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Distress correlates with the degree of chest pain: a description of patients awaiting revascularisation.

https://arctichealth.org/en/permalink/ahliterature46465
Source
Heart. 1996 Mar;75(3):257-60
Publication Type
Article
Date
Mar-1996
Author
A. Bengtson
J. Herlitz
T. Karlsson
A. Hjalmarson
Author Affiliation
Department of Heart and Lung Diseases, Sahlgrenska Hospital, University Göteborg, Sweden.
Source
Heart. 1996 Mar;75(3):257-60
Date
Mar-1996
Language
English
Publication Type
Article
Keywords
Aged
Anxiety
Chest Pain - complications - psychology
Coronary Angiography
Depression - etiology
Dyspnea - etiology
Fear
Female
Humans
Male
Middle Aged
Myocardial Ischemia - complications - psychology - surgery
Myocardial Revascularization - psychology
Research Support, Non-U.S. Gov't
Sleep Disorders - etiology
Waiting Lists
Abstract
AIM: To describe various symptoms other than pain among consecutive patients on the waiting list for possible coronary revascularisation in relation to estimated severity of chest pain. DESIGN: All patients were sent a postal questionnaire for symptom evaluation. SUBJECTS: All patients in western Sweden on the waiting list in September 1990 who had been referred for coronary angiography or coronary revascularisation (n = 904). RESULTS: 88% of the patients reported chest pain symptoms that limited their daily activities to a greater or lesser degree. Various psychological symptoms including anxiety and depression were strongly associated with the severity of pain (P
Notes
Comment In: Heart. 1996 Mar;75(3):2218800981
PubMed ID
8800988 View in PubMed
Less detail

Impact of different patterns of invasive care on quality of life outcomes in patients with non-ST elevation acute coronary syndrome: results from the GUSTO-IIb Canada-United States substudy.

https://arctichealth.org/en/permalink/ahliterature179397
Source
Can J Cardiol. 2004 Jun;20(8):760-6
Publication Type
Article
Date
Jun-2004
Author
Padma Kaul
Paul W Armstrong
Yuling Fu
J David Knight
Nancy E Clapp-Channing
Wanda Sutherland
Christopher B Granger
Daniel B Mark
Author Affiliation
University of Alberta, Edmonton. pkaul@ualberta.ca
Source
Can J Cardiol. 2004 Jun;20(8):760-6
Date
Jun-2004
Language
English
Publication Type
Article
Keywords
Aged
Angina, Unstable - diagnosis - mortality - therapy
Anticoagulants - therapeutic use
Canada - epidemiology
Cardiac Catheterization - psychology - statistics & numerical data
Cohort Studies
Coronary Angiography - psychology - statistics & numerical data
Coronary Care Units - statistics & numerical data
Electrocardiography
Female
Fibrinolytic Agents - therapeutic use
Health Status Indicators
Humans
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction - diagnosis - mortality - therapy
Myocardial Revascularization - psychology - statistics & numerical data
Physician's Practice Patterns
Quality of Life
Treatment Outcome
United States - epidemiology
Abstract
Comparing American and Canadian practice patterns and outcomes offers a natural experiment to examine the relative benefits of aggressive versus conservative management of coronary artery disease. In a prospective substudy of the Global Use of Strategies to Open Occluded Coronary Arteries IIb (GUSTO-IIb) trial, differences in the management of non-ST elevation acute coronary syndrome, and the associated impact on quality of life (QOL) outcomes, were examined in the two countries.
The patient population, selected randomly from the parent trial population, comprised 390 Canadian and 1122 American patients for whom both baseline and one-year data were available. Validated instruments were used to assess QOL, including the Duke Activity Status Index (DASI) and scales from the SF-36 questionnaire. At baseline, American patients had significantly higher cardiac catheterization rates (83% versus 45%), percutaneous coronary intervention rates (39% versus 24%) and coronary bypass surgery rates (19% versus 12%) than did Canadian patients, respectively. However, at one year, Canadian coronary bypass surgery rates were at par with those in the United States (24% versus 26%, respectively). At baseline, the mean DASI score was 24.6 among Canadian patients and 23.4 among American patients (P=0.14). At one year, neither cohort reported any significant change in functional scores and there was no intercountry difference in DASI scores, even after accounting for baseline risk. Canadian patients had significantly worse mental health scores than American patients at baseline (mean score 71.6 versus 75.4, respectively; P=0.02), but by one year, Canadian patients had better scores (mean score 80.1 versus 76.2, respectively; P=0.01). After adjusting for baseline characteristics, Canadian patients continued to report better mental health status scores than did American patients (4 points higher, P
PubMed ID
15229756 View in PubMed
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Quality of life after coronary revascularization in the United States and Canada.

