso , Angina Estável/cirurgia , Ansiedade/epidemiologia , Doenças Cardiovasculares/epidemiologia , Comorbidade , Depressão/epidemiologia , Feminino , Humanos , Lipídeos/sangue , Masculino , Saúde Mental , Pessoa de Meia-Idade , Fatores de Risco
16.
Health Qual Life Outcomes ; 14: 44, 2016 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-26980077

RESUMO

BACKGROUND: A Sinhalese version of a validated, disease-specific patient-reported heart disease health related quality of life instrument is lacking. The purpose of this study was to validate the interviewer-administered Sinhalese version of the MacNew Heart Disease Health-related Quality of Life Questionnaire (MacNew) in patients with clinically diagnosed stable angina. METHODS: The Sinhalese translation of the MacNew was carried using standard forward- backward translation technique. In this validation study, the MacNew was administered to 200 patients with stable angina. Reliability was assessed by internal consistency and test-retest reliability. Construct validity was explored by exploratory factor analysis using principal component analysis and confirmed by confirmatory factor analysis using the robust maximum likelihood method and known group comparison. The correlation between compatible domain scores of MacNew and the World Health Organization's quality of life -brief questionnaire was used to assess concurrent validity. RESULTS: The original 3-factor model (Physical, Emotional and Social) of the MacNew with cross-loadings was confirmed: principal component analysis with 53.42 % of the explained variance and confirmatory factor analysis with adequate fit for each of the three model fit criteria considered [root mean square error of approximation = 0.044 (90 % CI = 0.031 to 0.056); comparative fit index = 0.99; χ(2)/df = 1.39]. Internal consistency of the MacNew was acceptable with Cronbach's α of 0.92 on the Global scale and on the domain scales ranging from 0.85-0.91. Test-retest reliability was also found to be satisfactory with intraclass correlation coefficients of >0.9 for total and domain scores. A satisfactory level of concurrent validity was demonstrated with statistically significant correlations between compatible domain scores of MacNew and the World Health Organization's quality of life questionnaire (Pearson correlation ranging from 0.36-0.79). CONCLUSIONS: The interviewer-administered Sinhalese MacNew is a valid and reliable patient-reported outcome measure to assess disease specific health-related quality of life among Sinhalese patients with stable angina.


Assuntos
Angina Estável/psicologia , Psicometria , Qualidade de Vida/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Análise Fatorial , Feminino , Humanos , Funções Verossimilhança , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Sri Lanka , Inquéritos e Questionários , Traduções , Organização Mundial da Saúde
17.
Int J Cardiol ; 205: 111-116, 2016 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-26730841

RESUMO

OBJECTIVE: Primary objectives were to evaluate tolerability, compliance, and perception of ranolazine effectiveness for chronic stable angina in a routine clinical setting. The secondary objective was safety evaluation. METHODS: Prospective, multi-centre, observational, study with a 6-month follow-up and study visits at baseline, 3- and 6 months in patients with chronic stable angina. Ranolazine was administered according to the summary of product characteristics and investigator discretion. Data was collected on patient and disease characteristics, concomitant therapy, angina frequency and severity, quality of life (QoL), perception of effectiveness, compliance, and adverse events. RESULTS: Between July 2010 and July 2012, 189 patients were enrolled at 20 centres. Ranolazine decreased the proportion of patients experiencing angina attacks from 88.4% at baseline to 26.5% at 6 months (p<0.001). Heart rate and blood pressure were not appreciably affected. The proportion of patients without symptoms on normal exertion (Canadian Cardiovascular Society grading class I) increased from 22.3% to 75.3% (p<0.001); patients reporting limitations in daily activities decreased from 80.4% to 35.5%. (p<0.001). Patient- and physician-assessed QoL improved (both p<0.001). Therapeutic efficacy was rated "good" or "very good" in 67.7% of cases by physicians, and by 63.5% of the patients. Physicians rated compliance "good" or "very good" in 73.5% of cases. Adverse events were consistent with previous reports, and consisted of 40 events in 24 patients; 12 were serious. CONCLUSIONS: Ranolazine was associated with decreased angina frequency and severity, and improvements in QoL. The benefits provided by ranolazine in controlled clinical trials are maintained in the clinical setting.


