Impact of Cardiovascular Interventions on the Quality of Life in the Elderly

ABSTRACT INTRODUCTION: The elderly population is growing rapidly. Political and socio-economic changes led to the demographic transition in this population with the highest number of surgeries and as well as many comorbidities. OBJECTIVE: To evaluate the impact of cardiovascular intervention on quality of life of elderly patients after three and six months. METHODS: Analytical prospective cohort study with elderly between 60 and 80 years of age, of both sexes, with a diagnosis of coronary artery disease and underwent cardiovascular intervention during the period June 2010 to June 2011. Data were collected by individual interviews in the pre and postoperative periods (after three and six months) by telephone. We used the SF-36 to analyse quality of life in order to assess the physical and mental health of the study population. RESULTS: Of the 44 individuals evaluated, 59.1% were men, 75% in the range of 65 to 74 years, 38.6% were white and 38.6% were black, 31.8% were uneducated, 43.2% were married and 68.2% had less than a minimum wage. Prevailed patients: non-diabetics (68.2%), non-obese (81.8%), hypertensive (84.1%), non-alcoholic and non-smokers (68.2% and 61.4%, respectively). A significant increase in the average of the SF-36 scores between pre and post-surgical periods (three and six months) for the domains: functional capacity, pain, general health, vitality and emotional aspect. CONCLUSION: The elderly population undergoing intervention may have cardiovascular benefits and improvements of quality of life. Physical fitness improvement measures can be taken to resume that capability.

Impact of Cardiovascular Interventions on the Quality of Life in the Elderly.

INTRODUCTION: The elderly population is growing rapidly. Political and socio-economic changes led to the demographic transition in this population with the highest number of surgeries and as well as many comorbidities. OBJECTIVE: To evaluate the impact of cardiovascular intervention on quality of life of elderly patients after three and six months. METHODS: Analytical prospective cohort study with elderly between 60 and 80 years of age, of both sexes, with a diagnosis of coronary artery disease and underwent cardiovascular intervention during the period June 2010 to June 2011. Data were collected by individual interviews in the pre and postoperative periods (after three and six months) by telephone. We used the SF-36 to analyse quality of life in order to assess the physical and mental health of the study population. RESULTS: Of the 44 individuals evaluated, 59.1% were men, 75% in the range of 65 to 74 years, 38.6% were white and 38.6% were black, 31.8% were uneducated, 43.2% were married and 68.2% had less than a minimum wage. Prevailed patients: non-diabetics (68.2%), non-obese (81.8%), hypertensive (84.1%), non-alcoholic and non-smokers (68.2% and 61.4%, respectively). A significant increase in the average of the SF-36 scores between pre and post-surgical periods (three and six months) for the domains: functional capacity, pain, general health, vitality and emotional aspect. CONCLUSION: The elderly population undergoing intervention may have cardiovascular benefits and improvements of quality of life. Physical fitness improvement measures can be taken to resume that capability.

Psychological characteristics of patients undergoing percutaneous coronary interventions.

BACKGROUND: There is few data evaluating the prevalence and influence of adverse psychological characteristics on the prognosis of individuals submitted to percutaneous coronary interventions. No study has addressed this issue in Brazil. OBJECTIVE: To investigate the prevalence of depression, anxiety, psychological stress, and Type D personality and its association with cardiovascular events in patients undergoing percutaneous coronary interventions. METHODS: Psychological characteristics were evaluated by scales: Beck Depression Inventory, Beck Anxiety Inventory, Lipp Inventory for Stress Symptoms for Adults and Type D Personality Scale. The end-point of this study was the occurrence of major cardiovascular events in one-year follow-up. RESULTS: During March and May 2006, 137 patients were included. Type D personality was identified in 34% of the cases, 29% presented anxiety, 25% presented depression and 70% of the patients presented stress. In relation to the frequency of psychological characteristics according to the occurrence of major adverse cardiovascular events, there was no statistical difference between both groups of patients regarding depression (29% vs. 26% p = 0.8), anxiety (33% vs. 23% p = 0.3), stress (76% vs. 65% p = 0.3), and Type D personality (33% vs. 32% p = 0.9). However, the negative affectivity score was significantly higher in the group of patients presenting events (13.9 vs. 9.8 p = 0.01). CONCLUSION: In patients submitted to percutaneous coronary interventions, the prevalence of adverse psychological characteristics was high. One-year major cardiovascular adverse events were associated with baseline negative affectivity, but not with the other psychological characteristics studied.

