Clinical investigationsInvasive treatment in unstable coronary artery disease promotes health-related quality of life: results from the FRISC II trial
Section snippets
Study design
The FRISC II trial design has been published previously.6, 15 In brief, it was a prospective, randomized multicenter trial with parallel groups. In the study, there were 58 Scandinavian centers, 16 of which were interventional. The comparison of invasive and noninvasive strategies was open. Patients were eligible for inclusion when they had objective signs and symptoms of ischemia. The exclusion criteria encompassed increased risk for bleeding, being on the waiting list for a coronary
Patients
From June 1996 until May 1998, 2457 patients were randomized to the invasive or the noninvasive regimen. Exclusion criteria were fulfilled by 591 patients (ie, previous open-heart surgery, 256 patients; advanced age, 282 patients; other reasons, 53 patients). Of those excluded for advanced age, the median age was 80.4 years.
General characteristics
There were no significant differences in baseline characteristics in the 2 groups (Table I). The median age was 66 years, and 70% were men. Most of the patients could be
Discussion
Studies of quality of life in patients with coronary artery disease28, 29, 30 have been published. The Randomized Intervention Treatment of Angina (RITA-2) trial, which compared percutaneous coronary intervention (PCI) and continued medical treatment in patients with stable angina pectoris, showed significantly greater improvements in quality of life as long as 1 year in the PCI group.26 The Angioplasty Compared to Medicine (ACME) trial showed significant improvement in quality of life in the
Acknowledgements
We thank all the patients who agreed to participate and the investigators and research nurses for their dedicated work, especially Elisabeth Logander at the Heart Center, University Hospital, Linköping, Sweden.
References (33)
- et al.
One-year results of the Thrombolysis in Myocardial Infarction (TIMI) IIIB clinical triala randomized comparison of tissue-type plasminogen activator versus placebo and early invasive versus early conservative strategies in unstable angina and non-Q wave myocardial infarction
J Am Coll Cardiol
(1995) - et al.
A prospective randomized trial of triage angiography in acute coronary syndromes ineligible for thrombolytic therapyresults of the medicine versus angiography in thrombolytic exclusion (MATE) trial
J Am Coll Cardiol
(1998) - et al.
Outcome at 1 year after an invasive compared with a non-invasive strategy in unstable coronary-artery diseasethe FRISC II invasive randomised trial
FRISC II Investigators. Fast Revascularisation during Instability in Coronary artery disease. Lancet
(2000) - et al.
Changes in health-related quality of life following coronary artery bypass graft surgery
Ann Thorac Surg
(2001) - et al.
Predictors of quality of life following acute coronary syndromes
Am J Cardiol
(2001) - et al.
Self-assessment of health before and after a myocardial infarction
Soc Sci Med
(1988) - et al.
The Swedish SF-36 Health Survey III. Evaluation of criterion-based validityresults from normative population
J Clin Epidemiol
(1998) - et al.
The Swedish SF-36 Health Survey—I
Evaluation of data quality, scaling assumptions, reliability and construct validity across general populations in Sweden. Soc Sci Med
(1995) - et al.
Anti-anginal therapy and quality of lifea comparison of the effects of transdermal nitroglycerin and long-acting oral nitrates
J Clin Epidemiol
(1991) - et al.
A summary index for the assessment of quality of life in angina pectoris
J Clin Epidemiol
(1991)
Quality of life after coronary angioplasty or continued medical treatment for anginathree-year follow-up in the RITA-2 trial
Randomized Intervention Treatment of Angina. J Am Coll Cardiol
Percutaneous transluminal coronary angioplasty versus medical therapy for stable angina pectorisoutcomes for patients with double-vessel versus single-vessel coronary artery disease in a Veterans Affairs Cooperative randomized trial. Veterans Affairs ACME Investigators
J Am Coll Cardiol
Comparison of medical and surgical treatment for unstable angina pectorisresults of a Veterans Administration Cooperative Study
N Engl J Med
Outcomes in patients with acute non-Q-wave myocardial infarction randomly assigned to an invasive as compared with a conservative management strategy
Veterans Affairs Non-Q-Wave Infarction Strategies in Hospital (VANQWISH) Trial Investigators. N Engl J Med
Emergency coronary angioplasty in refractory unstable angina
N Engl J Med
Cited by (29)
Health-related quality of life of ticagrelor versus clopidogrel in patients with acute coronary syndromes - Results from the PLATO Trial
2013, Value in HealthCitation Excerpt :However, the EQ-5D questionnaire values observed at 12 months are consistent with those reported in the MERLIN-TIMI 36 study. Quality of life in patients after an episode of ACS is generally high and not substantially different from a comparable control population [20,21]. Thus, unlike some other secondary preventive treatments such as antihypertensives, the benefits in survival and reduction of cardiovascular events by long-term preventive treatment with ticagrelor as compared with clopidogrel came without any impediment to the quality of life in these patients [22].
Quality of life after percutaneous coronary intervention in the elderly with acute coronary syndrome
2012, International Journal of CardiologyCitation Excerpt :A number of studies have demonstrated improved quality of life in patients with coronary artery disease after revascularization procedures including PCI and CABG [3,5,17–20]. Fewer studies compared improvement in quality of life in CAD patients undergoing revascularization procedures versus medical therapy over time [3,21–23]. In a recent sub-study of the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial which randomized 2287 patients with chronic CAD to either PCI plus optimal medical therapy or optimal medical therapy alone, Weintraub et al. [21] evaluated HRQoL using the Seattle Angina Questionnaire (SAQ) and RAND-36.
Measuring health related quality of life in coronary heart disease: The importance of feeling well
2011, International Journal of CardiologyCitation Excerpt :Given that older patients with CHD seem to experience less decrement in QoL compared to healthy contemporaries, this finding creates a case for intervention in older patients who may not recognize the potentially large gains in QOL that treatment may bring. In the FRISC II and RITA-3 trials, early invasive strategy (IS) was compared to conservative strategy (CS) in the management of acute coronary syndrome [39,40]. At 1 year follow-up, SF-36 scores were significantly higher in the IS groups of both trials.
Unemployment and deprivation are associated with a poorer outcome following percutaneous coronary angioplasty
2007, International Journal of Cardiology