https://arctichealth.org/en/permalink/ahliterature196627
Source
Am J Cardiol. 2000 Mar 1;85(5):548-53
Publication Type
Article
Date
Mar-1-2000
Author
M G Bourassa
M M Brooks
D B Mark
J. Trudel
K M Detre
B. Pitt
G S Reeder
W J Rogers
T J Ryan
H C Smith
P L Whitlow
R D Wiens
M A Hlatky
Author Affiliation
Montreal Heart Institute, Quebec, Canada.
Source
Am J Cardiol. 2000 Mar 1;85(5):548-53
Date
Mar-1-2000
Language
English
Publication Type
Article
Keywords
Angina Pectoris - epidemiology
Angioplasty, Balloon, Coronary
Coronary Artery Bypass
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Revascularization - psychology - utilization
Quality of Life
Quebec - epidemiology
Survival Rate
Time Factors
Treatment Outcome
United States - epidemiology
Abstract
Cardiac procedures are performed less frequently in Canada than in the United States (US), yet rates of cardiac death and myocardial infarction are similar. We therefore sought to compare long-term symptoms and quality of life in Canadian and American patients undergoing initial coronary revascularization. The 161 patients enrolled in the Bypass Angioplasty Revascularization Investigation at the Montreal Heart Institute were compared with 934 patients enrolled at 7 US sites. Patients' outcomes were documented for 5 years after random assignment to percutaneous transluminal coronary angioplasty or coronary artery bypass graft surgery. Functional status was assessed using the Duke Activity Status Index. Canadian patients were significantly younger and had more angina at study entry. Death and nonfatal myocardial infarction were not significantly different between Canadian and US patients after adjustment for baseline risk. Canadian patients had significantly greater improvements in functional status at 1-year follow-up (Duke Activity Status Index score + 13.5 vs. + 6.0, p = 0.002), but this difference progressively narrowed over 5 years. Angina was equally prevalent in Canadian and US patients at 1 year (16% vs. 19%), but significantly more prevalent in Canadian patients at 5 years (36% vs. 16%, p = 0.001). Repeat revascularization procedures were performed less often over 5 years among Canadian patients (26% vs. 34%, p = 0.08), especially coronary artery bypass graft surgery after initial percutaneous transluminal coronary angioplasty (18% vs. 32%, p = 0.03). These results suggest more anginal symptoms are required in Canada before coronary revascularization, but as a result Canadians receive greater improvements in quality of life after the procedure.
PubMed ID
11078265 View in PubMed
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A simultaneous test of the relationship between identified psychosocial risk factors and recurrent events in coronary artery disease patients.

https://arctichealth.org/en/permalink/ahliterature137552
Source
Anxiety Stress Coping. 2011 Jul;24(4):463-75
Publication Type
Article
Date
Jul-2011
Author
Keerat Grewal
Shannon Gravely-Witte
Donna E Stewart
Sherry L Grace
Author Affiliation
Faculty of Health, Kinesiology & Health Science, York University, Toronto, Ontario, Canada.
Source
Anxiety Stress Coping. 2011 Jul;24(4):463-75
Date
Jul-2011
Language
English
Publication Type
Article
Keywords
Aged
Angina Pectoris - psychology - rehabilitation
Anxiety Disorders - diagnosis - psychology
Coronary Artery Disease - psychology - rehabilitation
Depressive Disorder - diagnosis - psychology
Female
Hostility
Humans
Longitudinal Studies
Male
Middle Aged
Myocardial Infarction - psychology - rehabilitation
Myocardial Revascularization - psychology
Ontario
Patient Readmission
Personality Inventory - statistics & numerical data
Prognosis
Psychometrics - statistics & numerical data
Recurrence
Reproducibility of Results
Risk factors
Social Support
Stress, Psychological - complications
Abstract
Psychosocial factors are increasingly recognized as risk indicators for coronary artery disease (CAD) prognosis and they are likely interrelated. The objective of this study is to simultaneously test the relationship between key psychosocial constructs as independent factor scores and recurrent events in CAD patients. There were 1268 CAD outpatients of 97 cardiologists surveyed at two points. Recurrent events or hospitalization in the intervening nine months were reported. Factor analysis of items from the Hospital Anxiety and Depression Scale, Perceived Stress Scale, the ENRICHD Social Support Inventory, and Hostile Attitudes Scale was performed to generate orthogonal factor scores. With adjustment for prognostic variables, logistic regression analysis was performed to examine the relationship between these factor scores and recurrent events. Factor analysis resulted in a six-factor solution: hostility, stress, anxiety, depressive symptoms, support, and resilience. Logistic regression revealed that functional status and anxiety, with a trend for depressive symptoms, were related to experiencing a recurrent event. In this simultaneous test of psychosocial constructs hypothesized to relate to cardiac prognosis, anxiety may be a particularly hazardous psychosocial factor. While replication is warranted, efforts to investigate the potential benefits of screening and to investigate treatments are needed.
PubMed ID
21271407 View in PubMed
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The use of cholesterol-lowering medications after coronary revascularization.