Características psicológicas dos pacientes submetidos à intervenção coronária percutânea / Psychological characteristics of patients undergoing percutaneous coronary interventions

FUNDAMENTO: Há poucos dados sobre análises da prevalência e da influência de características psicológicas adversas no prognóstico dos indivíduos submetidos a intervenções coronárias percutâneas. Nenhum estudo abordou essa questão no Brasil. OBJETIVO: Investigar a prevalência de depressão, ansiedade, estresse psicológico e personalidade tipo D, bem como sua associação com eventos cardiovasculares em pacientes submetidos à intervenção coronária percutânea (ICP). MÉTODOS: As características psicológicas foram avaliadas por escalas: inventário de depressão de Beck (IDB), inventário de ansiedade de Beck (IAB), inventário de sintomas de estresse de Lipp para adultos (ISSL) e escala de personalidade tipo D. A meta do estudo foi a ocorrência de eventos cardiovasculares maiores em um seguimento de um ano. RESULTADOS: Durante março e maio de 2006, 137 pacientes foram incluídos. A personalidade tipo D foi identificada em 34 por cento dos casos; 29 por cento apresentaram ansiedade, 25 por cento apresentaram depressão, e 70 por cento dos pacientes apresentaram estresse. Em relação à frequência de características psicológicas de acordo com a ocorrência de eventos cardiovasculares adversos maiores, não houve diferença estatística entre os dois grupos de pacientes no que se refere à depressão (29 por cento vs. 26 por cento p = 0,8), ansiedade (33 por cento vs. 23 por cento p = 0,3), estresse (76 por cento vs. 65 por cento p = 0,3) e personalidade tipo D (33 por cento vs. 32 por cento p = 0,9). No entanto, encontrou-se um escore de afetividade negativa significativamente maior no grupo de pacientes que apresentaram eventos (13,9 vs. 9,8 p = 0,01). CONCLUSÃO: Em pacientes submetidos à intervenção coronária percutânea, a prevalência de efeitos adversos psicológicos característicos foi alta. Eventos adversos cardiovasculares maiores em um ano foram associados à afetividade negativa basal, mas não a outras características psicológicas estudadas.

BACKGROUND: There is few data evaluating the prevalence and influence of adverse psychological characteristics on the prognosis of individuals submitted to percutaneous coronary interventions. No study has addressed this issue in Brazil. OBJECTIVE: To investigate the prevalence of depression, anxiety, psychological stress, and Type D personality and its association with cardiovascular events in patients undergoing percutaneous coronary interventions. METHODS: Psychological characteristics were evaluated by scales: Beck Depression Inventory, Beck Anxiety Inventory, Lipp Inventory for Stress Symptoms for Adults and Type D Personality Scale. The end-point of this study was the occurrence of major cardiovascular events in one-year follow-up. RESULTS: During March and May 2006, 137 patients were included. Type D personality was identified in 34 percent of the cases, 29 percent presented anxiety, 25 percent presented depression and 70 percent of the patients presented stress. In relation to the frequency of psychological characteristics according to the occurrence of major adverse cardiovascular events, there was no statistical difference between both groups of patients regarding depression (29 percent vs. 26 percent p = 0.8), anxiety (33 percent vs. 23 percent p = 0.3), stress (76 percent vs. 65 percent p = 0.3), and Type D personality (33 percent vs. 32 percent p = 0.9). However, the negative affectivity score was significantly higher in the group of patients presenting events (13.9 vs. 9.8 p = 0.01). CONCLUSION: In patients submitted to percutaneous coronary interventions, the prevalence of adverse psychological characteristics was high. One-year major cardiovascular adverse events were associated with baseline negative affectivity, but not with the other psychological characteristics studied.

The effect of femoral and popliteal percutaneous transluminal balloon angioplasty on patients' quality of life.

