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

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

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.

Abstract

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.

Article and Author Information

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.