https://arctichealth.org/en/permalink/ahliterature182667
Source
CMAJ. 2003 Nov 25;169(11):1153-7
Publication Type
Article
Date
Nov-25-2003
Author
James M Brophy
Chantal Bourgault
Paul Brassard
Author Affiliation
Department of Medicine, McGill University Health Center, McGill University, Royal Victoria Hospital, Montréal, Que. james.brophy@mcgill.ca
Source
CMAJ. 2003 Nov 25;169(11):1153-7
Date
Nov-25-2003
Language
English
Publication Type
Article
Keywords
Aged
Anticholesteremic Agents - therapeutic use
Cohort Studies
Coronary Artery Disease - prevention & control - surgery
Drug Prescriptions
Female
Humans
Male
Multivariate Analysis
Myocardial Revascularization - psychology
Patient Compliance - psychology
Predictive value of tests
Quebec
Abstract
In clinical trials, cholesterol-lowering medications have been proven to decrease mortality and morbidity and are strongly recommended as secondary prevention for patients with established coronary artery disease. Whether physicians and patients follow this recommendation is unknown. Our objective was to determine the rate at which patients fill at least one prescription for cholesterol-lowering medications after coronary revascularization.
Using the computerized administrative databases of the Régie de l'assurance maladie du Québec, we identified all elderly patients (older than 65 years) who had a coronary revascularization procedure (percutaneous coronary intervention or coronary artery bypass graft) between Apr. 1, 1995, and Dec. 31, 1997, and who survived until hospital discharge. We also determined the percentage of these patients who filled one or more prescriptions for cholesterol-lowering drug therapy before Dec. 31, 1999, or death, whichever date came first. We used multivariate logistic regression models to examine the independent associations between filling a prescription for a cholesterol-lowering drug, patient characteristics and the type and year of coronary revascularization.
We identified 11 958 elderly patients who had a coronary revascularization between Apr. 1, 1995, and Dec. 31, 1997. During a follow-up period that averaged 3 years, 4443 (37.2%) patients did not fill a prescription for a cholesterol-lowering medication. Patients who were male, of advanced age, who had diabetes or congestive heart failure were less likely to fill a prescription for a cholesterol-lowering medication. Patients whose initial revascularization procedure was coronary artery bypass grafting were also less likely than those who had angioplasty to start cholesterol-lowering medication (relative risk [RR] 0.77, 95% confidence interval [CI] 0.73 - 0.81). Use of cholesterol lowering medications before the revascularization procedure was very strongly associated with future drug use (RR 7.20, 95% CI 6.83-7.58).
In this population-based study of revascularized patients, we observed a substantial underutilization of cholesterol-lowering medications after revascularization. Our observations suggest an important role for continuity of care in the treatment of cardiovascular patients undergoing revascularization procedures.
Notes
Cites: N Engl J Med. 1993 Mar 18;328(11):779-848123063
Cites: Circulation. 1994 Mar;89(3):1333-4458124825
Cites: Br Heart J. 1994 May;71(5):408-128011402
Cites: Lancet. 1994 Nov 19;344(8934):1383-97968073
Cites: J Clin Epidemiol. 1995 Aug;48(8):999-10097775999
Cites: N Engl J Med. 1995 Nov 16;333(20):1301-77566020
Cites: N Engl J Med. 1996 Oct 3;335(14):1001-98801446
Cites: N Engl J Med. 1997 Jan 16;336(3):153-628992351
Cites: Circulation. 1998 May 12;97(18):1837-479603539
Cites: Circulation. 1998 Sep 1;98(9):851-59738639
Cites: N Engl J Med. 1998 Nov 5;339(19):1349-579841303
Cites: J Am Coll Cardiol. 1999 Jul;34(1):106-1210399998
Cites: Can J Cardiol. 1999 Nov;15(11):1277-8210579743
Cites: JAMA. 1999 Dec 22-29;282(24):2340-610612322
Cites: CMAJ. 2001 May 1;164(9):1285-9011341137
Cites: Heart. 2002 Jul;88(1):15-912067933
Cites: Heart. 2002 Jul;88(1):25-912067936
Cites: Lancet. 2002 Jul 6;360(9326):7-2212114036
Cites: JAMA. 2002 Jul 24-31;288(4):455-6112132975
Cites: JAMA. 2002 Jul 24-31;288(4):462-712132976
Cites: Lancet. 2002 Nov 23;360(9346):1623-3012457784
Cites: JAMA. 1984 Nov 9;252(18):2545-86387196
Cites: JAMA. 1986 Nov 28;256(20):2823-83773199
Cites: J Chronic Dis. 1987;40(5):373-833558716
PubMed ID
14638648 View in PubMed
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6 records – page 1 of 1.