Key result
Models predicting 1-year angina and QoL after PCI versus OMT show modest to good discrimination.
Why the study?
Does PCI added to OMT improve angina and quality of life at 1 year in patients with stable ischemic heart disease compared to OMT alone?
RCT
Does PCI added to OMT improve angina and quality of life at 1 year in patients with stable ischemic heart disease compared to OMT alone?
Angina and quality of life at 1 year in stable ischemic heart disease are improved by PCI but are more strongly associated with other patient characteristics.
Answers are grounded in this paper and cite their sources.
Models discriminate post-PCI angina and QoL modestly well in stable IHD; leaves open utility for individualized decisions pending validation.
BACKGROUND: Percutaneous coronary intervention (PCI) is a therapy to reduce angina and improve quality of life in patients with stable ischemic heart disease. However, it is unclear whether the quality of life after PCI is more dependent on the PCI or other patient-related factors. To address this question, we created models to predict angina and quality of life 1 year after PCI and medical therapy. METHODS AND RESULTS: =0.07 versus 0.29, 0.03 versus 0.22, and 0.05 versus 0.24 in the domain of angina frequency, physical limitation, and quality of life, respectively). There was modest/good discrimination of the models (C statistic=0.72-0.82) and excellent calibration (coefficients of determination for predicted versus observed deciles=0.83-0.97). CONCLUSIONS: The health status outcomes of stable ischemic heart disease patients treated by OMT+PCI versus OMT alone can be predicted with modest accuracy. Angina and quality of life at 1 year is improved by PCI but is more strongly associated with other patient characteristics. CLINICAL TRIAL REGISTRATION: URL: https://www.clinicaltrials.gov. Unique identifier: NCT00007657.
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Zhang et al. (2018) conducted an RCT in stable ischemic heart disease. OMT+PCI vs. OMT alone was evaluated on angina and quality of life (C statistic 0.72-0.82). Predictive models for 1-year angina and quality of life after OMT+PCI versus OMT alone in stable ischemic heart disease showed modest to good discrimination.
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