CONTEXT AND OBJECTIVE: Peripheral arterial occlusive disease (PAOD) is a prevalent atherosclerotic disorder characterized by limb pain on exertion, limb loss and a high mortality rate. Because of its chronic nature, it often has a negative impact on patients' quality of life (QOL). This study aimed to assess QOL among patients with PAOD that was treated by endovascular intervention using femoral and popliteal percutaneous transluminal balloon angioplasty (PTBA). DESIGN AND SETTING: This study was local, prospective and longitudinal. It was carried at the Second Department of Internal Medicine of Charles University Hospital in Hradec Kralove, Czech Republic. METHODS: Thirty PAOD patients (20 male and 10 female) were treated by endovascular intervention using femoral and popliteal PTBA. The Czech version of the international generic European Quality of Life Questionnaire (EQ-5D) was applied. RESULTS: The statistical evaluation demonstrated that QOL presented highly significant statistical dependence on femoral and popliteal PTBA (p < 0.0001). CONCLUSION: The results showed that femoral and popliteal PTBA had a highly positive effect on the QOL of patients with PAOD.

The effect of femoral and popliteal percutaneous transluminal balloon angioplasty on patients' quality of life

CONTEXT AND OBJECTIVE: Peripheral arterial occlusive disease (PAOD) is a prevalent atherosclerotic disorder characterized by limb pain on exertion, limb loss and a high mortality rate. Because of its chronic nature, it often has a negative impact on patients' quality of life (QOL). This study aimed to assess QOL among patients with PAOD that was treated by endovascular intervention using femoral and popliteal percutaneous transluminal balloon angioplasty (PTBA). DESIGN AND SETTING: This study was local, prospective and longitudinal. It was carried at the Second Department of Internal Medicine of Charles University Hospital in Hradec Kralove, Czech Republic. METHODS: Thirty PAOD patients (20 male and 10 female) were treated by endovascular intervention using femoral and popliteal PTBA. The Czech version of the international generic European Quality of Life Questionnaire (EQ-5D) was applied. RESULTS: The statistical evaluation demonstrated that QOL presented highly significant statistical dependence on femoral and popliteal PTBA (p < 0.0001). CONCLUSION: The results showed that femoral and popliteal PTBA had a highly positive effect on the QOL of patients with PAOD.

CONTEXTO E OBJETIVO: Doença arterial oclusiva periférica (DAOP) é uma desordem aterosclerótica prevalente, caracterizada por dor esforço do membro, perda do membro e alta taxa de mortalidade. Devido à sua natureza crônica, freqüentemente tem impacto negativo na qualidade de vida (QV) dos pacientes. Este estudo objetivou avaliar a QV entre pacientes com DAOP tratada por intervenção endovascular usando angioplastia com balão transluminal femoral e poplítea (ABT). TIPO DE ESTUDO E LOCAL: Este estudo local, prospectivo e longitudinal foi realizado no Segundo Departamento de Medicina Interna do Charles University Hospital em Hradec Kralove, República Checa. MÉTODOS: 30 pacientes com DAOP (20 homens) foram tratados por intervenção endovascular usando ABT femoral e poplítea. A versão checa do Questionário Europeu de Qualidade de Vida (EQ-5D) foi aplicada. RESULTADOS: A avaliação estatística demonstrou que a QV apresentou dependência altamente significativa da ABT femoral e poplítea (p < 0,0001). CONCLUSÃO: Os resultados mostraram que a ABT femoral e poplítea teve efeito altamente positivo na QV dos pacientes com DAOP.

Traços psicológicos dos pacientes submetidos a angioplastia transluminal coronária / Psychological profile of patients subjected to transluminal coronary angioplasty

Este trabalho teve por objetivo a identificaçao de traços psicológicos e características emocionais comuns aos pacientes que foram, pela primeira vez, submetidos a angioplastia transluminal coronária (ATC), no Instituto Dante Pazzanese de Cardiologia. Foram analisados 84 pacientes, de ambos os sexos, com idade média de 55 anos. Foram realizadas, pela equipe de psicólogos, duas entrevistas semidirigidas, durante cada uma das quais foram aplicados o Inventário de Ansiedade Traço - Estado (IDATE) e a Escala de Hamilton. Essas entrevistas foram realizadas imediatamente anterior à ATC e um dia após o procedimento, na alta dos pacientes. Os resultados permitiram-nos concluir que a grande maioria apresentou padrao comportamental tipo A, próprio do coronariano, alto estresse constitucional e ambiental e ansiedade - traço acima da média. Obtiveram alta porcentagem, também, as variáveis tensao, depressao, grau de competitividade e labilidade de humor.