Assuntos
Angina Estável/tratamento farmacológico , Angina Estável/epidemiologia , Fármacos Cardiovasculares/uso terapêutico , Qualidade de Vida , Ranolazina/uso terapêutico , Índice de Gravidade de Doença , Idoso , Idoso de 80 Anos ou mais , Angina Estável/psicologia , Feminino , Seguimentos , Grécia/epidemiologia , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida/psicologia , Resultado do Tratamento
18.
Cardiology ; 133(2): 83-90, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26501486

RESUMO

OBJECTIVES: Elevated heart rate can increase myocardial oxygen demand and reduce myocardial perfusion, provoking myocardial ischemia and angina symptoms. We evaluated adding ivabradine to the therapy of patients on metoprolol. METHODS: ADDITIONS (prActical Daily efficacy anD safety of Procoralan® In combinaTION with betablockerS) was a multicenter, 4-month, noninterventional, prospective, open-label trial that involved stable-angina patients. Along with metoprolol, patients received ivabradine (5 or 7.5 mg, b.i.d.). We investigated the effect of ivabradine on heart rate, angina attacks, nitrate consumption, quality of life (QoL) and tolerability as well as the influence of baseline heart rate. RESULTS: Heart rate fell by 19.7 ± 11.2 bpm, with an 8-fold decrease in weekly angina attacks (1.7 ± 2.2 to 0.2 ± 0.7) and nitrate consumption (2.4 ± 3.4 to 0.3 ± 0.9). Patient numbers in Canadian Cardiovascular Society class I more than doubled (i.e. from 29 to 65%) and QoL improved (the EQ-5D index and visual analog scale scores rose from 0.68 ± 0.27 to 0.84 ± 0.20 and 58.1 ± 18.4 to 72.2 ± 15.5 mm, respectively). The effect of ivabradine was greater in patients with a baseline heart rate ≥70 bpm (mean reduction in heart rate -21.2 ± 10.4 bpm, with a relative reduction in angina attacks and short-acting nitrate consumption of 87.1 and 87.2%, respectively). CONCLUSIONS: Ivabradine combined with metoprolol safely and effectively reduces heart rate, angina attacks and nitrate use, and improves QoL in stable-angina patients.


Assuntos
Antagonistas de Receptores Adrenérgicos beta 1/farmacologia , Angina Estável/tratamento farmacológico , Benzazepinas/farmacologia , Fármacos Cardiovasculares/farmacologia , Metoprolol/farmacologia , Idoso , Idoso de 80 Anos ou mais , Angina Estável/psicologia , Quimioterapia Combinada , Feminino , Alemanha , Frequência Cardíaca/efeitos dos fármacos , Humanos , Ivabradina , Masculino , Pessoa de Meia-Idade , Nitratos , Estudos Prospectivos , Qualidade de Vida , Inquéritos e Questionários
19.
Kardiologiia ; 56(11): 12-17, 2016 12.
Artigo em Russo | MEDLINE | ID: mdl-28290814

RESUMO

OBJECTIVE: To study the effect of nicorandil on the elasticity of the great vessels, cardiac functional parameters and quality of life in patients with coronary heart disease (CHD). MATERIAL AND METHODS: In a double-blind, randomized, placebo-controlled trial of nicorandil was attended by 154 patients with stable angina III functional class (FC), divided into 2 comparable age and sex group. Study duration was 12 months. RESULTS: In the group treated with nicorandil compared with placebo, the number of angina attacks and nitrate intake of short-significantly reduced, improved elastic properties of large arteries, improved quality of life. In a cohort of patients with CHD and left ventricular ejection fraction less than 45% nikorandil addition to standard therapy has improved the systolic function of the heart and reduce left ventricular remodeling. CONCLUSION: The use of nicorandil in addition to standard therapy can not only improve the quality of life in patients with coronary artery disease, but also a positive impact on the state of elasticity of blood vessels and morpho-functional parameters of the heart.


Assuntos
Angina Estável , Nicorandil/uso terapêutico , Rigidez Vascular/efeitos dos fármacos , Vasodilatadores/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Angina Estável/tratamento farmacológico , Angina Estável/fisiopatologia , Angina Estável/psicologia , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Qualidade de Vida , Distribuição Aleatória
20.
Kardiologiia ; 56(6): 26-31, 2016 06.
Artigo em Russo | MEDLINE | ID: mdl-28290843

RESUMO

The aim of the study to assess the influence of medicamentous therapy to the quality of life of ischemic heart disease patients with stable angina pectoris by activator potassium channels nicorandil in comparison with traditional therapy by isosorbide dinitrate. The study included 84 ischemic heart disease patients. Authors consider quality of life as an estimated category of state of the subject in an illness situation. The dynamic of physical and psychological components of quality of life are compared in ischemic heart disease patients under the treatment by nicorandil and isosorbide dinitrate. Indicators of quality of life, defined on the basis of a questionnaires of SAQ and GHQ supplementing an illness picture, are an multiple-factor criterion of an assessment of a condition of this category of patients. The benefits of nicorandil in influence on quality of life indicators were revealed in the study.


Assuntos
Angina Estável/tratamento farmacológico , Angina Estável/psicologia , Nicorandil/farmacologia , Canais de Potássio/agonistas , Qualidade de Vida , Vasodilatadores/farmacologia , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nicorandil/uso terapêutico , Vasodilatadores/uso terapêutico
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